For many years when my client would dose off during their hygiene appointment I used to pat myself on the back and think I must be so gentle if my clients can fall asleep during their maintenance visits. Fast forward many years I hear about this serious medical condition called sleep apnea and although I continue to work diligently to keep my clients so comfortable they could potentially fall asleep, now I realize my clients may be falling asleep in my chair due to a serious medical condition called sleep apnea.
What is Sleep Apnea?
Sleep Apnea is when an individual stops breathing or has very shallow breathing when sleeping. These absences of breathing are generally 10 to 20 seconds in length and can occur 30 times in a 1 hour period of time. When breathing returns the individual with generally make an audible noise like they are gasping for air. There are 3 types of sleep apnea 1. Central Sleep Apnea: often occurs in older population, people with heart disorders like congestive heart failure, those that have had a stroke, those on long lasting narcotic pain medications. This is when the brain doesn't send out the signal for your body to take a breath. 2. Obstructive Sleep Apnea- this is the most common and is due to having a restricted airway for a multiple of reasons. 3. Is a combination of the two types.
These absences of oxygen can lead to medical complications such as but not limited to the following:
1. Daytime fatigue- leading to poor job performance, lack of concentration, falling asleep while driving.
2. High Blood Pressure or Heart problems due to the sudden drops in blood oxygen levels.
3. Type 2 Diabetes
4. Metabolic Syndrome- leading to increase in waist circumference, abnormal cholesterol readings
6. Liver Disease
7. Complications with medications
Symptoms to Watch For in Yourself or Loved one
1. Loud or frequent snoring
2. Choking or gasping while you sleep
3. Insomnia due to difficulty staying asleep
4. Waking up with a dry mouth or sore throat
5. Trouble concentrating
6. Memory or learning problems
7. Moodiness or irritability
8. Waking up with headaches frequently
9. Low sex drive
Symptoms your Dental Professional Will Watch out for
1. A large uvula: tissue that hangs from the roof of your mouth, way at the back.
2. When it is difficult for your hygienist to see the back of your throat due to your tongue posture
3. Large tongue with scalloped boarders.
4. Falling asleep during dental procedures.
5. Mouth Breathing
Personal Risk Factors for Obstructive Sleep Apnea
1. Males are 2 times as likely to have sleep apnea over women
2. More often in older adults
3. Family history
4. Use of Alcohol, sedatives or tranquilizers as they relax the throat muscles
5. Smoking makes you 3 times more likely to have sleep apnea over non smokers
6. Nasal congestion
7. Excess weight makes you 4 times more likely than someone that is at their healthy weight
8. Large neck circumference: for men anything over 43 cm, for women anything over 38 cm are at a higher risk
9. Narrow Airway either naturally or from large tonsils or adenoids
Sleep Apnea is a serious medical condition please see your medical doctor is you feel you are at risk. They will likely have you take a short Sleepiness Scale test called Epworth Sleepiness Scale and possibly refer you to a sleep center. If you suspect you have sleep apnea and are prone to falling asleep when watching TV or when reading ask someone else in your home to watch over you during your nap and see if you make that classic struggling to get your breathe noise. When in doubt always see you MD.
Three Primary Treatment Options for those with sleep apnea
1. Gold Standard is a CPAP machine worn during sleep
2. Oral Appliance for those who can't tolerate a CPAP. Mild to Moderate Sleep Apnea
The official website of Epworth Sleepiness Scale