How is Sleep Apnea Treated?

There have been a multitude of theories about what causes sleep apnea. Because of this there have been many treatments proposed as well. The solutions range from surgery on the various tissues in the nose, mouth and throat; to CPAP (continuous positive air pressure) and a very large selection of oral and nasal appliances. Because people vary in their response to treatment, many of these therapies have worked for at least some people. The best treatment is that which keeps the airway open with the fewest negative side effects and risk. Additionally, the treatment must be one which people will use.

 

CPAP meets many of the criteria for success. It opens the airway, has few side effects, has a low risk profile and is readily available. However, many people find the mask, tubes and associated maintenance to be too cumbersome and uncomfortable to use on a daily basis.

 

Surgery, likewise, has its proponents and for some conditions surgery is necessary. For instance, to remove overgrown tissue from the airway or correct malformed jaw bones. Surgery, however,  does not have a low risk profile, can have significant side effects, requires highly specialized skills and must be done in an operating room environment.

 

Oral appliances are suggested as a first line treatment for mild and moderate sleep apnea. Oral appliances can also be effective for severe sleep apnea and are used frequently is patients who don’t tolerate CPAP. Oral appliances require at least a few teeth to hold them in and do put a strain on the teeth and supporting structures. This is usually not significant. We will help with determining if your teeth are strong enough.

 

The key takeaway is that we seek to limit the bad effects of sleep apnea on your health with the fewest treatment side effects. The only way to know how you will respond to treatment is to measure your sleep apnea both before and after treatment. This is done with a home sleep test which records many parameters of sleep during the night. Both the experience in working with different devises and the ability to monitor the results of therapy are the reasons to choose professional help in treating your own sleep disorders.

 

The consequences of poor sleep are serious and substantial. We have a quick, easy and well thought out process to help you. Please contact us.

Seven signs of SDB in Children

Sleep matters. At no time in medical history has this been clearer. During the critical formative years, making sure that children get the restful, quality sleep they need is vital.

For children, the symptoms of sleep-disordered breathing — including OSA (Obstructive Sleep Apnea) and snoring — have been shown to negatively impact behavior and the ability to pay attention. Much was learned about this in the Avon Longitudinal Study of Parents and Children that examined the impact of mouth breathing, apnea and snoring on behavior in a group of more than 11,000 subjects spanning from infancy to age 7. This study uncovered a litany of connections between sleep-disordered breathing and heightened risk of attention deficit hyperactivity disorder, tendencies toward aggression, anxiety disorders, and behavior problems. The authors found that sleep-disordered breathing symptoms occurring before age 5 were associated with a 40% greater chance of special education needs by age 8.

Because their brains are still developing, screening for sleep disorders is paramount for children, as any hindrance in adequate oxygenation, and therefore parasympathetic sleep, can have an immediate and lasting effect.

Physically, evidence of sleep-disordered breathing presents in myriad forms, such as a long and narrow face, habitual open-mouth posture or venous pooling (dark circles under the eyes). Behavioral symptoms might include chronic mouth breathing, hyperactivity, snoring or bedwetting.

The seven common signs of sleep-disordered breathing include:

  1. High/narrow palatal vault
  2. Mouth breathing
  3. Clenching and grinding or tooth wear
  4. Enlarged tonsils and adenoids
  5. Allergic rhinitis or prevalence of allergy symptom
  6. Tongue tie and/or lip tie
  7. Maxillary and mandibular deficiency       

If a clinician detects any of these symptoms, the next step would be to get the parents/caregivers involved. Key questions might include:

  • Does the child snore, or make any noise while sleeping?
  • Does he or she stop breathing for short periods during sleep?
  • How rested does the child seem upon waking?
  • Has he or she experienced behavior issues at home or school?

Assessing a child’s sleep habits can also help oral health professionals in treatment planning and educational efforts. Toward this end, the parent/caregiver should be asked not just how long a child sleeps, but also how well the child sleeps. Many adults will report their children sleep the whole night, which is usually a sign of adequate sleep quantity, but if the child shows signs of sleep-disordered breathing, the adult should be suspicious of possible poor sleep quality. Asking the parent/caregiver to spend 20 minutes watching the child sleep may help answer the first two question. How the clinician proceeds will vary based on relationships with other qualified health professionals, which, as previously noted, could include referrals to a pediatrician, ENT specialist, sleep physician, orthodontist, pediatric dentist or oral myofunctional therapist experienced in treating malocclusion that might be comorbid with sleep-disordered breathing and airway restriction. Utilizing a team approach will help optimize treatment for each patient.

Why Be Diagnosed and Treated for Apnea by Florida Snoring and Sleep Apnea Centers?

Hi. My name is Dr. Tim Morris and years ago I began my training in sleep medicine when it was realized that an oral appliance could be a successful treatment for many sleep breathing conditions from simple snoring to yes, even severe sleep apnea.

It was clear to us from the beginning, to best diagnose and treat patients, a model that was patient centered needed to be created.

This process had to be easy, quick and simple.

It was also clear this model had to not only include medical sleep specialists, but had to coordinate care between the professions so that the best interest of the patient could be addressed.  And that is exactly what we have done.

Once our patients have been screened with a simple questionnaire, the first step is for them to see a Florida sleep certified physician.  We have made this a simple process.  Our patients schedule their visit with our hand picked top notch physicians who are not only well versed in the science – but committed to including the patient in all decision making where appropriate. 

Your first visit is scheduled at either our Merritt Island or Hibiscus office where our physician will see you via telemedicine. 

If a sleep test is indicated, rather than being sent to a sleep lab to spend the night, a validated sleep test will be provided for you, and this simple test can be quickly done in your own home!  You will be given instructions about the test equipment at your interview visit, but there is also a 24 hour hot line you can call with questions.

The results of that test will then be reviewed with you at a follow up telemedicine visit.  At that visit treatment alternatives will be presented, and your preferences will be considered strongly. It is at this point our extensive training in oral appliance therapy for snoring and sleep apnea will play a major role in your treatment.   If this treatment is indicated and something you would prefer after being given all the information concerning this treatment and others, then plans can be made to start the treatment and the appliance can be constructed and delivered efficiently. 

All your questions will be answered at this follow up visit including your insurance coverage for whatever treatment is recommended. 

We will file insurance for you, including Medicare.

We have made it easy to be seen by a sleep physician, and have assured that the sleep physician you see is patient oriented and not biased towards any treatment.  We have made sure that whatever treatment is recommended, whether it is CPAP, an oral appliance, or anything else, you have a well-trained person guiding you through this process, to help answer your questions and address your concerns.

And, should an oral appliance be indicated, we can assure you that our high level of training will lead to the highest likelihood of long-term compliance and the highest possible efficiency.

We have created a patient centered alternative that helps assure you are properly and easily diagnosed and that the treatment is tailored uniquely for you. We look forward to seeing you in the near future.

A Primer on Sleep Apnea

Sleep apnea is a serious sleep disorder that occurs when a person’s breathing is interrupted during sleep. People with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times. This means the brain — and the rest of the body — may not get enough oxygen.

Millions of Americans suffer from sleep apnea, but many go undiagnosed and untreated, mainly because some of the telltale symptoms occur during sleep—frequent snoring, gasping for air, silent breathing pauses that can last seconds to minutes. Yet, as NHLBI-funded studies have found, sleep apnea can have severe health consequences over time if left untreated. The disorder has been associated with an increased risk of high blood pressure, heart attack, stroke, obesity, diabetes, and glaucoma. And new findings indicate that pregnant women with sleep apnea have a higher chance of developing high blood pressure and giving birth prematurely. 

The fallout is not just on individuals, but the public at large: because many with the disorder feel persistent sleepiness even after a full night’s sleep, untreated sleep apnea has been associated with lower work performance and a higher risk of while driving and at work.

So, what should the average person know? Here’s a quick primer:

Who’s affected most by sleep apnea? People of all ages, genders, and races suffer from sleep apnea, but African-American males, Asians, Native Americans, and Hispanics appear to have it more, compared to European whites. Excessive weight gain tends to increase the likelihood of getting the disorder, and it affects the severity of the breathing, too. That’s because excessive fat can cause the airway walls to thicken and narrow the inside of the windpipe, making it harder to keep open.  Finally, alcohol, smoking, and certain types of medications, such as opioid pain killers, can interfere with the control of breathing and increase the severity of sleep apnea. 

Are there different kinds of apnea? Yes, there are two main types:  obstructive sleep apnea and central sleep apnea.  Obstructive sleep apnea, the most common, is caused by blockage of the upper airway and results in temporarily impaired airflow during sleep.  This blockage sometimes causes loud snoring, snorting, and gasping, but not everyone who snores has sleep apnea.  Central sleep apnea occurs when the brain fails to send correct signals to your breathing muscles, resulting in breathing stoppage or abnormal breathing patterns. The frequency and severity of this stoppage is classified as mild, moderate or severe after an overnight sleep test has been performed.
 
What should you do if you think you have it? First take the short quiz on Sleep Apnea here.

If you score over 43 points we can arrange an appointment with a certified sleep physician, via telemedicine, in our Merritt Island or Hibiscus offices.

What treatments are currently available to help? No drugs are currently on the market for sleep apnea, but you can take certain steps to help keep the airway open during sleep.  Losing weight, sleeping on your side, and exercising throat muscles can reduce, in some cases, the severity of mild obstructive sleep apnea. The two most common treatments for sleep apnea are CPAP (continuous positive airway pressure) which involves an air pump, hose and mask; and a professionally fabricated oral appliance which keeps the airway open.

Are there other options? Surgery that widens breathing passages and implants that stimulate airway and tongue muscles: All may be recommended by a physician.  

In our next article on sleep apnea, we will discuss the various treatments in detail to give you a broad understanding on which option might work best for you.

At Florida Snoring and Sleep Apnea Center, we work together with physicians, sleep centers and dentists to effectively design and implement an individual treatment plan for you to manage your sleep problem. This is a medical condition and it is covered under your medical insurance. We are providers for major medical plans.

Dr. Timothy Morris has been working successfully with patients like you for over 20 years. He has received extensive training in this field and stays up to date on the latest improvements in sleep medicine.

To schedule an appointment with Dr. Morris, please contact one of the practices below:

Florida Snoring and Sleep Apnea Center
775 E. Merritt Island Cswy, Suite 115
Merritt Island, FL 32952
321-831-2961
Monday – Friday: 9am – 5pm

 

Florida Snoring and Sleep Apnea Center
1390 S Babcock St
Melbourne, FL 32901
321-831-2961
Monday – Friday: 9am – 5pm