Monday Medical: Treat OSA now for a better life
Snoring is no laughing matter. If you snore, or if you sleep with someone who snores, you probably are not getting enough sleep at night. Lack of sleep can cause health issues, just as snoring can create social issues among couples.
More importantly, snoring often is a sign of a serious condition called obstructive sleep apnea, or OSA.
Normally, air passes through the nose and past the flexible structures in the back of the throat, such as the soft palate, uvula and tongue. OSA is a condition in which the entire upper airway is blocked during sleep, causing airflow to stop.
OSA often goes undiagnosed. Instead, patients’ symptoms are treated – they include sleepiness, high blood pressure, depression, relationship difficulties, insomnia, acid reflux, arrhythmias, stroke, heart attacks and inability to lose weight. In addition, severe OSA patients have a sevenfold greater rate of involvement in motor vehicle accidents.
Attention deficit disorder and attention deficit hyperactivity disorder in children also are symptoms of OSA.
At present, OSA is not as well-known to the public as some other health conditions are. Ninety-five percent of an estimated 16 million Americans who suffer from sleep disorders remain undiagnosed.
If you suspect you may have OSA, consult your physician or a sleep specialist. You may request an overnight study at Yampa Valley Medical Center’s Sleep Study Center or get a home-monitored unattended study. These tests give a definitive diagnosis.
With a proper diagnosis of OSA, the interpreting sleep physician, such as pulmonary and sleep specialist Dr. David Kukafka, can recommend treatment options. The goal of these treatments is to eliminate the collapse of the upper airway (nasal passages) and lower airway (neck region) by dilating the airway so that air may flow in and out of your lungs.
Depending on the severity of the OSA and patient tolerance to treatment choices, treatment may include continuous positive air pressure machine therapy, an oral appliance for mandibular advancement by a specially trained dentist, or evaluation for airway surgery.
All of these options are available in Steamboat Springs.
The gold standard for OSA treatment is CPAP therapy. However, only 30 percent of the people who are treated with the CPAP mask and machine continue to use it on a long-term basis.
Oral appliance therapy is not quite as effective as CPAP, but patients clearly prefer it by a large margin. It is more easily tolerated because it is similar to wearing an orthodontic retainer or very refined athletic mouth guard.
Oral appliances are a treatment option for some patients with mild to moderate OSA. They should be fitted by qualified dental personnel who are trained and experienced in the oral structures and sleep dentistry, oral health, temporal mandibular joint dysfunction and dental occlusion.
Monitoring is an important aspect of any treatment option. Proper encouragement and follow-up from the sleep-disorder team is critical and includes yearly follow-ups with your sleep specialist or physician.
With today’s diagnostic technologies and treatment choices, a healthy approach can be taken to treat OSA. Successful treatment can address high blood pressure, depression, daytime sleepiness, acid reflux, insulin resistance, increase in the aging hormone cortisol and weight gain from the decrease in Leptin and depressed immune system.
It should be noted that the effects of untreated OSA are cumulative. Research shows that undiagnosed mild OSA in one’s earlier years can lead to cardiovascular health disease in one’s 70s or beyond.
If you snore or have any of the symptoms listed in this article, ask your doctor whether there is a physical cause for your snoring and whether you need to be tested for OSA. Early diagnosis and treatment may prevent more serious health conditions and contribute to the optimal health that our society desires.
Snoring can signal a serious health challenge. It is not something you want to lose any sleep over.
Alice Kaniff, DDS, is a dentist practicing at Dental Center of Steamboat Springs.
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