CPAP Alternatives in Naperville IL
Sleep Apnea/Snoring
About 90 million Americans suffer from snoring during sleep. More than half of those people are simply snorers and it is bothersome to others, but in the other half it could be a sign of a more serious sleep disorder called Obstructive Sleep Apnea (OSA). Do your research. Knowing the difference between the two conditions is key in getting the right treatment. Snoring is a result of the tissues in the throat relaxing enough to partially block the airway and creating the vibrating sound (snoring). On the other hand, loud snoring can lead to OSA which is characterized by multiple pauses in breathing that are greater than ten seconds due to airway narrowing or collapse.
Untreated OSA can contribute to:
- High blood pressure
- Stroke
- Heart disease
- Workplace accidents
- Motor vehicle accidents
Untreated OSA can contribute to:
- Loud snoring
- Wake up choking or gasping
- Waking up with a dry mouth or sore throat
- Morning headaches
- Mood changes
- Irritability
- Depression
- Frequent Night time urination
- Daytime sleepiness/fatigue
- Frequent breaks or pauses in breathing
- Acid reflux
- Clenching and grinding
- Fractured/cracked/broken teeth
- Abfraction of teeth
Greater health risks and comorbidities associated with OSA:
- Congestive heart failure
- Atrial fibrillation
- Diabetes
- Stroke
- Sudden death
- High blood pressure
- Anxiety
- Acid reflux/GERD
- Depression
- Alzheimer's Disease
- Memory loss
- Irritable bowel syndrome
A sleep study is necessary to determine if snoring is due to OSA.
Oral Appliance for Sleep Apnea
Oral appliance therapy is an effective treatment option for snoring and obstructive sleep apnea (OSA). An oral device fits over your teeth like an orthodontic retainer while you sleep and keeps your jaw forward to keep your airway clear. A custom-fit dental appliance can enhance your sleep, restore your alertness, and regenerate your health. Oral appliance therapy is a simple, non-invasive treatment that fits into your schedule. Oral appliance therapy is popular among patients since it is:
Oral appliance therapy is a simple, non-invasive treatment that fits into your schedule. Oral appliance therapy is popular among patients since it is:
- Simple to put on
- Quiet
- Portable
- Convenient
- Comfortable
- Simple upkeep
Sleep Apnea Appliances
Currently there are a large number of dental oral appliances on the market that can be used to successfully treat and manage this condition. An oral devices’ primary function is either one of two things, either to retain the tongue from collapsing into and obstructing the airway, or to move the lower jaw slightly forward; hence accomplishing the same thing as to keep the airway from becoming obstructed.
The majority of patients that opt for oral appliance therapy to treat their apnea report that they no longer experience the loud snoring associated with sleep apnea and are getting a much more complete and healthy nights’ rest. An oral appliance work best with patients who are not significantly overweight and is a very viable alternative to CPAP therapy (Continuous Positive Airway Pressure).
Because there are so many appliances available, Dr. Patel will hand select the right one for you and have it custom made to treat your sleep apnea.
Treatment for Snoring and Sleep Apnea
Snoring is a common sleep disorder that can affect all people at any age. An estimated 30 million, or 1 in 8 people, snore. Although it occurs more frequently in men and people who are overweight, studies estimate that 45% of men and 30% of women snore on a regular basis. Snoring has a tendency to worsen with age.
- Individuals who snore have a high likelihood of having (or developing) obstructive sleep apnea
- Approximately 18 million Americans suffer from sleep apnea
- Some 28 percent of men over the age of 65 suffer from sleep apnea
- Up to 50 percent of sleep apnea patients have high blood pressure
- Risk of heart attack and stroke also may increase among those who have sleep apnea
- Nearly 60 percent of Americans suffer from day time sleepiness, a side effect of sleep apnea
- Snoring and mild-moderate apnea is improved and often eliminated in many patients who use oral appliances
- Prevalence of Obstructive Sleep Apnea (OSA) in the USA
- OSA – 20 million
- Compare with
- Asthma – 10 million
- Diabetes – 16 million
- More common in males than females
- Progressively worsens with age
- Progressively worsens with increasing weight
- Each year, sleep disorders add an estimated $15.9 billion to national healthcare bill.
- Untreated apneic's have 2.8x hospitalized days than treated apneic
- Motor Vehicle Accidents
1997 Dement - $12.4 Billion MVA related to sleep disorder patients
- 7-15x increase in accident frequency
- 8x increase in at-fault frequency
- Sleep Deprivation – the main factor in Exxon Valdez and Challenger Accidents
- Obstructive Sleep Apnea contributed to the 2004 death of football great Reggie White.
- Reduced quality of life and cognitive performance
- Up to 10 times higher frequency of automobile accidents
- Increased cardiovascular disease
- Insulin resistance
- Impaired glucose metabolism
- Impaired endocrine function
- Headaches
- Attention Deficit/Hyperactivity Disorder
- Increased mortality
- Individuals with undiagnosed sleep disorders are heavy users of medical services
- 44% of women with Polycystic Ovarian Syndrome (PCOS) have obstructive sleep apnea
- Cardiovascular Disease in OSA patients
57% have Hypertension
25% have Ischemic Heart Disease
17% have Coronary Heart Disease
7% have had Stroke
- Pregnancy
In one large study, 14% of pregnant snorers developed hypertension and 10% developed preeclampsia
- Weight & Metabolic Functioning
Perpetual lack of sleep in healthy young adults results in changes in glucose metabolism and endocrine functioning
Clear correlation between lack of sleep and increased sympathetic nervous system activity
- Three Categories of Sleep Disorders
Snoring
Upper Airway Resistance Syndrome
Obstructive Sleep Apnea
- Classified as the most moderate manifestation of sleep disordered breathing
- Considered an indication of the existence or the onset of a sleep breathing disorder
- Younger than Obstructive Sleep Apnea patients, and generally female
- Accompanied by gastro esophageal reflux, depression, bruxism, hypothyroidism, and asthma
- Marked by apnea and hypopnea
Apnea – Cessation of airflow at the nostrils and mouth lasting at least 10 seconds
Hypopnea- An episode of shallow breathing (airflow reduced by at least 50%) during sleep lasting 10 seconds or longer, usually associated with a decrease in blood oxygen saturation.
- The complete cessation of breathing for a minimum of 10 seconds
- It occurs due to a narrowing of the throat caused by the tongue falling back and the tissues in the back of the throat collapse, blocking the airway, thus no air gets to the lungs
- The event can last up to 90 seconds and can occur as many times as 150 times an hour
Obstructive Sleep Apnea is classified in the following manner, determined by an overnight sleep study:
Normal– Less than 5 apnic events per hour
Mild – 5-19 apnic events per hour
Moderate – 20-39 apnic events per hour
Severe – 40 or more events per hour
The sleep study reports these events by numerical value and are called AHI/RDI results.
- Snoring: Intermittent with pauses
- Excessive Daytime Sleepiness
- Awakenings with gasping or choking
- Fragmented, non-refreshing, light sleep
- Poor memory, clouded intellect, difficulty concentrating
- Irritability, personality changes
- Decreased sex drive, impotence
- Morning headaches
- Gastro-esophageal reflux (GERD)
- Dry mouth upon awakening
- Overweight
- Depression
- Perspiring during sleep
- Heartburn
- Frequent nocturnal urination
- Confusion upon awakening
- Obesity
- Increasing Age
- Male Gender
- Anatomy Abnormalities of Upper Airway
- Family History
- Alcohol or Sedative Use
- Smoking
- Neck size
- If External Neck Circumference is:
Men > 17 inches
Women > 16 inches
The health care provider will perform a physical exam. This will involve carefully checking your mouth, neck, and throat. You will be asked about your medical history. Often, a survey that asks a series of questions about daytime sleepiness, sleep quality, and bedtime habits is given.
A sleep study (polysomnogram) is used to confirm obstructive sleep apnea.
Other tests that may be performed include:
- Arterial blood gases
- Electrocardiogram (ECG)
- Echocardiogram
- Thyroid function studies
- Lifestyle changes
Avoiding alcohol and sedatives at bedtime
Weight management and weight loss
- Dental Oral Appliances
- To help advance the position of your tongue and soft palate to keep your air passages open
Medical Interventions
CPAP -Continuous Positive Airway Pressure – this approach involves wearing a pressurized mask over your nose while you sleep. The mask is attached to a small pump that forces air through your airway, which keeps it open. CPAP eliminates snoring and prevents sleep apnea. Although CPAP is the preferred method of treating obstructive sleep apnea, some people find it uncomfortable.
Surgery
UPPP (Uvulopalatopharyngoplasty) – traditional surgery where you're given a general anesthesia and your surgeon tightens and trims excess tissues ; a type of face-lift for your throat.
LAUP Laser Surgery – Outpatient surgery where your doctor uses a small hand-held laser beam to shorten the soft palate and remove your uvula. Removing excess tissue enlarges your airway and reduces vibration. You may need more than one session to get your snoring under control. Laser surgery isn't advised for occasional or light snoring, but it's an option if your snoring is loud and disruptive. Laser surgery generally isn't recommended for sleep apnea.
Somnoplasty – Radiofrequency tissue ablation. –During this outpatient procedures using local anesthesia, doctors use a low-intensity radiofrequency signal to remove part of the soft palate to reduce snoring. The technique causes slight scarring of the soft palate, which may help to reduce snoring.
Dental Surgery- Tongue Reduction, Tongue-tying, Mandibular Jaw Advancement
The only way to be sure if you have obstructive sleep apnea is to have a sleep test either at home from a qualified sleep physician or in a hospital sleep center, but a score of 9 or above on this test is an indication that you should see your doctor.
The Epworth Sleepiness Scale is a “test” based on a patient's own report that establishes the severity of sleepiness. A person rates the likelihood of falling asleep during specific activities. Using the scale from 0-3 below, patients rank their risk of dozing in the scenarios below.
How likely are you to doze off or fall asleep in the following situations? Choose the most appropriate number for each situation:
0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = High chance of dozing
Activity
1) Sitting and Reading
2) Watching TV
3) Sitting, inactive in a public place (theatre, office, meeting, etc.)
4) As a passenger in a car for an hour without a break
5) Lying down to rest in the afternoon
6) Sitting and talking to someone
7) Sitting quietly after lunch without alcohol
8) In a car, while stopped for a few minutes in traffic
Total
After ranking the risk of dozing for each activity, calculate the total score. The range is 0-24, with the higher score, the more sleepiness
Scoring:
0-9 = Average daytime sleepiness
10-15 = Excessive daytime sleepiness
16-24 = Moderate to severe daytime sleepiness
Breaking it down further, excessive daytime sleepiness is greater than 10. Primary snorers usually have a score less than 10, and individuals with moderate to severe sleep apnea usually have a score greater than 16.
See your healthcare professional for advice if you snore, have been told that you awake gasping for breath, or if you are sleepy during the day.
Sleep Apnea Procedures
Dr. Patel has a working knowledge with different types of Sleep and TMD appliances which he can choose to best treat the patient. He understands that the discomfort of living with sleep apnea or chronic pain caused by the misalignments of teeth and neck, although misunderstood it is very real.
Dr. Patel's focus is on the relief of Snoring, Sleep Apnea, Temporomandibular Joint Dysfunction (TMJ ),chronic pain, headaches, ear pain, and neuromuscular problems using conservative methods. He seeks the most advanced diagnostic and treatment techniques available. All approaches are non-invasive and non-surgical. We work closely with the patient's physicians.
Sincerely,
Dr. Hitesh Patel
Center of Excellence for TMJ and Sleep
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