Sleep Apnea

Sleep Apnea Symptoms

Sleep Apnea and Sleep Apnea Specialists

 “Turn over your snoring again” followed by a swift kick in the rump. How about waking up to find that your sleep partner is holding a pillow over your face. If you have experienced any of these moments you may indeed have Sleep Apnea. If you are interested in keeping your relationship together and protecting your health, book a complimentary consultation at 172 NYC Dental with our sleep apnea specialist, Dr. Dmitry Nikitayev. 

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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.

Sleep apnea side effects

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.  

Sleep Apnea Treatment Options

CPAP Machine

CPAP (continuous positive airway pressure). This appliance consists of an apparatus that pumps the air into the mask through the air tubes. The treatment consists of the patient wearing the CPAP mask while they are asleep. The masks cover the nose and mouth. A CPAP pump controls the stream of air going into the mask. This pressure holds the floppy muscles of the throat, in position preventing them from closing the airway. The doctor determines the amount of pressure to be used. These masks are effective but compliance has been an issue. If a CPAP machine or surgery is recommended, you will be referred to a cardiologist or ENT doctor. All of your findings and results and our prescription will be forwarded to the doctor.

CPAP MACHINE

Dental Sleep Apnea Appliance

Dental sleep apnea appliances are worn only at night ( or when a person traditionally sleeps). They fit like an orthodontic retainer. The appliance supports the jaw in a down and forward position to help maintain an open, unobstructed upper airway. Research shows that the dental oral appliance is an effective therapy for snoring and obstructive sleep apnea. This device is meant to treat those with mild to moderate OSA. It is easy to wear, easy for travel. Sleep apnea mouthguards are by far the most popular option. It should be noted again that for patients diagnosed with severe sleep apnea; the CPAP machine is the gold standard of care. According to many studies, though the CPAP machines considered to provide a better solution for patients with severe sleep apnea; due to their many restrictions, discomforts, and numerous side effects, many patients end up switching to sleep apnea mouth guards for their comfort and ease of use.

 At 172 NYC Dental Impressions and records for the Sleep Apnea Oral Appliance can be taken on the same day that you receive your results. These include study models done with a tiny wand, no more gooey gagging impressions in our office. This Is the magic of 3D Imagining. We take measurements that depict the horizontal and lateral movements of your mouth. These records will then go to our premier sleep apnea laboratory. The company that we use is called Somnomed. They make several different types of appliances depending upon the particular needs for each patient.  We use the Herbst Advance, the Flex, Air, and Suad varieties. Many people are now undergoing Invisalign orthodontic treatment; where they wear clear retainers at night. A special type of sleep apnea appliance can be made to fit over these trays. So that orthodontic and breathing problems can be treated all at the same time.

Surgery

In cases where the apnea is caused by a physical deformity, surgery might be required before any appliance is prescribed. The success rate from surgical procedures is not high. It is also one of the most invasive procedures used to treat sleep apnea. Commonly surgeons remove and tighten tissue to form a more patent (open) airway.

Medications

Prescription medicines are another possible treatment. They have not been proven to be very successful. Stimulants are given to reduce the number of apnea episodes each night. The side effects can be pronounced such as palpitations and insomnia. In cases where patients aren’t sleeping well, stimulants may be given to prevent daytime drowsiness. Overall we feel that this is an ineffective way of treating the problem.

Book a Sleep Apnea Consultation with 172 NYC Dental

At 172 NYC Dental, we feel that diagnosing and treating Sleep Apnea is a fundamental part of our mission to deliver comprehensive dental care to our patients. We have the cutting edge diagnostic equipment, we have the experience and expertise. Make an appointment for a complimentary Sleep Apnea consultation.

 

Schedule an appointment today! Book Online 212-355-2290

What Our Patients Are Saying

With over 1000 reviews from all over the webwith an average rating of 4.9 we are proud to be in the Manhattan Dental Elite.
I had a wonderful experience with Dr. Nikitayev. Dr. Nikitayev was professional, gentile, and caring. He didn’t over-assess and provided possible options without imposing them. He explained every step of the process and I didn’t feel a thing (even without [...] Suh Eun Kim | google
Had to get an infected wisdom tooth extracted and some minor gum surgery. All I can say is if I could give him 10 stars I would. The procedure went smoothly. I didn’t even know he had already extracted my [...] Yolanda F | google
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I happened to pick NYC Dental as my dentistry when I moved to NYC, which happened to be a great choice. It is easy to schedule an appointment here, and the staff is very helpful and have explained my coverage [...] Eric K | yelp
“I have been a client for several years and this dental office has basically saved my mouth and left me great teeth!! Several gum and deep cleanings etc proven to give me confidence and I am thrilled with this dental [...] Deborah F | demandforce
” Dr. Ahn is amazing. I fractured a tooth and came in the same day as a new patient on an emergency basis as I was in terrible pain. The tooth was extracted and a bone graft put in place. [...] John D | yelp
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“Best practice in the city!!! Would not go anywhere else… Every dentist, periodontist, Doctor, nurse, receptionist is amazing. They work with you and insurance while remaining to be a top motch office. They are really the best and I’m so [...] New York City Patient | heathgrades
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“I have been going to this practice for many years now. I have seen a few different dentists here and they are all terrific. The staff is helpful, friendly and on top of things. I highly recommend this office if [...] Lisa A. | yelp
– “I happened to pick 209 Dental as my dentistry when I moved to NYC, which happened to be a great choice. It is easy to schecdule an appointment here, and the staff is very helpful and have explained my [...] Abhinav R | google
“Dr. Ben Ifraimov is the best. He has been our family dentist for the last decade or so. He is very professional, efficient, conservative in his treatments, and always listens to and time for his patients. Recently, I had a [...] Khristina N | yelp
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The best experience at the dental office. Extremely professional. | facebook
I’ve been going to 209 dental for years. I now live in long Island and still make the trip out for my appointments. Dr’s Ahn and Kafko are caring individuals. Best dental experience ever! Anna G | yelp
Oxanna is the absolute best hands down best cleaning ever!!! Dr Wang and Laura are simply amazing!. I would never go anywhere else this place is top-of-the-line. Melissa P | yelp
“This is first dental practice I look forward to going to. The front desk staff, hygienist and dentists are some of the friendliest and best in Manhattan.” Erin | yelp
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“Everyone there is so nice and patient with overgrown toddlers like myself haha. I recommend Dr. Ahn and Dr. Wang especially.” Shelly Kanner | yelp
“I have always liked Dr Anh and the staff! That is not true of many medics or their staffs.” Susan K Manning | yelp
“I’ve been seeing Dr. Ahn for my Invisalign and I’m very happy about the service at 209 NYC Dental and the result. Dr. Ahn is knowledgeable, detailed and patient.” Kana | yelp
“My surgeon recommended seeing Dr Ahn after I had an implant and I can not be happier with the quality of care that I have received not only from him but also from the staff at 209 Dental.” Jules W. | yelp
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