Vail Daily health: Snoring is a not-so-silent Killer
Vail, CO Colorado
VAIL –While many people, especially unlucky spouses, consider snoring to be annoying or even obnoxious, there is increasing evidence that snoring is a sign of a much more dangerous problem. Obstructive Sleep Apnea (OSA) is a disorder where a person stops breathing multiple times a night because of a blockage of the throat or airway. OSA episodes can occur over a hundred times each night preventing the body from getting the quality sleep needed for normal body functions.
Common signs of OSA in addition to snoring are excessive daytime sleepiness, poor memory, depression, impotence, heart disease and uncontrolled or high blood pressure just to name a few. Essentially, the body suffers from oxygen deprivation or desaturation leading to these medical complications which would otherwise have been attributed to other sources. Dr. William Dement from Stanford School of Medicine and director of Stanford Sleep Disorders and Research Center has said that “sleep disorders in their various manifestations are arguably the number one health problem in the United States.”
The American Academy of Sleep Medicine estimates that there are at least 20 million Americans with Obstructive Sleep Apnea, 90 percent of which are not diagnosed. There is an alarming lack of knowledge about OSA both in the public at large and the medical community. According to the Sleep and Breathing Journal, over half of the dentists in the U.S. could not identify the common signs of OSA nor did they know the treatment options available. The survey also revealed that three quarters of physicians do not even screen for OSA.
This lack of understanding has resulted in an epidemic of complications associated with OSA. It has been shown that at least 1,400 traffic fatalities occur every year that can be directly attributed to people suffering from insomnia linked to OSA. One study conducted at Yale estimated that having untreated OSA for just five years leads to a 30 percent increase in premature death.
One of the largest contributors to the dramatic increase in OSA in the United States is the ever growing number of Americans that are obese. The latest statistics demonstrate that nearly one third of all Americans are currently considered to be obese. This problem is directly related to the rise in OSA cases. Men with a neck size of 17-inches or a woman with a neck size of 15-inches are prime candidates for developing OSA and should strongly consider be screened for this condition.
In the past the only option for diagnosing OSA was to do an overnight sleep disorders study in a hospital or sleep center. Even with the help of medical insurance, these studies are expensive and, because people are not in their natural sleeping environment, results are not always conclusive. The FDA has now approved several at-home or devices for screening and diagnosing OSA. These devices are usually administered by your doctor or a specially trained dentist and are much less expensive than traditional sleep studies. The results are very accurate as the person sleeps in their own bed and only has a small recording device to wear for the night.
Treatment options have also evolved and improved dramatically over the past few years. The “gold standard” treatment of OSA for many years has been the CPAP (Continuous Positive Airway Pressure Machine). This is worn while a person sleeps in order to push air through the mouth or nose. While this device has been proven to work, even in severe OSA cases, it is cumbersome and intrusive compliance or long-term usage is very poor due to the discomfort of being connected to a machine all night, every night, for the rest of your life. Many couples also report a lack of intimacy for these same reasons. So while it may save a person’s life it does not necessarily improve some of the ancillary problems created by severe snoring n the first place!
More recently, some dentists have become more involved in the treatment of OSA because of their ability to prescribe and fit patients with ‘oral appliances,’ which physicians can’t fabricate. These devices which are very effective in treating many forms of OSA especially moderate cases. Known as MADS (Mandibular Advancement Devices) they help prevent the collapsing of the airway by holding the jaw forward during sleep. Not only does this stop the snoring but because the airway remains open the medical problems of OSA are also prevented. MADS when prepared correctly are very well accepted and, as compliance studies show, are used for many years in at least 80 percent of the people fitted for them.
If you or someone you know suffers from snoring or excessive daytime sleepiness you should consult your physician or dentist with experience in sleep disorders. Not only could this help you or your bed partner get a better nights sleep, it could be the one thing that allows them to live a long and healthy life!
Dr. James Harding practices dentistry at the Vail Valley Center for Aesthetic Dentistry, in Avon. He is a preferred medical provider for the US Ski and Snowboard Team and is on the teaching staff at the Las Vegas Institute for Advanced Dental Studies. For more information, call 970-845-9980 or go to http://www.vailsmiles.com.