Sleep-Related Breathing Disorders
Integrative Dental Medicine and the American Dental Association
In October 2017, the American Dental Association (ADA) released a policy statement addressing dentistry’s role in sleep-related breathing disorders. The policy encourages dental professionals to screen their patients for Obstructive Sleep Apnea (OSA), Upper Airway Resistance Syndrome (UARS), and other breathing disorders. The ADA advocates working in collaboration with trained medical colleagues to address these issues. With the endorsement of the ADA, screening and treating sleep-related breathing disorders has become the newest focus of integrative dental medicine.
“Other than emergency care, the first procedure performed by every dentist, for every patient, of any age should be a proper airway examination and evaluation of breathing function.”
— Dr. Tom Colquitt, President Emeritus, American Academy of Restorative Dentistry
Sleep apnea, otherwise known as central sleep apnea, refers to a disorder where a patient’s breathing repeatedly stops and starts throughout the sleep cycle. If you experience lethargy after a full night’s sleep there’s a possibility you may have sleep apnea or other airway related disturbances.
There are several related breathing disorders that fall within the disturbed breathing category including:
The signs and symptoms for OSA and UARS include:
- Observed episodes of stopped or abnormal breathing patterns during sleep
- Abrupt awakenings accompanied by shortness of breath
- Shortness of breath that’s relieved by sitting up
- Difficulty staying asleep (insomnia)
- Excessive daytime sleepiness (hypersomnia)
- Chest pains at night
- Difficulty concentrating
- Mood changes
- Morning headaches
- Lower tolerance for exercise
For an in-depth medical description of sleep-related breathing disorders, Glossary of Medical Terms.
Have you been experiencing Sleep-Related Breathing Disorder Symptoms? Call us for an appointment to evaluate your concerns.
Glossary of Medical Terms
Central Sleep Apnea (CSA)
Central Sleep Apnea (CSA) is a central nervous system disorder in which the respiratory center in the brain fails to transmit a signal to the body to inhale. CSA frequently occurs among people who are seriously ill from other causes: chronic heart failure, diseases of and injuries to the breathing control centers in the brainstem, Parkinson’s disease, stroke, kidney failure, and even severe arthritis with degenerative changes to the cervical spine and base of the skull. It is also seen among users of opiates. Idiopathic CSA is a description used when the cause is unknown. Mixed Apnea describes the simultaneous occurrence of both OSA and CSA.
Snoring is a sign of airway blockage as the tissues of the soft palate vibrate against the posterior wall of the pharynx (located behind the mouth and nasal cavity, and above the esophagus and larynx). This can be accompanied by the tongue dropping back as well. Approximately one in three snorers also suffer from obstructive sleep apnea.
Obstructive Sleep Apnea (OSA)
Obstructive Sleep Apnea (OSA) is a very serious breathing disorder that has significant systemic effects due to the mechanical collapse of the posterior throat airway. An apneic breathing (absence of breath) event occurs when breathing ceases for 10 seconds or longer accompanied by drops in oxygen saturation in the bloodstream. During sleep, multiple events in intervals of several minutes or longer can mimic the experience of choking and stimulate activation of the sympathetic nervous system (Fight or Flight response). Stress hormones, including cortisol, are released into the bloodstream, producing an acute excitation of the heart rate. The increase in blood flow attempts to deliver needed oxygen throughout the body. Chronic elevated cortisol levels in the blood can produce several damaging effects including increased blood pressure, cardiac arrhythmia, insulin resistance, and energy imbalance (leptin/ghrelin). For instance, an increased hunger drive can be stimulated by imbalances between leptin and ghrelin.
Upper Airway Resistance Syndrome (UARS)
Upper airway resistance syndrome is a common sleep disorder where a narrowing of the airway results in disruption to sleep. The most common symptoms include excessive fatigue and chronic insomnia.
A deviated septum, a condition in which the bone and cartilage of the nasal cavity are off-center, making it difficult to breathe. A deviated septum can be present from birth, a direct result of Maxillary hypoplasia or can occur as a result of a nose injury. It can contribute to difficulty breathing through the nose, and its most noticeable symptoms include nasal congestion, recurrent sinus infections, nosebleeds, difficulty sleeping, snoring, sleep apnea, headaches and post-nasal drip.
Mouth Breathing Syndrome
Mouth Breathing Syndrome is considered a breathing dysfunction that bypasses the critical physiologic benefits of nasal breathing. In this case, the air is humidified through the nose with a sterilized/anti-microbial effect of nitric oxide produced in the paranasal sinuses, where the breathing rate is controlled to help maintain an optimum carbon dioxide-oxygen ratio in the bloodstream (Bohr Effect). Mouth breathing eliminates the possibility of ideal physiologic breathing, allowing “dirty air” containing microbes, pollutants, pesticides, smog, allergens, pollen, and spores, to pass through the mouth straight to the lymphoid tissues of the adenoids and tonsils. This can result in both inflammation and infection in the posterior throat.
Are You Experiencing Symptoms of a Sleep-Related Breathing Disorder?
Robert Sorin, DMD PC is a patient-centered, relationship-based dental practice dedicated to delivering optimum health, comfort, and beauty. We can evaluate and provide treatment options for your Sleep-Related Breathing Disorder, and welcome patients to our midtown Manhattan cosmetic/restorative dental office from 8:30 am to 5:30 PM Monday and Wednesday, and from 7:30 AM to 5:30 PM on Tuesday and Thursday.