No one likes to be told that they snore loudly. It can be a serious inconvenience for your bed partner and a source of embarrassment for you. But did you know that snoring is often a sign that you suffer from sleep apnea? This serious health condition impacts about 12 million people across the country and can place you at risk of other serious disorders if it is not treated properly.
What Is Obstructive Sleep Apnea?
Obstructive sleep apnea is the most common form of sleep apnea. This type of sleep apnea occurs when the muscles in the back of the throat relax. Because they support all of the surrounding tissues, such as the tonsils and side walls of the throat, when these muscles relax these tissues can collapse inward, narrowing the airway or completely blocking it. In some people their tongue can also fall backward a bit, blocking the upper airway. In others, the airway tissues simply aren’t rigid enough and collapse on themselves. When we’re awake, our brains make sure our tongue stays out of the way and it makes sure we keep the muscles involved with our airway rigid. And, of course, we’re not lying down so gravity doesn’t play a part. But when we’re asleep, our brain isn’t paying attention, until it is forced to rouse the person because the airflow has been blocked.
Over time, obstructive sleep apnea can place you at a greater risk of developing conditions such as:
- Heart attack
- Cardiac arrhythmia
- High blood pressure
- Gastric reflux
How Is Sleep Apnea Diagnosed?
Dr. Fleschler will evaluate your symptoms and you’ll be asked to provide a sleep history/sleep diary. You’ll need help from a spouse or partner for this.
From there, evaluation will likely include overnight monitoring at a sleep center, or possibly a home sleep test will suffice. These are the two typical tests used to detect sleep apnea:
. Nocturnal Polysomnography
— At a sleep center, you are hooked up to equipment that monitors your heart, lung, and brain activity. It also records breathing patterns, arm and leg movements, and blood oxygen levels while you sleep.
. Home Sleep Tests
— Testing may be able to be done at home by using portable monitoring devices. These devices provide simplified testing, usually of your heart rate, blood oxygen level, airflow, and breathing patterns.
In certain situations, Dr. Fleschler may work with a local sleep center to more accurately diagnose the cause of your condition.
Symptoms Of Sleep Apnea
- Chronic fatigue
- Daytime sleepiness
- Waking up with a choking or gasping sensation
- Reduced sex drive
- Weight gain
- Headaches in the morning
- Short term memory problems
- Difficulty concentrating
- Sore throat or dry mouth
If you suffer from one or more of these symptoms, Dr. Fleschler can perform a sleep evaluation to determine whether sleep apnea is the cause.
Sleep Apnea Treatment
Once we have performed a thorough diagnostic exam, Dr. Fleschler will devise a customized sleep apnea treatment plan based on your unique condition. For mild cases of sleep apnea, you may be able to alleviate the condition by making minor lifestyle adjustments.
However, for more serious cases, Dr. Fleschler may recommend one of the following treatments:
- Oral appliance therapy
- CPAP (continuous positive airway pressure)
- Positional sleep therapy
Oral Appliance Therapy
With oral appliance therapy, you will wear a customized mouthpiece during sleep to maintain an open airway. These FDA-approved devices perform several important functions to prevent your soft tissue from collapsing and blocking your airway:
- Stabilize your tongue and jaw to eliminate any airway obstructions
- Reposition your soft palate, tongue, and lower jaw
- Support your muscles to help prevent a collapse of your airway
Dr. Fleschler typically prefers oral appliance therapy as her sleep apnea treatment method of choice due to the effective results that can be achieved.
For decades, CPAP (continuous positive airway pressure) was considered the gold standard for sleep apnea treatment. It is a device that uses a mask worn over your nose and mouth to deliver a constant flow of air pressure while you sleep. This air pressure helps keep your airway open all night.
While CPAP is an effective sleep apnea treatment method, many patients find the device to be rather uncomfortable and as a result, don’t use it as often as necessary to achieve their desired results. For this reason, Dr. Fleschler will often recommend oral appliance therapy before trying CPAP.
Treatment Options For Mild Cases Of Sleep Apnea
If you only suffer from a mild case of sleep apnea, Dr. Fleschler may simply recommend a series of lifestyle adjustments to keep your airway open while you sleep. These often include:
- Cutting back on alcohol consumption
- Quitting smoking
- Losing weight
- Modifying your sleeping position so that you are on your side instead of your back
- Eliminating heavy meals right before bedtime
- Using additional pillows to elevate your head and facilitate breathing while you sleep
In more severe cases of sleep apnea, these lifestyle adjustments may not be effective on their own. In these situations, Dr. Fleschler may explore other treatment options as well.
Can Sleep Apnea Be Treated Surgically?
If sleep apnea patients don’t respond to oral appliance therapy, CPAP, or other non-surgical treatments, surgery may be necessary. Surgery is tailored to the area of obstruction in each particular patient. These areas of obstruction can be anywhere in the upper respiratory tract, including the nose, tongue, and throat. Here are the most common surgical approaches, along with brief descriptions:
. Nasal Surgery
— The septum, tubinates, and the nasal valve often contribute to obstruction. Surgery may straighten out the septum and reduce the size of the turbinates. If the nasal valve is weak and tends to collapse, cartilage can be placed to strengthen it.
— This procedure is the most common surgery. It removes tissue from the soft palate and the pharynx. It will also remove the tonsils, if they still remain.
. Soft Palate Implants
— Three polyester rods are placed into the soft palate to stiffen it.
. Hyoid Advancement
— This procedure repositions the small hyoid bone to keep the tongue from falling back and obstructing the airway.
. Tongue Advancement
— This procedure involves advancing one of the main tongue muscles forward.
. Tongue Base Reduction
— The base of the tongue can be reduced, either by using repeated treatment with radiofrequency waves or by excision.
. Lower Jaw Advancement
— This complicated procedure achieves enlargement of the entire upper airway through expansion of the skeletal framework that encircles the airway.
Sleep Apnea FAQs
There are certain characteristics/risk factors that make it more likely someone would suffer from sleep apnea. These are:
- Having a neck circumference over 17 inches
- Being obese
- Having overly large tonsils and adenoids
- Having a small lower jaw with a deep overbite
- Having a family history of sleep apnea
Leaving sleep apnea untreated is a bad idea; you’re basically rolling the dice on various serious health concerns. Your body needs consistent deep sleep to repair tissues and other body processes; it does this while we sleep. Sleep apnea can cause serious damage to your body, even shortening your life. Not treating sleep apnea can lead to high blood pressure, heart disease, stroke, automobile accidents, diabetes, depression, and other health problems.
Positional sleep therapy is a behavioral strategy used to treat what it known as “positional sleep apnea,” which generally occurs when a person sleeps on his or her back. The idea is to keep the patient sleeping on their side, rather than their back. This therapy may include wearing a special device around your waist or back that keeps you sleeping on your side. There is also another option that uses “vibro-tactile feedback.” This is worn on the back of the neck, and when the patient starts to sleep on their back it gently vibrates. This doesn’t wake the person, but it does signal the body to change positions.
There are certain lifestyle choices that could be leading to your sleep apnea. These changes may help you reduce the effects of sleep apnea:
- Maintain a healthy weight — People who are overweight, especially those who carry weight around the jaw and neck, are more likely to have sleep apnea than those who maintain a healthy weight. The extra fat and tissue around the neck can easily sag and create blockage in the airway.
- Avoid alcohol or drugs — Alcohol and certain drugs act to relax the central nervous system. This can cause the muscles of the throat to relax, leading to blocking of the airway.
- Quit smoking — Cigarette smoking decreases lung capacity and it shrinks blood vessels. Both of these play a part in sleep apnea in smokers. Quitting will improve the way your body breathes.
- Address allergies — If you have allergies, taking a decongestant before you go to bed may improve airflow through your nose.
The long term health risks associated with sleep apnea can be very serious. Failure to treat the condition can result in a greater risk of heart attack, stroke, diabetes, gastric reflux, or high blood pressure. For this reason, it is crucial that you seek sleep apnea treatment as soon as you notice any warning signs.
Dr. Heather Fleschler has been treating sleep apnea patients in the Houston areas of West University, River Oaks, Meyerland, and Bellaire since 2004. She can determine whether you are suffering from sleep apnea and create a customized treatment plan to provide you with the relief you need.
If you think you may be suffering from sleep apnea, please call (713) 660-6500 today to schedule a sleep apnea evaluation at our Houston office.
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“I love Dr. Fleschler’s work, her office, and employees. I never wait long to be taken back for treatment. When I’m in the back I’m made really comfortable by her hygienist/assistant. I love this place!” –Thresa P.
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Dr. Heather Fleschler understands the serious risks associated with sleep apnea, and she can help you devise a treatment plan that will alleviate the condition, restoring a restful night's sleep. Please call (713) 660-6500 today to schedule a consultation. Dr. Fleschler serves patients in the West University, Bellaire, River Oaks, and Meyerland areas of Houston.