Obstructive sleep apnea (OSA) is a common subset of a variety of sleep disorders. It is caused by increased resistance to peacefully airflow through your upper respiratory system. The primary issue addressed by an oral device is the tongue and supporting airway structures collapsing and closing the airway. The obstruction can also be due to a variety of issues including but not limited to craniofacial development, improper muscular response, weight gain, and tonsil/nasal issues. The ability to breathe through your nose is very important to allow your airway to remain open while asleep. If you are forced to open your mouth to breathe then the tongue is more likely to fall backwards and cause apneas. In addition, if you grind or clench your teeth (closing the airway in the mouth) without the ability to breathe through your nose then your airway may be compromised.
There are two pathological factors associated with OSA that may affect your health: The first is the intermittent lowering of blood oxygen saturation caused by the decrease in airflow to the lungs and the second is sleep stage interruption due to the arousals required to wake yourself up to receive the needed oxygen.
The drop in blood oxygen saturation causes a cascade of negative neurological and endocrine events that are needed to prevent death by hypoxia while sleeping. Adrenaline is released by the adrenal glands to start the “fight or flight response” to alert your brain to the danger of hypoxia. This unwanted stimulation has effects of all systems including the circulatory system where elevated blood pressure and atrial fibrillation are associated. It has be shown that both atrial fibrillation and drug resistant hypertension, as defined by taking more than one blood pressure medication, correspond with a 75% incidence of OSA.
Sleep Stage interruption is the lesser evident process which can have a major impact on subjective daytime fatigue and long term health. For a healthy/non-OSA individual, sleep begins in light stages, progressing into deeper sleep and finally to REM stage (Rapid Eye Movement) before circling back to light sleep and another cycle. Cycling through these three stages throughout the night is very important as each stage is associated with specific biological processes such as the release and production of hormones as well as the removal of toxins and biologic byproducts. Obstructive events caused by OSA interfere with biochemical processes and peaceful sleep stage transitions that are important for healthy sleep.
The quantity, or amount of total sleep time, is important however if you are not receiving the quality of sleep required then you may not be cycling and spending enough time in deeper levels of sleep and getting the needed benefits.
Snoring is a sign but not a definitive condition which means that you have OSA. Snoring represents an interference but not a complete blockage to airflow as snoring is the sound of air passing through your upper airway. If have been told that you stop snoring for long periods of time (20 secs to several minutes) following by a loud gasping and recovery breathing then this is the hallmark of an obstructive event. Daytime fatigue, nighttime teeth grinding, morning headaches or the presence of cardiac issues as stated above combined with the presence of snoring is a good sign that you should be screened.
If you or someone you know feels that they would benefit from sleep disorder screening or you have any questions regarding sleep apnea or our practice then contact our office today.