This weekend I took a class on sleep apnea to get the latest information and review the latest technology. What I learned might possibly have saved my life. I went to the class because many of my patients have struggled with sleep apnea and/or snoring for years.
Sleep apnea is a potentially deadly condition that happens when the throat muscles relax during sleep and occlude the airway causing the person to stop breathing. When the brain realizes that the oxygen levels have fallen to a dangerous level it wakes the person up so they will begin to breathe again. This can happen over and over again eventually causing the person to wake up fatigued and go on to feel sleepy all day.
Snoring is often combined with sleep apnea, and although not dangerous alone snoring can be very annoying to those around you. I have been snoring for years and Maria will tell me in the morning that my snoring kept her from falling asleep. She would even tell me that some nights she could hear me stop breathing and then gasp myself back to life.
THE TEST THAT COULD SAVE MY LIFE
On the first night of the course I was given the opportunity to do a home sleep test (HST) to evaluate the quality of my sleeping. I had been given this opportunity before though could not find a time that made sense to leave my family at home while I spent the night in a center having someone watch me sleep.
This home sleep study offered a sleep test in the comfort of my own bed without all the wires and someone monitoring my every move. The home sleep test device looks like a large watch that you wear on one hand and a sensor taped to the base of the front of your neck to record how loud and often you snore.
MY TEST RESULTS BLEW ME AWAY
When the instructor reviewed my test results in front of the whole class he did so because I was one of the worst (or best, depending on you look at it) at snoring. But even scarier was the amount of time that I was not breathing or getting quality sleep. My snoring was not the most he had ever seen but did measure out at 65 decibels at I snored almost all night long.
The frightening numbers were the amount of time that I was not breathing. When I am breathing normally my oxygen saturation level is in the high 90′s. If I hold my breath for a while it will slowly drop and at around 90% oxygen level I start to really feel that I need to take a breath. I discovered I spent 109 minutes below 90% and almost 24 minutes of that time I spent below 85%. That is a hard stressor on my body which can result in a host of health problems including higher blood pressure, depression, weight gain, stroke, sleepiness and fatigue. It has also been shown that the average lifespan of a sleep apneic is 55 years old. I need to take action now.
THREE CHOICES: CPAP, ORAL APPLIANCE OR SURGERY
Current sleep apnea and snoring therapy offer three choices. The gold standard is the CPAP machine.
The CPAP machine is a device that is worn at night and pushes air through your nose and into the lungs to help open up the tissue that has fallen to the back of your throat. The CPAP is the first choice of every sleep medicine physician and many people have great success with this machine. We have many patients that wear this and swear by it.
A sleep apnea oral appliance is typically the second choice of treatment for sleep apnea. An oral appliance also works to fight sleep apnea by opening the airway. Instead of using air to force open the muscles that have closed the throat an oral appliance pulls the lower jaw forward and the tongue comes with it thereby opening the airway. There are many different designs that can be used to pull the jaw forward. In fact we learned about one that was designed and used as early as 1924. They typically consist of an upper and lower piece and something that keeps the jaw from falling back. Here is one made by Somnamed:
Surgery is the third option for sleep apnea treatment. The idea of opening the airway is the same as the previous two treatments. In this case the airway is opened by surgically removing extra tissue in the back of the throat. Many people such as me have large tonsils and tissue that make the airway smaller. By removing this excess tissue there is less to fall to the back of the throat while sleeping. I have had a number of patients and friends that have had this procedure done. Some have said this worked great and others did not have as good of results. I have not been brave enough to choose this treatment option.
TONIGHT’S THE NIGHT
Tonight will be the first night of wearing my sleep apnea/snoring appliance. Each of the attendees of the course was fitted for their own custom device. This was a two step process where impressions were taken at one appointment and then 3-4 weeks later the device was ready to be inserted. The try-in was relatively uneventful. It fit great on the first try and did not have to be adjusted very much. It is kind of weird at first because of the way the device pushed my jaw forward, but I was able to open and close my mouth easily and after a few minutes I was totally comfortable.
MEDICAL INSURANCE MAY COVER THE DEVICE
Lately getting things covered by health insurance seems difficult but with sleep apnea oral appliances the opposite seem to be true. In the last several years insurance companies have been covering these devices more often than not for people with true sleep apnea. I think the reason coverage is easier is because wearing one can improve other conditions such as heart disease, hypertension, depression, weight gain, stroke, acid reflux, etc. This means insurance companies will possibly save money in the long run by not having to treat these more expensive diseases.
SLEEP STUDY OPTIONS
The only way to know for sure if you have sleep apnea (remember I was not sure I was just snoring or had snoring AND sleep apnea) is to have a sleep study done. This can be done at a local sleep study center or you can get the home sleep study kit like the one that I used. In either case the results are read by a physician who will make the final diagnosis and recommendation for treatment.
Do you feel sleepy or fatigued much of the day? Do you have trouble losing weight? Has someone told you that you snore or stop breathing during the night? If so, you can take this simple screening test to see if you might be at risk.
CLICK HERE TO TAKE THE TEST AND FIND OUT IF YOU ARE AT RISK
Read PART 2 of the series about my sleep apnea
– Allan Acton DDS
