You may have been wondering whether you suffer from sleep apnoea or not, but it’s incredibly difficult for you to diagnose it yourself.
Reading this will help you to understand what exactly sleep apnoea is defined as, and how it affects your body.
Sleep apnoea can be described as a sleep disorder where you stop breathing for prolonged periods of time, causing you to briefly wake up and never fall into a deep sleep.
Common symptoms of sleep apnoea
There are many signs of sleep apnoea, but the largest one is snoring. Snoring not only impacts your sleep, but it also impacts the sleep of your partner, and others around you.
People will usually find snoring as an embarrassment, which also causes them to struggle to have a good night’s sleep.
Snoring can also be a sign of obstructive sleep apnoea (OSA), the condition in which your upper airway is obstructed; which can also be a precursor to a more serious medical issue such as heart disease, stroke, and high blood pressure.
Generally, your partner will be better at diagnosing your sleep apnoea as they will notice many of the symptoms, like snoring or choking.
However, some symptoms you can identify yourself include:
- Frequent sleepiness or fatigue throughout the day
- Restless sleep
- Waking up repeatedly
- Grinding your teeth at night
- Waking up with headaches
- Tossing and turning throughout the night
- Feeling out of breath, tired, or very thirsty upon waking up
What causes sleep apnoea?
Obstruction in the throat is the most common cause of sleep apnoea, as it makes it difficult to breathe.
Naturally when we sleep, all of our muscles relax, including our throat muscles. Sleep apnoea causes the muscles to relax too much, causing blockages to your airway. Once your brain becomes aware of this, you briefly wake up to open your airway back up; this wake up is usually so brief you do not remember.
Sleep apnoea can also be caused by a far less common issue when your brain fails to transmit signals to your breathing muscles. This means your body makes no effort to breath for a short time, which may cause you to wake up with a loss of breath.
There are a number of risk factors which increase the chances of suffering from sleep apnoea, including, but not limited to the following:
- Being overweight – Obesity increases the chances of sleep apnoea, as fat deposits around your airway may obstruct breathing.
- Narrowed airway – Maybe you have a narrow airway, which immediately increases the chances of suffering from obstructed breathing. Tonsils and adenoids can also block the airway.
- Old age – Higher occurrence of sleep apnoea in older people.
- Family history – Unfortunately sleep apnoea can be genetic. If family members in the past have suffered sleep apnoea, you too may be at a higher risk.
- Alcohol and sedatives – Both of these relax the muscles in the throat, which can make sleep apnoea worse.
- Nasal congestion – If you have nasal congestion temporarily or chronically, you may suffer from obstructive sleep apnoea.
- Smoking – Smoking increases the chances of sleep apnoea, usually because your upper airway can become inflamed due to smoke.
- Males – Sorry males, unfortunately men are recorded to be two to three times more likely to have sleep apnoea than women. However, for women, menopause increases the risks of sleep apnoea.
Treatments to cure sleep apnoea?
The CPAP machine works by creating a constant flow of air to the lungs, which keeps the airways open. However, patients may find the CPAP mask as an annoyance and uncomfortable.
For this reason, at TMJ Centre Melbourne we prefer the mandibular advancement splint (MAS) device based on patient’s compliance to both treatments.
TMJ Centre Melbourne treats sleep apnoea and snoring by improving the position of the jaw, head, and neck. The aim for improving the position is to help reduce or remove pressure from your airways.
Dr Shah our TMJ doctor can design you a MAS, also known as a bite plate, that gently moves the jaw forward and down.
While our chiropractor will use methods to ensure your airways from the nose to the throat are as clear as possible. They will also make sure your nasal is clear to ensure nose breathing at night, as this is key to getting a good night’s sleep.
We further consult with ENT (ear nose throat) surgeons, sleep physicians and general practitioners when required, to ensure you receive the best treatment.
Mandibular advancement splint
The MAS gently moves the jaw forward and down. This tightens the soft tissues and muscles of the upper airway to help prevent breathing obstructions during sleep. The tightening can also stop snoring, as it reduces vibrations in the upper airway when air passes through. The full effects of the MAS device can be found in this journal which explains the advancement on the upper airway structure in obstructive sleep apnoea.
The following case study was undertaken by Chan ASL, et al. (2010). ‘The effect of mandibular advancement on upper airway structure in obstructive sleep apnoea’. Thorax. 65, pp. 726-732. doi: 10.11.136/thx.2009.131094.
The journal addresses a study which was undertaken using a sample of 69 patients who suffered from sleep apnoea. These patients had no significant differences between age, BMI or gender.
Sleep apnoea’s severity can be measured by the Apnea-hypopnea index (AHI):
- Normal pattern: AHI<5
- Mild sleep apnoea: 5≤AHI<15
- Moderate sleep apnoea: 15≤AHI<30
- Severe sleep apnoea: AHI≥30
AHI refers to the apnoea events suffered per hour (events/hr), apnoea’s refers to pauses in breathing.
These 69 patients selected who suffered from OSA, underwent treatment using a custom-made MAS.
The mean AHI of the patients was 27.0±14.7 events/hr before undergoing MAS treatment, which meant the patients suffered from mild to severe sleep apnoea.
The study defined the results by categorising the patients into two groups, “responders” and “non-responders”. Responders are patients who achieved a ≥50% reduction in AHI, while non-responders are the patients who achieved a <50% reduction in AHI.
After the patients underwent MAS treatment, the mean AHI of the patients was drastically decreased to 12.2±12.5 events/hr, with 36.2% of the patients achieving <5 events/hr after treatment.
Out of the 69 patients, 47 were listed as responders and 22 as non-responders. However, the study found that between both groups, there was little difference in mandibular advancement, volume of the airway, soft tissue structure or skeletal structure.
The 47 responders had a mean of 7.7±7.3 events/hr post treatment, and 53.2% of these respondents were able to achieve a full response (reduction to <5 events/hr); while 46.8% achieved a partial response (≥50% reduction in AHI, ≥5 events/hr).
If you would like to view the case study to view the full results and how exactly the MAS device works, then please click here.
Sleep apnoea can become very detrimental to your health, so it is recommended to come visit us at TMJ Centre Melbourne if you find yourself suffering. We offer treatment from both a TMJ dentist and chiropractor at the same time, which has many benefits. For more information regarding sleep apnoea, snoring, TMJ disorders, or to book an appointment, please contact us here.