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Obstructive Sleep Apnea Treatment

Obstructive sleep apnea is a common and serious sleep disorder that causes you to stop breathing during sleep. The airway repeatedly becomes blocked, limiting the amount of air that reaches your lungs. When this happens, you may snore loudly or making choking noises as you try to breathe. Your brain and body becomes oxygen deprived and you may wake up. This may happen a few times a night, or in more severe cases, several hundred times a night.

Obstructive sleep apnea

In many cases, an apnea, or temporary pause in breathing, is caused by the tissue in the back of the throat collapsing. The muscles of the upper airway relax when you fall asleep. If you sleep on your back, gravity can cause the tongue to fall back. This narrows the airway, which reduces the amount of air that can reach your lungs. The narrowed airway causes snoring by making the tissue in back of the throat vibrate as you breathe.

Sleep apnea can make you wake up in the morning feeling tired or unrefreshed even though you have had a full night of sleep. During the day, you may feel fatigued, have difficulty concentrating or you may even unintentionally fall asleep. This is because your body is waking up numerous times throughout the night, even though you might not be conscious of each awakening.

The lack of oxygen your body receives can have negative long-term consequences for your health. This includes:

  • High blood pressure
  • Heart disease
  • Stroke
  • Pre-diabetes and diabetes
  • Depression

There are many people with sleep apnea who have not been diagnosed or received treatment. A sleep medicine physician can diagnose obstructive sleep apnea using an in-lab sleep study or a home sleep apnea test. Sleep apnea is manageable using continuous positive airway pressure (CPAP) therapy, the front-line treatment for sleep apnea, oral appliance therapy or surgery.

Obstructive sleep apnea in adults is considered a sleep-related breathing disorder. Causes and symptoms differ for obstructive sleep apnea in children and central sleep apnea.

Symptoms

The most common symptom of sleep apnea is snoring. However, not everyone who snores has sleep apnea. Snoring is likely to be a sign of sleep apnea when it is followed by silent breathing pauses and choking or gasping sounds.

People with sleep apnea often have daytime sleepiness or fatigue.

Common symptoms of sleep apnea include:

  • Loud or frequent snoring
  • Silent pauses in breathing
  • Choking or gasping sounds
  • Daytime sleepiness or fatigue
  • Unrefreshing sleep
  • Insomnia
  • Morning headaches
  • Nocturia (waking during the night to go to the bathroom)
  • Difficulty concentrating
  • Memory loss
  • Decreased sexual desire
  • Irritability

Risk Factors

The major risk factor for sleep apnea is excess body weight. You are much more likely to have sleep apnea if you are overweight or obese. However, sleep apnea can occur in slim people too. Common risk factors for sleep apnea include:

  • Excess weight – Your risk for sleep apnea is higher if you are overweight with a body mass index (BMI) of 25 or more or obese with a BMI of 30 or higher.
  • Large neck size  Your risk for sleep apnea is higher if you have a neck size of 17 inches or more for men, or 16 inches or more for women. A large neck has more soft tissue that can block your airway during sleep.
  • Middle age – Sleep apnea can occur at any age. However, it is more common between young adulthood and middle age.
  • Male gender – Sleep apnea is more common in men than in women. For women the risk of sleep apnea increases with menopause.
  • Hypertension – High blood pressure is extremely common in people who have sleep apnea.
  • Family history – Sleep apnea is a heritable condition. This means that you have a higher risk of sleep apnea if a family member also has it. Inherited traits that increase the risk for sleep apnea include obesity and physical features such as a recessed jaw. Other common family factors – such as physical activity and eating habits – also may play a role.

If you have sleep apnea symptoms or someone you care for does – then schedule a consultation appointment today and we can help you get that good night sleep.  We offer comfortable at-home sleep test and sleep apnea solutions. Please email, or call us at (830) 890-5225 for a consultation.




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Sleep Apnea Oral Therapy Appliance Benefits

Sleep Apnea oral therapy appliances have a higher compliance rate than a CPAP machine and mask.

Sleep Apnea Oral Therapy

Oral appliance therapy is a treatment for snoring and obstructive sleep apnea. It involves wearing a removable oral appliance in your mouth as you sleep. The device fits much like a sports mouth guard or orthodontic retainer.

An sleep apnea oral therapy appliances prevents your airway from collapsing by either holding the tongue or supporting the jaw in a forward position. You must be custom fitted for an oral appliance in order for it to be effective. Over-the-counter devices are not recommended as a treatment option for snoring or obstructive sleep apnea.

Members of the sleep team collaborate to provide you with oral appliance therapy. The board certified sleep medicine physician must diagnose obstructive sleep apnea using a sleep study. Once you are diagnosed, a dental sleep medicine specialist can fit you with an oral appliance. These dentists must have special training in treating sleep apnea.

The most effective treatment for obstructive sleep apnea is CPAP therapy. But some patients prefer an oral appliance because it is small, portable and easy to use. Oral appliance therapy is most helpful for people with less severe sleep apnea.

Types of oral therapy appliances

There are a variety of oral appliances that can treat obstructive sleep apnea. Each device may differ in appearance. Most devices fall under one of the two following types:

Mandibular re-positioning devices – These oral appliances re-position your lower jaw forward and down slightly to keep your airway open while you sleep. Mandibular re-positioning devices are the most widely used oral appliances.

Tongue retaining devices – These oral appliances hold your tongue in place to keep your airway open.

For mild to moderate sleep apnea, oral appliance therapy offers many of the same health benefits as CPAP. By treating your sleep apnea, you can reduce your risk for heart disease, stroke and diabetes. You will also improve your daytime alertness, concentration and emotional stability.

The additional benefits of sleep apnea oral therapy appliances include:

Ease of use – Some patients prefer oral appliances because they can be easy to wear. For most patients it takes a few weeks to get used to sleeping with an oral appliance in your mouth.

Small and easy to transport – Traveling with your sleep apnea treatment is easy with an oral appliance therapy. Unlike CPAP, oral appliances are small enough to fit in your purse or carry-on bag.

Possible side effects

Oral appliance therapy may cause frequent but minor side effects. These include:

  • Excessive salivation
  • Dry mouth
  • Tooth and jaw discomfort
  • Temporary bite changes

Some patients experience potential complications such as:

  • Jaw pain
  • Permanent changes to your bite
  • TMJ symptoms

If you have sleep apnea symptoms or someone you care for does – then schedule a consultation appointment today and we can help you get that good night sleep.  We offer comfortable at-home sleep test and sleep apnea solutions. Please email, or call us at (830) 890-5225 for a consultation.




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Sleep Apnea Untreated is Risky

Sleep apnea untreated can lead to diabetes, stroke, heart disease, memory loss, and more…

Sleep apnea may hasten memory and thinking declines, leading to earlier diagnoses of mild cognitive impairment and Alzheimer’s disease, suggests a study recently released. Patients with sleep apnea were, on average, diagnosed with mild cognitive impairment (MCI) nearly 10 years earlier than those who didn’t suffer from breathing problems during their slumber, according to New York University researchers. The timespan for developing Alzheimer’s also seemed to speed up: Those with sleep apnea were diagnosed, on average, five years sooner than sound sleepers, the authors reported. “This study is adding to the emerging story that sleep apnea may be contributing in some way to the acceleration of cognitive decline as you age,” said study coauthor Dr. Andrew Varga, an instructor in medicine at the New York University Sleep Disorders Center. “And that is potentially another good reason to get evaluated and treated.” The study was published in the journal Neurology.

Sleep Apnea Untreated

Research has shown that sleep apnea untreated is quite common in older adults, affecting as many as 53 percent of men and 26 percent of women. Varga and his colleagues reviewed the medical histories of 2,470 people aged 55 to 90 who had participated in an earlier study designed to look for markers of Alzheimer’s disease. At the outset, study volunteers were categorized as being free of memory and thinking problems, or in the early stages of mild cognitive impairment, or with Alzheimer’s disease. The researchers found that sleep apnea untreated was associated with a much quicker decline in cognitive function. But there was some good news from the study: Treatment for breathing problems during sleep appears to be protective, delaying the onset of MCI by approximately 10 years. Essentially, this meant that people who got treated declined at the same speed as people who didn’t have apnea at all, Varga said. The treatment can include machines that help people breath better as they sleep. It’s not clear yet exactly how sleep apnea is damaging the brain. Studies have shown that “sleep apnea is associated with repetitive drops in the blood oxygen level, which can affect various organs in the body differently,” said Dr. Charles Atwood, a sleep specialist and an associate professor of medicine at the University of Pittsburgh School of Medicine.

Oxygen levels drop because people with sleep apnea untreated have periods during the night when their throats close up and they briefly stop breathing, said Atwood, who was unaffiliated with the study. A common cause is obesity, he said. The weight of the flab around the neck pushes down on the throat at a time when its muscles have relaxed with sleep. That pressure can briefly close the throat until the person partially awakens, gasping for air. And that can happen as many as 300 to 400 times a night, Atwood said. “They often don’t wake up enough that they are conscious of being awake,” Atwood said. “Then they wake up in the morning feeling really tired an unrefreshed.” Sleep is the time for the brain’s janitors to sweep up all the waste. If sleep is disturbed, those janitors might not get the job done, leaving an accumulation of the proteins that gunk up nerve cells. And, as it turns out, low oxygen levels may hurt some parts of the brain more than others. “It’s known that certain neurons in the hippocampus — where much of Alzheimer’s is thought to start — are exquisitely sensitive to drops in oxygen,” Varga said. “Sleep apnea may just stress those neurons out.” Another possibility is that disrupted sleep messes with the brain’s housecleaning. Sleep is the time for the brain’s janitors to sweep up all the waste. If sleep is disturbed, those janitors might not get the job done, leaving an accumulation of the proteins that gunk up nerve cells, said Dr. Mark Wu, a sleep medicine specialist and an associate professor of neurology at Johns Hopkins Medicine. The important message here “is that Alzheimer’s is untreatable and it’s a big, big problem,” said Wu, also unaffiliated with the new study. “It costs the United States billions of dollars. If we could reduce the speed at which it develops, people might then die of cancer or a heart attack and not Alzheimer’s.” “The message has to be loud and clear to family practitioners, primary care physicians and ob-gyns that sleep apnea should be screened for,” agreed Dr. Alon Avidan, a professor of neurology at the University of California, Los Angeles, and director of the UCLA Sleep Disorders Center. “Unfortunately, sleep apnea doesn’t hurt like chest pain. It doesn’t bring up a specific complaint. The patient may be a little sleepy or confused. People often fail to make the correlation that the daytime sleepiness may be related to disrupted sleep at night,” Avidan added. In fact, people often aren’t diagnosed until there is a dire consequence, Avidan said. “Either they are in a car accident because they were sleepy or they develop high blood pressure or have a stroke.”

If you have sleep apnea symptoms or someone you care for does – then schedule a consultation appointment today and we can help you get that good night sleep.  We offer comfortable at-home sleep test and sleep apnea solutions. Please email, or call us at (830) 890-5225 for a consultation.




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Stop the Snore

Did you know that habitual snoring has been found in about 24% of adult women and 40% of adult men? Make your pledge to stop the snore.

stop the snore

You can Stop the Snore in a variety of ways. Talk to a doctor about your risk for sleep apnea. Encourage your bed partner to talk to a doctor about snoring. Join us in spreading the word about the warning signs for sleep apnea.

Should you talk to a doctor about sleep apnea?

Here are five warning signs for sleep apnea:

Snoring: Besides being a nuisance to your bed partner or roommate, loud and frequent snoring is a common symptom of sleep apnea. While not everyone who snores has this sleep illness, snoring is a warning sign that should be taken seriously.

Choking or gasping during sleep: When snoring is paired with choking, gasping or silent breathing pauses during sleep, it’s a strong indicator of sleep apnea.

Fatigue or daytime sleepiness: Sleep apnea can leave you waking in the morning feeling tired, even after a full night’s sleep.

Obesity: An adult with a body mass index (BMI) of 30 or higher is considered to be obese, and the risk of sleep apnea increases with the amount of excess body weight.

High blood pressure: Between 30 and 40 percent of adults with high blood pressure also have sleep apnea, and getting treatment for sleep apnea is a proven means of decreasing blood pressure.

If you have sleep apnea symptoms or someone you care for does – then schedule a consultation appointment today and we can help you get that good night sleep.  We offer comfortable at-home sleep test and sleep apnea solutions. Please email, or call us at (830) 890-5225 for a consultation.




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Oral Appliance Therapy

Did you know that oral appliance therapy is a comfortable, quiet and low-maintenance alternative to a CPAP machine and mask?

Oral Appliance Therapy

Oral appliance therapy is a treatment for snoring and obstructive sleep apnea. It involves wearing a removable oral appliance in your mouth as you sleep. The device fits much like a sports mouth guard or orthodontic retainer.

An oral appliance prevents your airway from collapsing by either holding the tongue or supporting the jaw in a forward position. You must be custom fitted for an oral appliance in order for it to be effective. Over-the-counter devices are not recommended as a treatment option for snoring or obstructive sleep apnea.

Members of the sleep team collaborate to provide you with oral appliance therapy. Obstructive sleep apnea must be diagnosed using a sleep study. Once you are diagnosed, a dental sleep medicine specialist can fit you with an oral appliance. These dentists must have special training in treating sleep apnea.

Types of oral appliances

There are a variety of oral appliances that can treat obstructive sleep apnea. Each device may differ in appearance. Most devices fall under one of the two following types:

Mandibular repositioning devices – These oral appliances reposition your lower jaw forward and down slightly to keep your airway open while you sleep. Mandibular repositioning devices are the most widely used oral appliances.

Tongue retaining devices – These oral appliances hold your tongue in place to keep your airway open.

If you have sleep apnea symptoms or someone you care for does – then schedule a consultation appointment today and we can help you get that good night sleep.  We offer comfortable at-home sleep test and sleep apnea solutions. Please email, or call us at (830) 890-5225 for a consultation.




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Easy At-Home Sleep Test

Do you have trouble sleeping or wake up snoring? You might have sleep apnea. An easy way to find out if you have this exhausting condition is a Simple and Easy AT HOME sleep test! Our sleep center offers WatchPAT – a portable device that uses the most innovative technology to ensure the accurate screening, detection, and follow-up for sleep apnea. Its ease of use is greatly complemented by the fact that WatchPAT testing is done in the comfort of your own bedroom; an environment that best reflects the pattern of your sleep habits.

Every day, doctors hear from both men and women that they have a loss of energy, they’re weary throughout the day, or they have trouble falling asleep, or they wake up in the middle of the night and have difficulty falling back asleep. Many complain that their bed partners snore loudly and then gasp for breath throughout the night. And even though many people are spending seven to eight hours in bed, they’re actually spending less time sleeping. If this sounds like you -then you might have sleep apnea.

The amount of time people sleep varies from person to person. The WatchPAT sleep test device is put on when you go to bed and runs ten (10) consecutive hours after turned on. You should take it off when you wake up in the morning and return it to the clinic for sleep data downloading. Thanks to WatchPAT’s automated data analysis, you don’t have to wait to get your diagnosis. Once you return the WatchPAT to your physician, you will receive an immediate detailed sleep report. This instantaneous report generation—compared to a lengthy wait in most hospital-based settings—allows you to initiate sleep apnea treatment the same day and without delay.

Here are just a few of the many features of the WatchPAT:

  • Real Sleep Time – measures actual time asleep—not just time in bed, like other home devices, providing a more accurate assessment of sleep apnea.
  • ODI (Oxygen Desaturation Index) – measurement of blood oxygen levels. When not enough oxygen reaches the brain, a person awakens from sleep.
  • Heart Rate -the number of heart beats per minute while sleeping.
  • Body Position – notes whether you sleep on your back (supine), front (prone) or side, all which influence apnea.
  • Snoring Intensity (dB) – loud snoring is a major indicator of sleep apnea.
  • Sleep Fragmentation – repeated short interruptions of sleep throughout the night, reducing the total amount of time spent in the deepest level of sleep.

sleep testIf you have sleep apnea symptoms or someone you care for does – then schedule a consultation appointment today and we can help you get that good night sleep.  We offer comfortable at-home sleep test and sleep apnea solutions. Please email, or call us at (830) 890-5225 for a consultation.




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Sleep Apnea Dental Appliance

Nearly 30 million Americans have sleep apnea symptoms and 80+% of sleep apnea patients remain undiagnosed. With the help of our sleep apnea Dental Appliance CPAP alternative – we are giving people the quality of sleep they once had. Jonathan from Atlanta GA says: “Getting more sleep changes everything. It’s life changing!”

Across the country, sleep apnea patients are waking up refreshed and feeling alive again. Enjoy their stories as they escape the sleep apnea fog and live the life that makes them whole.

sleep apnea dental appliance

Don’t just take our word for it. Hear what people have to say about our Sleep Appliances, in their own words.

Joanne, Long Island NY – “You can actually drink water at night, which I do often. I can speak with it, and it’s very easy to take off.”

If you have sleep apnea symptoms or someone you care for does – then schedule a consultation appointment today and we can help you get that good night sleep.  We offer comfortable at-home testing and sleep apnea solutions. Please email, or call us at (830) 890-5225 for a consultation.




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Sleep Apnea Treatments

We offer sleep apnea treatments that are small, convenient and easy to maintain. Joyce says: “I just pop it in and I sleep right until I wake up. I am approaching the day knowing that I can conquer anything.” This small mouth appliance is so much better than the common CPAP machine.

Interested in starting treatment with a comfortable and easy Sleep Appliance but don’t know where to start? It might be easier than you think.

Obstructive Sleep Apnea (OSA) occurs when the tongue and soft palate collapse onto the back of the throat and block the airway during your sleep. It restricts the flow of oxygen and causes common OSA symptoms like snoring or gasping. Our Sleep Appliances work by moving the jaw and tongue in an optimal position to maintain an open airway — all without respirators or tubes.

Sleep Apnea Treatments

 

5 benefits of our sleep appliances:

  • Covered by Medical Insurance
    • Most medical insurance covers our appliances. Four of our appliances are accepted under Medicare.
  • Hassle Free
    • No hoses. No mask. Easier care and no need to repurchase consumables. Travel light, everywhere.
  • Fully Customized
    • Wide variety of appliances that are customized for more effectiveness and comfort.
  • Provided by Dental Sleep Professionals
    • Our professionals are well educated and experienced with dental sleep medicine and sleep apnea treatments.
  • Sleep Naturally
    • You can sleep in any position you like, even on your side, and of course next to your partner.

If you have sleep apnea symptoms or someone you care for does – then schedule a consultation appointment today and we can help you get that good night sleep.  We offer comfortable at-home testing and sleep apnea solutions. Please email, or call us at (830) 890-5225 for a consultation.




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Sleep Apnea Driving and Pilots

On a daytime flight one February day in 2008, a commercial aircraft with three crew members and 40 passengers flew past its destination airport after both the captain and first officer fell asleep. The pilot awoke and turned back to the destination airport, where all deplaned safely – but behind schedule. The National Transportation Safety Board determined that contributing factors to the incident were the captain’s undiagnosed obstructive sleep apnea (OSA) and the flight crew’s recent work schedules, which included several days of early-morning start times.

Sleep Apnea Driving

To prevent events likes this from happening again, the goal of the FAA and the U.S. Department of Transportation’s (DOT’s) Federal Motor Carrier Safety Administration (FMCSA) is to reduce crashes, injuries and fatalities involving commercial motor vehicles (including large trucks and buses). One mechanism used to facilitate this effort to avoid sleep apnea driving is the updating of current, and the development of new, medical fitness standards and guidelines for medical examiners who are responsible for certifying drivers including DOT CDL as fit for duty. A pilot compliance recorder can be used for NTSB compliance.

Apnea is a medical term that means “being without respiration.” Obstructive sleep apnea is characterized as a repetitive upper airway obstruction during sleep, as a result of narrowing of the respiratory passages. Most people with this disorder are overweight and have higher deposits of adipose (fatty) tissue in their respiratory passages, and the size of their soft palates and tongues are larger than average. These conditions decrease the size of the upper airway and decrease airway muscle tone, especially when sleeping in the supine (back down and horizontal) position. Gravity can pull tissue down and over the airway, further decreasing its size, impeding air flow to the lungs during inhalation. Typically, a person suffering from OSA is not aware of the condition. The only way OSA and sleep apnea driving can be detected is through a sleep study.

Once recognized and identified, OSA is highly treatable, either with surgery or non-surgical approaches. Obviously, non-surgical methods should be tried first –

  • Behavioral changes
    • Change sleeping position (sleep on side or stomach).
    • Change sleeping environment (mattress, light level, temperature, etc.).
    • Lower body fat (10% weight loss will decrease the OSA index by 25%).
  • Dental appliances
    • Dental appliances that thrust the lower jaw forward or otherwise open the airway are an excellent treatment for mild-to-moderate OSA and are about 75% effective.
  • Continuous positive airway pressure —(CPAP) machine
    • Probably the best, non-surgical treatment for any level of OSA.
    • Uses air pressure to hold the tissues open during sleep.
    • Decreases sleepiness, as measured by surveys and objective tests.
    • Improves cognitive functioning on tests.
  • Medications
    • Any medication taken for OSA must be approved by the FAA.
    • Nasal steroid sprays are effective.
    • Medications that have been studied include medroxyprogesterone, acetazolamide, and theophylline.

Many of our sleep appliances have a compliance monitor component that complies with FAA and DOT requirements. If you, or someone you care for is struggling with sleep apnea driving, restlessness or snoring then we invite you to visit the Kerrville clinic for at-home testing and sleep apnea solutions. Please email, or call us at (830) 890-5225 for a consultation.




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Sleep Apnea Health Risks – Nearly 1 Billion Have It

A new data analysis presented by ResMed at the ATS 2018 International Conference indicates that the prevalence of sleep apnea health risks impacts more than 936 million people worldwide—nearly 10 times greater than previous estimates.

Sleep Apnea Health Risks

 

“The research and findings are a revelation in sleep apnea research and represent a vastly under reported major public health issue,” says Adam Benjafield, ResMed vice president of Medical Affairs and lead study researcher, in a release. “This new study demonstrates a need for expanded awareness around the diagnosis and treatment of OSA worldwide.” The study “Global Prevalence of Obstructive Sleep Apnea (OSA)” was conducted by an international panel of researchers seeking to provide a clear scope of the impact of the chronic sleep-disordered breathing condition.

The previous estimation of OSA prevalence (100 million) came from a 2007 World Health Organization study that used methods and data available at the time. By analyzing technology improvements in detecting OSA and under reported statistics from other areas of the world, this latest study depicts an impacted population significantly larger than previously identified.

ResMed chief medical officer Carlos M. Nunez, MD, says, “This study should encourage physicians to talk with their patients about how sleep affects our overall health. Those who have sleep apnea health risks don’t often realize they have it and, therefore, don’t realize they can do something to mitigate the resulting chronic fatigue or its more harmful long-term health risks. It should also cause more people to ask themselves, ‘Do I or my bed partner have this?’  Sleep apnea isn’t just a disease for older, overweight men, as once thought. It affects people of all ages, all ethnic and racial groups, all states of health, and is not gender specific. In fact, nearly half of newly diagnosed patients are female.”

A great night of sleep could be just around the corner! If you, or someone you care for is struggling with restless sleep, snoring or potential sleep apnea, we invite you to visit the Kerrville clinic for sleep apnea solutions, email, or call us at (830) 890-5225 for a consultation.