Sleep Apnea

Why would a dentist have sleep apnea on his or her website? Sleep apnea is a medical disorder, isn’t it? Sleep apnea treatment is administered by many different types of medical specialists, such as: otolaryngologists (ENT specialists), surgeons, pulmonary specialists, sleep medical doctors, pediatricians (yes, children get sleep apnea), cardiologists, and internal medicine practitioners. So, how do dentists fit into this medical model? To understand, let’s look at sleep apnea for what it is and the treatments that are available today. Please read below, and to learn more about sleep apnea, contact Dr. Edward Shukovsky.

Sleep Health Survey

Do you think you might have sleep apnea? Are you looking for answers about why you’re so tired during the day? If you’re not ready to sign up for a sleep study but are concerned about your sleep health, we invite you to take a brief sleep health survey. The survey will be sent to Dr. Shukovsky, and if you contact the office to make an appointment, he can reference your information.

What Is Sleep Apnea?

Make no mistake about it, sleep apnea is a serious condition. It is not simply about the annoyance of snoring. It is about not breathing during sleep and the body getting less than the necessary amounts of oxygen. Most of the time, sleep apnea is caused by some obstruction in the airway during sleep, such as a large tongue, a small mandible (lower jaw), or the soft palate and pharyngeal tissues in the back of the mouth. We call this condition obstructive sleep apnea (OSA). When oral tissues become excessively relaxed while sleeping, they can narrow or even completely block air passages, leading to loud snoring or long, dangerous breathing pauses. The repercussions of this lack of oxygen are many, and can lead to symptoms and side effects (described in the sections below) that can have a dramatic impact on a person’s livelihood—and significantly increase risks to one’s life and health.

What Are the Symptoms of Sleep Apnea?

The symptoms of sleep apnea can vary among those suffering from the condition; however, some of the most common include:

  • Breathing pauses that can last several seconds and occur multiple times throughout the night
  • Abruptly waking up with a sensation of gasping or choking
  • The need to visit the bathroom multiple times during the night
  • A feeling of restlessness during waking hours
  • Fatigue
  • Difficulty focusing and concentrating
  • Headache
  • Irritability/mood swings

What Are the Side Effects of Sleep Apnea?

Untreated sleep apnea can significantly heighten risks of serious health problems, and even lead to fatal consequences. It can also cause debilitating side effects that can impact one’s day-to-day life. Some of the risks and potential side effects of sleep apnea include:

  • Sudden cardiac arrest
  • Hypertension (high blood pressure)
  • Stroke
  • Heart disease
  • Acid reflux
  • Diabetes
  • Daytime sleepiness
  • Sexual dysfunction
  • Memory loss
  • Insomnia
  • Depression
  • Work accidents or automobile accidents

Sleep apnea can cause morbidity, sickness, and even death. If you believe that you or a loved one may suffer from sleep apnea, it is very important to seek a diagnosis and treatment. The risks and symptoms of sleep apnea can be dramatically reduced when the condition is effectively treated and controlled.

Who Has Sleep Apnea?

You can’t simply look at someone and know whether they have, or don’t have, sleep apnea. The prevailing myth is that only obese patients have sleep apnea; however, the simple fact is that anyone—regardless of their age, weight, or gender—can suffer from sleep apnea. While obesity is one of the most common risk factors for developing sleep apnea, the condition can be caused by irregularities in orofacial anatomy and other factors, as well.

What Are the Types of Sleep Apnea?

The following sections describe the three major types of sleep apnea:  

Obstructive Sleep Apnea

Often referred to simply as “OSA,” obstructive sleep apnea is the most common form of the condition. OSA occurs when air passages are blocked or narrowed while sleeping. This can happen as the result of an obstruction caused by the tongue, soft oral/nasal tissues, or other structural irregularity. Obstructive sleep apnea can cause a complete cessation of breathing during sleep. These breathing pauses can occur many times over the course of the night, and can last as much as 10 seconds or more at a time. OSA is a very dangerous, even life-threatening condition.

Central Sleep Apnea

Central Sleep Apnea, or CSA, is another dangerous type of the condition; however, it is characterized by a very different set of factors when compared to OSA. This form of sleep apnea is caused when the brain is not able to send consistent signals to the muscles that regulate normal breathing during sleep. CSA is not as common as OSA, and seems to be more prevalent in people who have suffered from conditions such as stroke, disorders of the cervical spine (neck), and/or problems that have affected the brainstem. Regardless of the distinctions between the causes of CSA and OSA, the effects are often the same: breathing pauses during sleep that can have severe repercussions for one’s life and health.

Complex Sleep Apnea

A mixture of both OSA and CSA is characterized as Complex Sleep Apnea Syndrome. Also known as “Mixed Sleep Apnea,” this type of the condition is typically indicated in patients who are found to suffer from Central Sleep Apnea as well as Obstructive Sleep Apnea.

Diagnosing Sleep Apnea

The only way to diagnose sleep apnea is to conduct a sleep study, which can be done in a hospital or sleep center. The study can also be done with a monitor that the patient brings home and attaches to the wrist prior to sleeping, which gathers information that is then downloaded onto a computer. Either way, a complete study of how the patient is sleeping is taken and interpreted.

Degrees of Sleep Apnea

There are varying degrees of sleep apnea. The particular degree to which patients may be affected can often be identified by measuring and evaluating levels of oxygen desaturation, respiratory disturbances, and what’s called AHI (Apnea Hypopnea Index) while the patient is sleeping. The AHI is essentially a calculation of the number of breathing pauses one experiences over a one-hour period during sleep. This calculation can ultimately help determine whether the individual has mild, moderate, or severe sleep apnea.  

Mild Sleep Apnea

Mild sleep apnea is typically indicated in patients who register five or more “events” each hour, but fewer than 15.

Moderate Sleep Apnea

Individuals who register 15 or more events on the AHI scale each hour, but fewer than 30, are often classified as having moderate sleep apnea

Severe Sleep Apnea

One who registers 30 or more events each hour while sleeping is typically categorized as having severe sleep apnea.

What Are the Treatment Options for Sleep Apnea?

There are several sleep apnea solutions that can be employed to help mitigate or eliminate this condition. One treatment for sleep apnea is the Continuous Positive Airway Pressure (CPAP) machine. However, the main problem with the CPAP is low compliance – many patients do not want to use it while sleeping. And what good is a treatment if the patient doesn’t use it? How many CPAP machines are in the closet gathering dust?

Surgery is also an option for some patients. However, what if the patient is not a candidate for surgery, or does not wish to undergo surgery, and is CPAP-intolerant? What is left? Here is where the dentist comes in. Enter the Oral Appliance. The oral appliance, technically referred to as a Mandibular Advancement Device, or MAD, keeps the airway open during sleep by moving the lower jaw slightly forward. There are a number of different types of MADs, but regardless of the type, they all basically work in the same manner. The appliance is made by Dr. Shukovsky at his office, and all require FDA-approval for the treatment of sleep apnea.

Are you starting to see why dentists are now involved with sleep apnea? That’s right; it is hard to have a conversation about obstructive sleep apnea without talking about the mouth!

Learn more about sleep apnea treatment options.

Can a Dentist Just Make a Sleep Appliance and Be Done?

No! What do we need to get? That’s right! A sleep study must first be carried out in order to diagnose sleep apnea. But there is another reason we want to start with the sleep study. Whether the treatment choice is surgery, a CPAP machine, an oral appliance, or any combination of these, we want to make sure the therapy is working. So we need the baseline sleep study from before therapy was initiated and then a follow-up sleep study some time later to make sure the patient’s condition is improving. So, sleep studies are important, not only for the diagnosis but also to see how the patient is doing with the particular therapeutic modality being used.

Sleep Apnea Treatment for Medicare Patients

Dr. Shukovsky is an approved Durable Medical Equipment provider for Medicare. Most qualified Medicare patients can receive full coverage for the cost of their sleep apnea oral appliance at our practice. To be eligible for coverage, you must be a Medicare patient who has completed a sleep study, received a physician’s prescription, and has demonstrated recorded intolerance for a CPAP machine (must have an Affidavit of CPAP intolerance). For more information about how Dr. Shukovsky can help treat Medicare patients with sleep apnea, please contact us today.

Contact Us for More Information On Sleep Apnea

Dr. Shukovsky is a member of the American Academy of Dental Sleep Medicine and is enthusiastic about treating patients that snore and/or have sleep apnea. Dr. Shukovsky says, “The goal here is to have our patients get healthier. Most of these patients have multiple symptoms related to their apnea, whether that is snoring, hypertension, or daytime sleepiness. So, ultimately, the place we want them to be is for them to feel better.”

Contact our practice today for more information about sleep apnea, or to schedule a consultation with Dr. Shukovsky.