Sleep Apnea

Sleep Apnea: Definition

Sleep apnea is a condition where people stop breathing while they are sleeping. It is a sleep disorder in which pauses in breathing or periods of shallow breathing occur much more than normal. Each pause can last for a few seconds or even a few minutes. They can occur many times each night, (anything more than 5x/night must be treated), usually followed by loud snoring. There may be a choking or snorting sound as breathing resumes. This disruption of one’s deep sleep (REM sleep) can have deleterious manifestations in one’s overall health. Patients complain of sleepiness or feeling tired, especially after lunch. There can be mood changes with spikes of irritability and lack of concentration. In children, we see the opposite, hyperactivity and attention problems. As the airway collapses the blood oxygen drops, releasing stress hormones (cortisol) in the bloodstream. This can lead to an increase in blood pressure and other cardiovascular problems. The medical disorders associated with sleep apnea include:

1. Various sleep disorders (insomnia)
2. Stroke
3. Heart attack, heart failure, and irregular heartbeat
4. Diabetes
5. Depression
6. Headaches
7. Lack of mental focus
8. Worsening of ADHD
9. Night Sweats
10. Sexual Dysfunction

Sleep Apnea Diagnosis

Sleep apnea can be very dangerous. It is important that if a person suspects that they may suffer from the malady; they should seek medical attention ASAP.

Dr. Dmytri Nikitayev is our sleep apnea expert. At a preliminary meeting, he will review your medical and dental history You will complete the Epworth questionnaire. He will examine the anatomy of your mouth and throat. He will measure your neck size, and study your face and bone structure.  He will ask questions about your sleeping habits and your mental focus during the day. If Dr. Nikitayev determines the need for further observation, he will suggest a Rhinometer and Pharyngometer test. The Rhinometer test measures the airflow of your nasal cavity with a tiny wand. As you breathe in and out from each nostril into the wand the results will show if the nasal airway is blocked. This blockage is called Upper Airway Resistance  Syndrome (UARS). If your nasal passages are severely obstructed we will advise you to see an ENT before any treatment by us commences.  If you are a candidate he will then suggest that you participate in an At Home Overnight Sleep Test (HST). 

Overnight Sleep Apnea Testing

172 NYC Dental provides patients with an option to perform this sleep test at their convenience and privacy of their own home, it’s an overnight test. We use the Watermark Home Sleep Testing Device. This device measures blood oxygen levels, heart rate, pulse rate, snoring index, sleep patterns, and positions. The results are sent to a laboratory and interpreted by a Sleep Specialist. The cost of the Home Sleep Test is low. For many their medical insurance will cover all or part of the cost. The results are interpreted by a Board of Certified sleep specialists. Once the monitors are set (worn on the top of the patient’s head); the patient goes to sleep on their own timetable. How long it takes a patient to fall asleep is also an important aspect of sleep apnea testing. 

Sleep is a complex activity. The  Sleep apnea monitor must correlate and measure everything pertaining to one’s sleep. The device will register the transitions and changes that occur during the sleep cycle. NREM (non-rapid eye movements and REM (deep sleep) are quantified every ninety minutes. Heart rate, eye movement, muscle, and brain activity are also measured. Sleep apnea testing helps to detect abnormal changes that take place during these transitions. Sleep Apnea is generally worse during REM sleep, so observing the patient for abnormalities while they are in REM (rapid eye movement) is particularly important.

Sleep apnea treatments include lifestyle changes, physical interventions, oral devices, surgery, prescription medicines, and breathing machines. In the concept of treating the whole person and simply not the symptoms; sleep apnea treatments will begin with lifestyle changes. These concepts include the avoidance of alcohol, limiting the use of sedatives and muscle relaxant medications, losing weight, and stopping smoking. Sleep apnea treatments can include using a special pillow or a device to keep patients from sleeping on their back.