Snoring warns of obstructive sleep apnea

Snoring may affect the sleep of your bed partner, and sometimes even your neighbor, but an underlying obstructive sleep apnea will put your life at risk, and even the lives of others.

OSA can increase the risk of high blood pressure, heart attacks, strokes, diabetes and daytime sleepiness, which makes us more dangerous while driving. Earlier research published in The American Review of Respiratory Disease found that patients with sleep apnea had a rate of automobile accidents seven times greater than those without apnea.

Snoring occurs when the muscles at the back of the mouth become relaxed and the upper airway passage becomes restricted during sleep as the lower jaw and the tongue fall back. This restricted airflow vibrates the soft tissue in the back of mouth creating the snoring noise. If the air passage becomes completely obstructed, the person then experiences apnea — a cessation of breathing.

Once the brain detects the low level of oxygen in the body, the person comes out from deep sleep to start breathing again. This fragmented sleep contributes to the daytime sleepiness seen in sleep apnea patients.

Not everybody who snores has Obstructive Sleep Apnea; however, the majority of people with OSA do snore. It is estimated that 20 to 40 percent of adult population snores, while OSA occurs in 2 to 4 percent of the adult population, though evidence suggests that many more OSA patients remain undiagnosed. Snoring is an important risk factor for OSA since it can appear years or decades before the appearance of OSA sequelae such as daytime drowsiness.

The gold standard for diagnosing obstructive sleep apnea involves an overnight sleep study conducted in a medical sleep center. The sleep medical team then offers treatment options such as positional therapy, behavioral modifications, continuous positive airway pressure (CPAP), and surgery. The current first choice of treatment of OSA is CPAP; however, patients can develop intolerance to CPAP machines.

In such situations, special oral appliances fabricated by dentists can be considered. These appliances move the lower jaw and the tongue forward to open the airway and are indicated for use in patients with mild to moderate OSA. Dentists do not diagnose nor recommend treatment for OSA, but they can fabricate and deliver sleep apnea oral appliances prescribed by medical doctors. Similar to other methods of OSA treatment, an oral appliance will still require a follow up sleep study in a sleep center to evaluate its effectiveness.

— Samer Alassaad is in private dental practice in Davis. Contact him at DrSamer@childressdentaldavis.com