Most Australians enjoy a restful sleep after a long day. Unfortunately, some Australians suffer from obstructive sleep apnoea, and do not sleep as well.
Obstructive Sleep Apnoea (OSA) is more than snoring; it occurs when an airway is fully or partially blocked during sleep. This obstruction forces the diaphragm and chest muscles to work harder to open the airway. It can cause uncomfortable muscle spasms throughout the night and severely disrupt sleep.
If you suffer from sleep apnoea, your partner may complain that you snore during the night. Your breathing may become shallow and stop for short periods. You may wake up several times throughout the night with a loud gasp. These brief, wake-sleep cycles repeat throughout the night. Most people don't remember them when they wake up, and they don't understand why they didn't get a good night's rest.
If you have OSA, you may wake up tired with a morning headache. You could stay drowsy throughout the day and fall asleep during inappropriate moments. Additionally, you might be unable to concentrate during the day.
What causes Obstructive Sleep Apnoea and what is it?
The throat's muscles support structures in your mouth, including your tongue, soft palate, uvula, and tonsils. OSA occurs when the muscles in the back of your throat relax too much to allow for normal breathing.
Once these muscles relax, your airway narrows or closes. This results in inadequate breathing for 10 seconds or longer. The lower level of oxygen in your blood can cause a buildup of carbon dioxide.
Your brain will sense your impaired breathing and briefly rouse you from sleep so that your airway can reopen. This awakening occurs quickly, so you may not remember what happened.
You can awaken with shortness of breath that corrects itself quickly within two deep breaths. You may make snorting, choking, or gasping sounds.
The pattern may repeat itself five to 30 times each hour, all night long. The disruptions impair your ability to sleep well, and you won't have deep and restful periods of sleep that humans need to thrive. You'll also probably feel drowsy throughout the day during your waking hours.
Patients with obstructive sleep apnoea may not be aware that their sleep was interrupted. Many people with this type of sleep apnoea think they've slept well at night, but can’t explain why they feel so exhausted during the day.
Risk factors for Obstructive Sleep Apnoea
Any person can develop obstructive sleep apnoea, but several factors can place individuals into an increased risk category. These include:
- Excessive Weight - Some people with obstructive sleep apnoea are overweight as fat deposits around the upper airway can obstruct their breathing. Medical conditions associated with obesity include hypothyroidism, polycystic ovary syndrome, and other conditions. Not everyone who is overweight will suffer from OSA, and thin people can also suffer from the disorder.
- Narrowed Airway - You can inherit naturally narrow airways through your genes. Your tonsils or adenoids may become enlarged, which can block the airway.
- High blood pressure (hypertension) - OSA is common in people who have hypertension.
- Chronic nasal congestion - OSA occurs twice as often in those who have consistent nasal congestion at night, regardless of the cause. Narrowed airways may cause this issue.
- Smoking - People who smoke are more likely to develop OSA.
- Diabetes - Obstructive sleep apnoea may be more common in individuals with diabetes.
- Sex - Men are twice as likely to develop OSA. The frequency of obstructive sleep apnoea also increases in women after menopause.
- Neck structure - People who have large or thick necks can also suffer from this condition.
Obstructive Sleep Apnoea symptoms
If you're not getting a good night's sleep, you may have sleep apnoea. Most patients with OSA symptoms suffer from:
- A dry mouth or sore throat in the morning
- Excessive drowsiness during the daytime
- Loud, habitual snoring that's bothersome to other people. However, not every person who snores loudly has OSA.
- Awakening without feeling refreshed.
- Observed episodes of stopped breathing during sleep
- Abrupt awakening accompanied by gasping or choking
- Morning headaches
- Difficulty concentrating during the day
- Experiencing mood changes, such as depression or irritability
- High blood pressure
- Night sweats
- Low libido
- Gastroesophageal reflux disease (GERD)
- Insomnia (restless sleep) with frequent tossing and turning during the night.
If you share a bed with someone, they may notice you have sleep apnoea before you do.
Childhood symptoms of Obstructive Sleep Apnoea
Adults are not the only ones who can suffer from OSA; children can have this issue too. Their symptoms differ slightly from adults. They include:
- Bedwetting
- Choking or drooling
- Night sweats
- Inward-moving ribcage as they breathe
- Learning and behavioural problems
- Issues at school
- Sluggishness or sleepiness (often seen as laziness)
- Snoring
- Teeth grinding
- Restlessness in bed
- Breathing that pauses or stops
- Unusual sleeping positions, such as sleeping on their hands and knees, or with their neck bent far back.
Some medications can also cause these symptoms. Please check with your General Medical Practitioner to rule them out.
Obstructive Sleep Apnoea treatments
If you suffer from obstructive sleep apnoea, there are several possible treatments to help your condition. Some steps include:
- Weight loss - Losing ten per cent of your body weight can make a difference in sleep apnoea
- Not drinking alcohol or sedatives - Avoiding alcohol and sleeping pills help your airway close during sleep. It can keep you breathing for longer periods
- Sleeping on your side - This can help if you only have mild sleep apnoea when you sleep on your back
- Nasal sprays - These can treat sinus problems if nasal congestion makes it harder to breathe while you sleep
Many patients with sleep apnoea will require more treatment beyond these simple steps.
- Oral appliances worn at night - Do you have mild or moderate sleep apnoea? National Dental Care can create a custom-made dental appliance, or "oral mandibular advancement" device. These appliances keep your tongue from blocking your airway as you sleep. Our experts can decide which ones may be right for your OSA
- Continuous Positive Airway Pressure (CPAP) via a nasal mask - These devices can include masks that you wear over your nose, mouth or both. An air blower forces constant air through your nose or mouth. The air pressure is just enough to keep your upper airway's tissues from relaxing too much while you sleep. A similar device is the BPAP which has two levels of airflow that change when you breathe in and out. CPAP machines are the most effective treatment for OSA, reducing daytime sleepiness and improving sleep quality. However, some people with OSA find the mask or feeling of pressure difficult to tolerate
- Surgical Treatment - Doctors rarely use surgery to treat OSA. Some treatments include the uvulopalatopharyngoplasty (UPPP). This procedure removes some of the throat's soft tissues that collapse the airway during sleep. Although it's effective at reducing snoring, it doesn't always treat obstructive sleep apnoea.
OSA can also impact your health when left untreated. This health condition can lower the flow of oxygen to your organs and cause uneven heart rhythms. If you suffer from these symptoms, speak with your General Medical Practitioner. Your doctor can refer you for a sleep study to better understand and treat your condition.
A dentist can help treat your OSA if the sleep study confirms your condition is mild to moderate by constructing an appliance called a Mandibular Advancement Splint. These appliances (also known as sleep mouth guards) work by ensuring that your lower jaw stays forward during the night. They prevent the tissues at the back of your throat from collapsing and blocking your airway. Your dentist can make these appliances using custom-made bite impressions so that it will perfectly fit your mouth.
You can use these devices as part of your holistic health plan to treat OSA.
How does a sleep apnoea treatment work?
If your doctor has confirmed that your obstructive sleep apnoea is a mild or moderate case, they may refer you to a dentist to be fitted for a Mandibular Advancement Splint, a dental appliance that looks a bit like a mouthguard.
After an examination of your teeth, gums, and mouth, your dentist will take impressions of your mouth using a soft clay-like material. They will send these impressions away to a lab to use to make a custom mandibular advancement splint.
It will usually take a couple of weeks for the lab to make a splint and return it to your dentist, at which point you can visit your dentist again to pick it up. During this appointment, your dentist will ensure a good fit and give you instructions for wear.
You will then wear your splint each night to sleep, so it can open up your airway and help you to breathe better - and therefore sleep better. It may take some getting used to wearing the device, but in time you should get used to it, and enjoy the benefits it brings.
Advantages of a sleep apnoea treatment
Receiving a sleep apnoea treatment can make a real difference in your life, from health to happiness.
- Better sleep: The key benefit of seeking OSA treatment is better sleep, so you will wake up feeling more refreshed and you won’t struggle with tiredness all day.
- Improved health: Sustained poor sleep can have negative health effects, from high blood pressure and an increased risk of hypertension, to depression and obesity.
- Non invasive: Using a mandibular advancement splint is a simple, non-invasive treatment, so you can enjoy the benefits of better sleep without medication or surgery.
How much does a sleep mouthguard cost?
A sleep mouthguard, or mandibular advancement splint, costs approximately $1,500 to $2,000 in Australia.
The cost depends on your exact needs and your dental office. Keep in mind that some private insurers may help to cover the costs of a sleep mouthguard.
What to expect from your sleep apnoea appointment
If your doctor has recommended seeing a dentist for a sleep mouthguard, here’s what you can expect from the process:
- Your dentist will perform an examination, and may take x-rays to assess your mouth and oral health
- Your dentist will take impressions of your teeth using a soft clay-like material that you will bite into
- These impressions will be sent to a lab that will make your custom sleep mouthguard
- It will take 2-3 weeks for the lab to make your sleep mouthguard and send it to your dentist
- Your will return to your dentist to pick up the splint and ensure it fits well
- Your dentist will advise you on proper wear and care
- Be sure to bring your sleep mouthguard to your future dental check ups so they can check how well it is wearing
If your general practitioner has advised you get a custom-made mandibular advancement splint, you will need to contact a dentist to have one made.
Find your nearest dental office and get in touch today to schedule an appointment.