Wednesday, October 21, 2009

Obstructive Sleep Apnea

It has been estimated that 17% of American adults have obstructive sleep apnea, with 85% being undiagnosed. OSA is the most common chronic disease in developed countries. The person who is suffering from sleep apnea, has brief periods of interrupted breathing during sleep. He is unaware that this is happening, but the quality of sleep suffers greatly.

The symptoms that most likely indicates risk for obstructive sleep apnea are snoring, fatigue, morning headaches, or daytime sleepiness. If you grind your teeth at night, your risk jumps to 80%. If you had four premolar teeth extracted for orthodontics, your risk is 80%.

Why should you be concerned? OSA is a cause of high blood pressure, which leads to risk of death by heart attack. Reggie White, a famous retired football player, died of a heart attack attributed to OSA in his sleep at age 43. OSA would be a much more common cause of death on death certificates, if it were not for the fact that it only causes the heart attack that causes death. Most autopsies list heart attack as the cause of death without commenting on the cause of the heart attack.

OSA also upsets the leptin cycle which causes your body to think it is hungry when it is not. The result is obesity. The weight gain that results then makes the OSA worse, which makes the weight gain worse.

OSA is a cause of ADHD, ADD, depression and sexual dysfunction. OSA is a major cause of heartburn and gastric reflux.

Why is a dentist interested in OSA? We see people every day with symptoms of OSA. Our office has a simple screening device which you wear at home for one night. When you return the device, we get a computer printout of how many times you have had episodes of obstructive breathing problems. If your problems are severe, we make a referral to a sleep disorders doctor. But if your problems are mild or moderate, you can be successfully treated with an oral appliance which holds your chin forward when you sleep (mandibular advancement device). I wear one of these appliances every night, and I have lost 25 pounds since I started. My blood pressure has dropped to normal, without pills that have side effects.