It is estimated that 22 million Americans suffer from sleep apnea, with 80 percent of those cases of moderate and severe obstructive sleep apnea (OSA) undiagnosed.
Obstructive sleep apnea can be seen in all age groups, including children, and is defined as intermittent airflow blockage during sleep. More specifically it is when your tongue causes you to choke, decreasing the oxygen available for your body to use.
What are the warning signs of OSA?
While it is thought that Body Mass Index (BMI) and a large neck circumference are the biggest determining factors for OSA study after study show that the largest determining factors are (THE BIG FOUR) the size of your tongue followed by neck circumference, the size of your airway (as determined by a Mallampati score) and having a high roof of the mouth. Other oral factors include tooth alignment or jaw relationship (specifically Angle’s Class II), mouth breathing and narrow jaws.
Oral symptoms of OSA are scalloped borders of the tongue, cracked and worn teeth caused by mechanical wear, chemical erosion from acid reflux, dry mouth (which causes rampant cavities), enlarged uvula, and temporomandibular disorders (commonly known as TMJ or TMD).
Other common symptoms of OSA include excessive daytime sleepiness, snoring, gasping during sleep, insomnia, hyperactivity (especially in children), irritability, bed wetting, sleep walking, night terrors, excessive urination at night, fatigue, depression, headache, lack of concentration, memory loss, reduced sex drive and sore throat.
Common long term results of untreated OSA include stroke, diabetes, heart disease, high blood pressure, cancer, dementia, atrial fibrillation, and ultimately death. Generally speaking people with untreated OSA have a 30 percent higher risk of premature death, with the mortality rate peaking around age 55.
How do you know if you have sleep apnea?
First, we assess THE BIG FOUR; tongue size (small indentations on the side of your tongue indicate that the tongue does not have enough space), the size of your neck, the size of your airway and the height of your palate. We will also evaluate the health of the teeth, tooth alignment and jaw alignment. We may ask you a few questions which are part of a pre-screening for OSA. If you have indications that you may have OSA, we will schedule a sleep study or refer you to your primary care physician for a sleep study.
What is a sleep study? The medical terminology for a sleep study is a polysomnogram. A sleep study records your body’s functions as you sleep. There are two types of sleep study. One type of sleep study is a take-home sleep test. A take-home sleep test is a small device that you wear while sleeping at home in your own bed. The second type of sleep test is an overnight stay at a sleep laboratory. This test is more accurate but not always necessary to determine if you have sleep apnea.