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SLEEP APNEA

The silent killer

Sleep apnea affects more than 18 million Americans and is as common as type 2 diabetes. It leaves them tired and if left untreated, it causes stroke, impotence, weight gain, memory problems, hypertension, and poor performance from metabolic syndrome. 

Hence, it is one of the most under diagnosed and debilitating conditions of our time.

WHAT IS SLEEP APNEA?

Sleep Apnea is a condition where you stop breathing in your sleep causing so your oxygen levels drop to dangerous levels which results in irreparable damage to your blood vessels and organs. Often people stop breathing hundreds of times during the night for a minute or longer without full awakening. As a result, most people do not know that they have sleep apnea and the condition becomes a silent killer with life-shortening consequences.

How do I know if I have Sleep Apnea?

You could be at risk for Sleep Apnea if you experience any of the following symptoms:

 

  • Loud snoring

  • Occasionally waking up with a choking or gasping sensation

  • Sleepiness or lack of energy during the day

  • Sleepiness while driving

  • Morning headaches

  • Restless sleep

  • Forgetfulness, mood changes, and a decreased interest in sex

  • Recurrent awakenings or insomnia

If you experience any of these symptoms you should get tested for sleep apnea. Schedule an appointment today.

How do I get tested for sleep apnea?

If you own a wearable device, like a fitbit or a smartwatch, the easiest way to predict your risk of having sleep apnea is to use an app such as www.cardiogr.am. The app uses data from your wearable device and AI technology to assess the probability of you having sleep apnea with a 90% accuracy rate.

Another at home option is a home sleep test. These can be ordered by Dr. Amanda Cheng  and you will be mailed a device to record your sleep for a couple of nights after which you mail back the device to have the results interpreted. The home sleep test will have less details about your condition, but is still fairly accurate. 

The most accurate assessment method would be to do an overnight sleep test in a sleep lab.  The polysomnography monitors your heart, lung and brain activity, breathing patterns, limb movements, and blood oxygen levels. Due to the requirement for an overnight stay, this test is normally given to patients that exhibit severe sleep apnea or to confirm the results of other tests.

Non-Invasive - Oral Appliance

A custom made oral appliance is an effective life changing treatment option for snoring and obstructive sleep apnea which can improve your sleep, restore your alertness and revitalize your health. Worn only during sleep, an oral appliance fits like a sports mouth guard and advances the lower jaw forward to keep the airway open. There are many types of oral appliances, Dr. Cheng will determine at the consultation the best type of oral appliance for you depending on your breathing and your bite. Custom-made oral appliances are emerging as an ideal treatment option particularly for mild to moderate sleep apnea.

Surgery - Maxillomandibular Advancement

Patients with more severe obstructive sleep apnea are suitable for maxillomandibular advancement (MMA) surgery to move both jaws forward to open the airway in the anterior-posterior dimension and to expand the airway laterally which is key for preventing collapse of the airway. A minimum advancement of 10mm is needed to effectively treat sleep apnea. Many patients elect to have an MMA surgery since it is less painful than soft tissue surgery of the palate and has less relapse. MMA surgery is an instant solution to their disease that does not involve wearing awkward or restricting medical devices.

CPAP

Continuous Positive Airway Pressure (CPAP) is the traditional treatment option for mild to severe sleep apnea. The treatment uses a cumbersome mask connected to a loud machine. It is a highly effective if you are able to use it throughout the night. For many patients this is not possible due to a variety of factors from social unacceptability, interference with intimacy, claustrophobia, and delayed sleep onset. If this is the case, there are other treatment options available to help you get a good night's rest.

Are there any non-invasive treatment options?

Both CPAP and oral appliances are non-invasive treatment options.  Dr. Cheng will choose the best option for you.

Many adults are offered Continuous Positive Airway Pressure (CPAP) therapy which  has a cumbersome mask connected to a loud machine The device is big and is not well tolerated by the majority of adults due to social unacceptability, interference with intimacy, claustrophobia, delayed sleep onset, and is not very portable. 

 

A custom made oral appliance is also an effective life changing treatment option for snoring and obstructive sleep apnea (OSA) which can improve your sleep, restore your alertness and revitalize your health. Worn only during sleep, an oral appliance fits like a sports mouth guard and advances the lower jaw forward to keep the airway open. There are many types of oral appliances, Dr. Cheng will determine at the consultation the best type of oral appliance for you depending on your breathing and your bite.Custom-made oral appliances are emerging as an ideal treatment option particularly for mild to moderate OSA.

What are the surgical treatment methods for adults?

There are a variety of different surgical options available. MMA, Inspire, UPP, Tonsils and Adonoids

Patients with more severe obstructive sleep apnea are suitable for maxillomandibular advancement (MMA) surgery to move both jaws forward to open the airway in the anterior-posterior dimension and to expand the airway laterally which is key for preventing collapse of the airway. A minimum advancement of 10mm is needed to effectively treat sleep apnea. Many patients elect to have an MMA surgery since it is less painful than soft tissue surgery of the palate and has less relapse. MMA surgery is an instant solution to their disease that does not involve wearing awkward or restricting medical devices.

Can my child have sleep apnea?

Sleep apnea can happen in kids and often they present as bed wetting, daytime fatigue, hyperactive behavior similar to ADHD and poor school performance due to an inability to concentrate. To treat kids, Dr. Cheng uses rapid palatel expansion as the main treatment procedure to enlarge the maxilla or upper jaw. By widening the maxilla when the skeletal sutures have not fused, the nasal cavity that exists above palate can be expanded which will increase the airflow for breathing. This will reduce sleep apnea in children but if more treatment is needed then the tonsils and adenoids will be removed and sometimes a protraction face mask is used to help jaw development. It is important to note that obstructive sleep apnea affects up to 10% of children.

What do I need to bring to my sleep apnea consultation?

You need to bring your medical history and sleep apnea report as well as your dental history showing that you are not getting a lot of restorative dental work otherwise the oral appliance will not fit. Depending on your insurance, we can take impressions that day and the oral appliance will be fabricated in 4-6 weeks.

Depending on the severity of your sleep apnea. You may also be a candidate for a maxillomandibular advancement surgery