Is it possible to find a family where no one is snoring at night? Grandfather or an uncle or granny….We all have observed and made fun of them sometime or other.
WHY SHOULD ORTHODONTISTS CONSIDER TREATING SLEEP APNEA?
Well, the incidence is increasing in recent times thanks to our sedentary life style and increased incidence of obesity.
Snoring occurs due to blockage of air passage mainly during sleep . Which in scientific term is Obstructive sleep Apnea (O S A )
OSA is an upper airway disorder that is characterized by recurring interruptions in normal sleep patterns due to pharyngeal obstruction
It mainly has anatomical reasons . While we sleep the tissues and muscles relax and so does the tongue. Due to this relaxation and gravity the tongue falls back and blocks the air passage which is just behind it.
This blockage of airway stops the oxygen supply to the brain. And brain raises an alarm and alerts the muscles to open the air passage. This blockage lasts from neon seconds upto 30 seconds in advanced stage .; disturbing sleep partially to completely .
This is a repetitive process As brain remains without Oxygen during these periods, and since sleep is disturbed several times during the night, such patients drift into sleep during the day.
The symptoms of OSA can be very revealing. The obvious one is, of course, snoring, but some less obvious symptoms include daytime sleepiness, impaired intellectual function, insomnia, depression, irritability, and poor workplace performance.
OSA can be a fatal disease if left undiagnosed. This is primarily due to the circulation of unsaturated blood during the night, which can cause cardiopulmonary changes, congestive heart failure, and strokes. Daytime sleepiness can also lead to fatal motor vehicle accidents
If a patient is suspected of having OSA, the diagnosis is confirmed by an overnight polysomnography (PSG), commonly referred to as a sleep study.
Once a sleep study is undertaken, the resulting data is the Respiratory Disturbance Index (RDI). This is a somewhat complex index that measures the number of apnic (total cessation of breathing) and hypopnic (shallow breathing) events per hour of REM and non REM sleep. For example, someone who has an RDI of 30 has 30 apnic or hypopnic events an hour. The range of RDIs is as follows: RDI < 5 Normal; RDI 5-15 Mild; RDI 15-30 Moderate; RDI > 30 Severe.
Patient willing to get treated for OSA generally visits a gen physician or E N T Surgeon. But an Oerthodontist discovers this problem as a part of routin examination.
The treatment most prescribed by physicians today is the CPAP machine, which can be effective for treating moderate to severe OSA . However, CPAP users have up to a 70% noncompliance rate due to the discomfort of the
mask and machine, the significant social impact, potential inhibition of midface development (in children), and side effects such as headaches and dry nose and throat. In fact, many patients cannot tolerate CPAP therapy, and
ultimately, CPAPs do not address the underlying cause of OSA.
Surgical treatment options can be effective, particularly in children ‘ especially when combined with expansion of palate and lifestyle changes
the most commonly recommended surgery—uvulopalatopharyngoplasty (UPPP)-A surgery of soft parts of palate and a tongue like projection beyond it.
However this operation includes the typical major surgery risks, and is costly, painful with lengthy recovery times, and has a high recurrence rate.
Well, the incidence is increasing in recent times thanks to our sedentary life style and increased incidence of obesity.
Snoring occurs due to blockage of air passage mainly during sleep . Which in scientific term is Obstructive sleep Apnea (O S A )
OSA is an upper airway disorder that is characterized by recurring interruptions in normal sleep patterns due to pharyngeal obstruction
It mainly has anatomical reasons . While we sleep the tissues and muscles relax and so does the tongue. Due to this relaxation and gravity the tongue falls back and blocks the air passage which is just behind it.
This blockage of airway stops the oxygen supply to the brain. And brain raises an alarm and alerts the muscles to open the air passage. This blockage lasts from neon seconds upto 30 seconds in advanced stage .; disturbing sleep partially to completely .
This is a repetitive process As brain remains without Oxygen during these periods, and since sleep is disturbed several times during the night, such patients drift into sleep during the day.
The symptoms of OSA can be very revealing. The obvious one is, of course, snoring, but some less obvious symptoms include daytime sleepiness, impaired intellectual function, insomnia, depression, irritability, and poor workplace performance.
OSA can be a fatal disease if left undiagnosed. This is primarily due to the circulation of unsaturated blood during the night, which can cause cardiopulmonary changes, congestive heart failure, and strokes. Daytime sleepiness can also lead to fatal motor vehicle accidents
