Snoring /Laborious Breathing- Can Your Dentist Help You?

Sleep Apnoea Syndrome

Sleep apnoea syndrome is a group of serious sleep disorders in which breathing repeatedly stops long enough during sleep to decrease the amount of oxygen and increase the amount of carbon dioxide in the blood and brain.

Sleep Apnoea occurs when breathing is temporarily interrupted during sleep.

There are three types:
1.Obstructive Sleep Apnoea
2.Central Sleep Apnoea
3.Mixed Sleep Apnoea

Obstructive Sleep Apnoea:

1.The most common type.
2.Caused by blockage in the throat or upper airway.
3.Affects mostly the middle aged men and women.
4.Most commonly seen in obese people who sleep on their back.
5.Smoking and excess use of alcohol worsens sleep apnoea.
6.Lung disorders contribute to lack of oxygen.
7.In children, enlarged tonsils or adenoids can cause obstructive sleep apnoea.

Central Sleep Apnoea:

1.Rarely seen.
2.Mainly caused due to dysfunction in the part of the brain that controls breathing (brainstem).
  
The role of the brainstem in breathing:
The brainstem is very sensitive to the changes in the blood level of carbon dioxide ( a by product formed in the metabolism of oxygen).

When the level of carbon dioxide in the blood rises due to inefficient breathing, the brainstem signals the respiratory muscles to breathe harder and faster to remove carbon dioxide while breathing out(exhalation).

What happens in Central Sleep Apnoea-
a.The brain stem is less sensitive even with high carbon dioxide level in the blood.
b.There is prolonged hyper ventilation to counteract the affect of carbon dioxide.
c.Sometimes due to a poor response of the brainstem... breathing paused might get prolonged.
d.Brain tumour is a reason for the poor functioning of the brain stem too.
e.Ondine's curse is a form, wherein people may not be able to breathe at all except when they are fully awake.

Mixed Sleep Apnoea:

A combination of the above two.

Symptoms:
1.Abnormally slow and shallow breathing.
2.Pause in breathing abruptly for more than ten seconds.
3.Snoring
4.Episodes of gasping, choking, pauses in breathing and sudden awakening.
5.Memory often impaired.
6.Sex drive may be reduced.
7.Involuntary naps during the day.
8.Risk of stroke,heart attack and blood pressure is increased.
9.Obese people have interruption in the easy movement of the chest wall.
10.Drowsiness, fatigue,irritability,headaches,slowness of thought and difficulty in concentration.

Prolonged sleep apnoea may lead to heart failure and malfunction of the lungs.

Treatment For Obstructive Sleep Apnoea:
1.Losing weight
2.Quit smoking
3.Avoid excess use of alcohol.
4.Heavy snorers must avoid sleeping aids and anti-histamines.
5.Nasal infections and allergies should be treated.
6.Anti snoring pillows available prevent snoring/ elevating the head of the bed.
7.A surgical procedure called uvulopalatoplasty removes a small piece of tissue hanging at the back of the mouth .

How Can Your Dentist Help???

Removable oral appliances, fitted by dentists can help relieve Obstructive sleep apnoea and snoring in many.
These appliances help keep the airway open.

Most appliances separate the jaws and push the lower jaw forward so the tongue cannot move backward to block the throat.
Others hold the tongue forward.

Other Measures:

1.Continuous Positive Airway Pressure(CPAP with/without humidifier)

2.Enlarging the airway through the throat called (uvulopalatopharyngoplasty)

Treatment For Central Sleep Apnoea:
1.CPAP
2.Oxygen through nasal prongs.
3.Acetazolamide and theophylline are used occasionally.

Have a peaceful sleep.
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Dr.Sreenita  Chowdhury
sreenita28@gmail.com