How Do I Know If I Have Obstructive Sleep Apnea?
Most people know if they snore because someone tells them that they do. Obstructive sleep apnea (OSA) is the most severe sleep-related breathing disorder (SRBD). This is recognized as a major public health concern and the prevalence in the general population is increasing. You will read very different estimates on the percentage of people with this disorder from about 2% to 20% of men and women worldwide! The real question you probably have is, ‘how do I know if I have obstructive sleep apnea?’ and whether or not it should be treated.
Your dentist should be able to do more than just use these tools that everyone loves!
Obstructive sleep apnea is all about the airway closing off as the tissues in the throat and the tongue relaxes causing breathing to actually stop for a time. What usually happens is that the body is startled awake in order to help you breathe again. This may happen several times during the night! Persons with OSA rarely wake up feeling very rested and alert. Morning headaches are common. There is a strong association with OSA and death from cardiovascular disease, type 2 diabetes and depression. Significant daytime sleepiness is known to be the cause of many vehicle accidents.
Obviously, breathing is important! The cycle of falling asleep, having your airway close off or collapse, and waking often with a startled gasp means you do not get enough oxygen and your sleep is interrupted over and over leading to or triggering other health problems.
What are common symptoms of Obstructive Sleep Apnea? Note that you could have some of these and not have sleep apnea, or even all of these and not have sleep apnea but something else that should be evaluated.
- Snoring
- Gasping for breath during sleep
- Choking during sleep
- Daytime sleepiness and fatigue
- Headaches
- Frequent nighttime potty breaks
A sleep test performed by a sleep physician will give you a definitive diagnosis. This test determines can your nighttime apnea-hypopnea index to count the total number of times you experience apnea (stopping breathing – no oxygen) or hypopnea (lowered breathing) events per hour.
As individuals age, their airways and bodies change in ways that may put them (you!) at higher risk for obstructive sleep apnea.
- Weight often increases over optimal levels
- Overall fat distribution even affects the tongue and neck
- Excessive weight may cause a tug on the trachea enough to make the airway longer and narrower (narrow = more restricted = easier to close off so that you cannot breath)
- The soft palate may lengthen
- Tissue in the back of the throat may increase
- The airway may become narrower and more restricted
Airway can be seen here as well as the whole uvula. This would be considered an open Class 1 airway.
Although these are generalities, a person is at a higher risk if they have any or all of the following:
- Large neck circumference (women over 15.5 inches or men over 17.0 inches)
- Really small neck circumference – less than 14 inches may indicate less airway room
- A small chin or a chin that is closer to the throat (recessed).
- A high or narrow palate
- Enlarged tonsils
- Double chin or very little indentation from the chin to the neck (lack of cricomental space)
- Deep overbite – more than 50% of the lower teeth are covered by the upper teeth when biting down.
- Falling asleep at inappropriate times
Ask your dentist to do a Mallampati classification or do one on yourself to gauge the amount of throat space and airway space available! Our office is very happy to do this simple test for you along with checking your neck, cricomental space and throat. We are happy to answer your questions about sleep apnea and now we can even offer our patients who have sleep apnea alternatives to wearing a CPAP machine that are every bit as effective!
Our office decided a couple years ago to add sleep appliance therapy and obstructive sleep apnea screening to our services years ago because we feel this is very important to our patient’s overall health. Each time you come to our office for a periodic exam we will include an airway assessment at no charge as part of your exam. It is a pleasure to be able to help our patients breath better at night!