Sleep Apnea and Snoring in Northport, NY
Being able to breathe is a necessary and reasonable expectation of our daily lives. However, a significant percentage of the population suffers from some degree of impaired breathing during sleep. Our airways are susceptible to collapse when relaxed and interrupted breathing ensues. Studies have conclusively shown a significant linkage between sleep apnea and numerous systemic health changes, especially cardiovascular.
Many of our patients who have been diagnosed, have accepted treatment modalities that fit their lifestyle. The increased awareness of the medical and dental communities has made obtaining a diagnosis and subsequent treatment easier. When screening reveals the likelihood of an involvement, a physician will order a PSG (polysomnogram) to be conducted at a convenient sleep center or utilize a simple Home Study. It is necessary to record data, not only to establish a baseline, but to define appropriate treatment recommendations.
It's Just Snoring...
Unfortunately, it's more complicated. Not everyone who snores has an obstructive apnea but 1 in 3 do.
Who's at risk
- 9% of men and 4% of women have signs of Obstructive Sleep Apnea (OSA) on testing
- 4% of men and 2% of women have signs and symptoms of OSA
- 1-3% of children
There is a substantial gap in the recognition of this disorder. Although the need for intervention is sometimes obvious to the entire household, there are many people who don't present outward signs of either a sleep disturbance or a breathing disorder.
Excessive Daytime Sleepiness (EDS) is a common symptom that not only undermines our health but endangers our lives. A common related consequence is an increase in motor vehicle accidents due to excessive drowsiness while driving. Please take the following self assessment to see how you score:
Epworth Sleepiness Scale
- CPAP or Continuous Positive Airway Pressure is the gold standard for treating obstructive breathing disorders that are due to airway relaxation and collapse. A machine supplies a flow of air sufficient to maintain an open airway . In severe cases, this airflow may be quite significant and side effects, such as dryness of the mouth, are more common. A mask is typically worn that may cover both the nose and the mouth. Many of our patients wear these devices and have adapted well to wearing them but there are a significant number who are either unable to utilize CPAP or are unwilling. Compliance over time drops significantly. Someone who needs to be managing their ability to breathe and decides not to, suffers systemic damage.
- Oral Appliance Therapy or OAT can often be substituted for CPAP. This is a decision that is made by the diagnosing physician and like any therapeutic device, its efficacy must be measured and validated over time. In the same way that it is determined how much airflow from a CPAP machine is necessary to maintain an airway, an oral appliance is adjusted for maximum effect. The success of these appliances is well documented. They generally are most effective in cases which are mild to moderate and can often be used instead of CPAP. In severe cases, it is less likely that they would be as effective as CPAP but for a patient with a severe problem who refuses or is unable to utilize CPAP, the degree of improvement from an oral appliance can have significant effects. Something is better than nothing.
- Combination Therapy - A dental appliance can be used in conjunction with CPAP. This is most effective in severe cases which require higher flow rates which most people find uncomfortable. The oral appliance helps to open the airway, thereby allowing the patient to "dial down" the airflow to a more acceptable rate. Again, the key is creating a solution to the problem that the patient is willing to embrace and obtain the necessary important health benefit.
- Vacation Appliance - Wearing your CPAP, and packing it for vacation or for business trips may tip the scales away from utilization. Having an oral appliance, that can be substituted for these intervals may be a more than reasonable compromise