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What Is Sleep Apnea?
Sleep apnea is a serious, potentially life-threatening sleep disorder. It is as common as adult diabetes and affects more than 12 million Americans, according to the National Institute of Health. It owes its name to the Greek word apnea , meaning “want of breath” and refers to episodes in which a person stops breathing for 10 seconds or more during sleep. With each episode, the sleeper's brain briefly wakes up in order to resume breathing, resulting in extremely fragmented or poor quality sleep.

What are the different types of sleep apnea?
There are three types of sleep apnea, all of which can severely disrupt the regular sleep cycle:

• Obstructive apnea (OSA) —A s you sleep the muscles in the walls of your throat relax to the point where the airway collapses and prevents air from flowing into your nose and mouth, but efforts to breath continue . This is the most common type of apnea.
• Central apnea— Breathing interruptions during sleep are caused by problems with the brain mechanisms that control breathing.
• Mixed apnea— Begins with central apnea but usually becomes obstructive in the same cycle.

What are the symptoms of obstructive sleep apnea?
People with sleep apnea usually do not remember waking up during the night. Indications of the problem may include the following:

• Morning headaches.
• Excessive daytime sleepiness.
• Irritability and impaired mental or emotional functioning.
• Excessive snoring, choking, or gasping during sleep .
• Heartburn. (Acid back up that causes heartburn may be responsible for some cases of sleep apnea.)

What is the difference between snoring and sleep apnea?
Unlike mild snoring, individuals with sleep apnea stop breathing completely for 10 seconds or more. Typically, the frequency of waking episodes in a single night is somewhere between 10 and 60. A person with severe OSA may have more than 100 waking episodes. If your partner hears loud snoring, punctuated by silences and then a snort or choking sound as you resume breathing, this pattern could signal sleep apnea. While snoring and sleep apnea are related disorders, not all snorers will develop sleep apnea, and not all sleep apnea patients snore.

Why is sleep apnea a concern?
Studies have shown that patients with this potentially life-threatening disorder are so fatigued during the day that when driving, their performance is similar to that of a drunk driver. If left untreated, sleep apnea can lead to impaired daytime functioning, high blood pressure, heart attack and possibly stroke. If you already have a weakened heart, apnea can aggravate your condition by placing stress on your heart during sleep.

Who is at risk for developing sleep apnea?
It is estimated that as many as 18 million Americans have sleep apnea. It is more common in men, although it may be under-diagnosed in women and young African-Americans. Sleep apnea tends to run in some families, although no genetic link has been proven. Risk factors associated with OSA include the following:

• Loud snoring
• Physical abnormality in the nose, throat, or other parts of the upper airway
• Obesity
• High blood pressure
• Smoking, which can cause inflammation, swelling, and narrowing of the upper airway
• Use of alcohol or sedatives and sleep medications before bed can aggravate this disorder

How can my dentist help?
If your dentist suspects you suffer from sleep apnea, he or she may refer you to a physician or a sleep specialist. For a proper diagnosis, you may have to undergo an overnight sleep study, called a polysomnography, which measures heart rate and how many times breathing is interrupted. If you have been diagnosed with sleep apnea, your dentist can work closely with the diagnosing physician to implement and manage the prescribed therapy.

What are my treatment options?
Treatment is based on your medical history, physical examination, and the results of polysomnography. If you have mild obstructive sleep apnea, initial treatment may include avoiding sleeping on your back. Dental appliances that reposition the lower jaw and the tongue have been helpful to some patients with mild sleep apnea, or those who snore but do not have apnea.

If you have severe sleep apnea, nasal continuous positive airway pressure (CPAP) systems—resembling something a jet pilot might wear—is a commonly prescribed physical therapy. CPAP delivers air through a small mask that covers the nose, and the constant pressure keeps the airway open, which prevents both snoring and episodes of apnea. If a patient has trouble tolerating CPAP, surgery also can eliminate OSA symptoms; but medications are generally ineffective.

Oxygen administration may safely benefit some patients with central sleep apnea caused by heart failure. But oxygen is a controversial treatment and it does not eliminate sleep apnea or daytime sleepiness. It also is not used to treat patients with OSA.

The Academy of General Dentistry is a non-profit organization of more than 37,000 general dentists dedicated to staying up-to-date in the profession through continuing education. A general dentist is the primary care provider for patients of all ages and is responsible for the diagnosis, treatment, management and overall coordination of services related to patient's oral health needs. Learn more about AGD member dentists or find more information on dental health topics at www.agd.org/consumer.

CONTACT: Susan Urbanczyk, public relations manager, at 312.440.4308 or media@agd.org or Jennifer Starkey, public relations coordinator, at 312.440.4341 or media@agd.org.

NOTE: Information that appears in General Dentistry, the AGD's peer-reviewed journal, AGD Impact, the AGD's newsmagazine and related press releases do not necessarily reflect the endorsement of the AGD.