Many people associate sleep apnea with snoring and heavy breathing during sleep. Even if these factors occur when you have the condition, the main cause of snoring is a brief blockage of the airways, which interrupts your breathing. When you stop breathing while asleep, the brain protects you by waking you slightly so you can restart breathing. Because of the abnormal pauses and restarts in breathing at night, you are unable to enjoy a healthy sleep and are susceptible to severe health complications in the future. Fortunately, you can manage sleep apnea, but to do so, you must identify its symptoms and causes.
Sleep apnea can happen due to airway blockage or failure by the brain’s command center to signal you to inhale. The best action you can take is to understand the symptoms and causes of the condition so you can discuss an appropriate treatment with your doctor. Additionally, a dentist can diagnose the condition during routine checkups and work with your doctor to provide the appropriate treatment.
Sleep Apnea at a Glance
Sleep apnea is a disorder that interrupts breathing while you sleep, especially at night. The condition pauses your breathing pattern when you fall asleep, as the muscles that keep the throat open relax. The throat relaxation initiates a disruptive cycle. When you stop breathing or experience an apneic episode, your blood oxygen levels drop. When this happens, the brain senses danger and activates a survival reflex that wakes you slightly and restarts breathing.
While the emergency brain signal keeps you alive, you do not remember in the morning, no matter the number of apneic events. Several apneic events a night disrupt your sleep and prevent you from getting healthy sleep. It is the reason you might wake up tired in the morning after a long night of sleep. Breathing interruptions also deprive essential organs, such as the heart, of oxygen, increasing the risk of developing severe health complications if you do not treat the disorder early enough.
Sleep Apnea Types
Sleep apnea happens in three main ways:
Obstructive Apnea
Obstructive apnea is the most prevalent form of sleep apnea. It occurs during sleep, when the throat muscles relax and compress the surrounding tissues against the windpipe (trachea), blocking airflow. The disorder occurs during recurring events, with partial or complete blockage of the airways. During this apneic event, you strain the chest and diaphragm muscles and apply extra pressure to open the blocked airways. When this happens, you deprive vital organs, including the heart, of oxygen, increasing the risk of heart-related issues.
Central Sleep Apnea
Abbreviated as CSA, central sleep apnea happens when the airways are unblocked. When you stop breathing, the body fails to transmit signals to the brain to activate the muscles, including the muscles involved in breathing, to restore normal function. The delayed neuronal transmission that occurs when you stop breathing causes a lag in the neurological function, leading to instability in the respiratory system and poor-quality sleep. This type of sleep disorder affects the central nervous system.
Mixed/Complex Apnea
Mixed sleep apnea is a combination of obstructive and central apnea.
Obstructive Apnea Causes
Obstructive apnea happens when the airway is physically blocked. To establish the cause of the condition, you must first examine the factors that increase the risk of blockage. When you sleep, throat muscles that support the airways relax, leading to the collapse or blockage.
Obesity
Obesity refers to excessive body fat. The fat not only builds up around the organs and the stomach but also accumulates around the neck and soft tissues of the tongue. When the tongue gains weight, it becomes heavy. If you lie on your back at night, gravity pulls the tongue towards the throat, which can cause breathing issues. The extra pressure from the fat around compresses the airways, narrowing the space for air passage. So, when you fall asleep, and the throat relaxes, the already narrow or compressed airways are completely blocked.
Excessive abdominal fat can also contribute to obstructive apnea. The fat applies upward pressure on the diaphragm, which compresses the lungs when you lie back during sleep. The excess weight of the stomach also compresses the lungs, reducing their volume. Reduced lung volume reduces windpipe traction, increasing the risk of the throat collapsing while you sleep.
For adults, the body mass index (BMI) that benchmarks obesity is 30 or higher. If you have a high BMI of at least 40, there is a 50% chance you have or will develop moderate to severe obstructive sleep apnea. Losing weight can be crucial in managing sleep apnea. However, weight loss does not cure the sleep disorder; it only reduces the number of apneic episodes you experience per night, improving your sleep quality.
Head and Neck Anatomy
Obstructive sleep apnea does not affect people with excessive weight alone. Even if you have a healthy weight, you could still suffer from the disorder because of natural anatomical reasons that affect the structure of your head and neck.
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A Receding Chin
The first reason is a receding chin. If your jaw slopes backwards toward the neck rather than sticking out, the space behind your tongue will be minimal, causing it to sit farther back near the throat and blocking the airways.
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Large Tongue
Also, you could develop obstructive apnea if your tongue is too large for your mouth. When you fall asleep, the large tongue can pull back, blocking the airways. The position of your tongue can block the airways, momentarily interrupting breathing. Many people unconsciously block their airways with the tongue for a few seconds without noticing. However, when you have a naturally larger tongue, you can struggle to maintain the position of the tongue to prevent airway blockage, especially when you fall asleep, causing obstructive apnea.
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A Vaulted or Narrow Mouth Roof
Having a narrow or vaulted palate or mouth roof also causes sleep apnea. A vaulted palate means your nasal cavity is also small, restricting breathing through the nose. If you cannot breathe through your nose properly, you are forced to rely on your mouth, which elevates the risk of a dry throat. When the throat dries up, the tongue pulls backwards, blocking the airways. Also, opening the mouth to breathe while sleeping can cause the chin to drop back, leading to obstructive apnea.
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Large Neck Circumference
Even people without obesity can have a naturally large neck circumference. A large neck can physically compress the airways, leading to sleep apnea.
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Large Tonsils
Large tonsils can also cause obstructive sleep apnea. Tonsils are tiny glands near the pharynx. The role of the tonsil is to prevent harmful germs that enter the breathing system from reaching the lungs. A normal human being has three tonsils. While they take up a small space in the pharynx, some individuals have larger-than-usual tonsils, which obstruct the upper jaw muscles when you lie on your back. The large tonsils cause the throat muscles to collapse, blocking the airways, which momentarily interrupts your breathing until the brain activates the survival signal, which wakes you up to reopen the airways and restart breathing.
If you have these structural characteristics, whenever you fall asleep, and your throat muscles relax, your airways can collapse, causing sleep apnea.
Lifestyle Triggers
Certain habits can collapse an otherwise narrow airway by triggering extreme relaxation of the throat muscles. The throat muscles keep the airways open. However, habits, such as taking alcohol or smoking before bed or sleeping on your back, can weaken these muscles, increasing the risk of airway collapse.
Alcohol and Other Sedatives
Alcohol is a muscle relaxant. So, when you take it before bed, it causes the throat muscles to relax more than when you are having natural sleep, leading to snoring and possible airway collapse. What makes alcohol more dangerous is that it can prevent the brain from sending survival signals to the body so that you can wake up and breathe, leading to severe obstructive apnea.
Cigarette Smoking
Another habit that can trigger obstructive apnea is smoking. The habit causes throat irritation and inflammation, which can adversely impact the airways, causing sleep apnea.
Sleeping on your Back
Lastly, sleeping on your back can trigger sleep apnea, especially in adults. It pulls the tongue, jaw, and palate back into the throat, leading to positional obstructive apnea.
Sleep Apnea Risk Factors
Anyone is at risk of sleep apnea. However, the risk of developing the sleep disorder is higher in some individuals than others. The risk factors of the disorder include:
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Age and Gender
Aging causes a natural loss of muscle tone, which affects even the throat muscles. As you age, the throat muscles weaken and sag, increasing the risk of collapse. While you cannot avoid aging, you should avoid any triggers that could increase the risk of airway blockage.
On the issue of gender, males over 50 years are more likely to be diagnosed with sleep apnea than their female counterparts.
On the issue of gender, the risk of developing sleep apnea in women is lower than in men because of a respiratory hormone called progesterone. The hormone elevates your breathing drive and is more common in young women. However, when they reach menopause, the hormone decreases, and the risk of sleep apnea becomes similar to that of men.
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Family History or Genetic Predisposition to Apnea
Genetics can cause you to inherit natural anatomical characteristics that cause sleep apnea, such as a narrow palate, large neck circumference, large tongue, large tonsils, or a receding jaw. If your family has a history of sleep apnea, you will likely inherit the disorder because of your genetics. If you learn that your genes predispose you to the disorder, you should take steps to reduce your risk of the condition.
Other factors include:
- Health conditions, such as acid reflux, hypertension, or heart disease
- Obesity
How a Dentist Can Help
Most patients discuss their sleep disorders with physicians and doctors specializing in the condition. However, dentists play a critical role in diagnosing and treating sleep apnea. In most situations, they are the first to identify the condition's symptoms during routine dental checkups. During biannual dental checks, the dentist evaluates your mouth and neck for any abnormalities. The vivid view of your mouth’s anatomy enables them to look for signs of diseases, including sleep apnea. Identifying these symptoms early is crucial in starting treatment to cure the disorder. External indications that could indicate to your dentist that the airways are straining include:
- Having a tongue that is large enough and not proportionate to your jaw
- Having a narrow or vaulted mouth roof
- Visible signs of throat inflammation or irritation
When your dentist spots signs of sleep apnea, they will refer you to a doctor specializing in the condition for a certified diagnosis. If the condition is moderate, your dentist can manage it with a mandibular advancement device, which holds the jaw in place to prevent it from receding while you sleep. As an alternative, one may use a tongue retainer to hold the tongue and prevent it from retracting into the throat, thereby blocking air passages. These solutions are less costly compared to surgical procedures and a doctor-prescribed Continuous Positive Airway Pressure (CPAP) device.
Advantages of Working with a Dentist for Sleep Apnea
Working with a dentist allows him or her to examine the teeth and jaw numerous times because this is necessary in order to provide a mandibular device that matches your specific condition. In addition, mandibular machines resemble mouthguards; thus, they help you maintain anonymity during therapy.
Remedies offered by dentists are less costly than surgical procedures and CPAPs. They help relieve your sleep apnea. When you wear tongue stabilizers or mandibular devices, depending on the cause of the disorder, you will sleep better as your airways remain open throughout the night. Healthy sleep will improve your mood, eliminate stress, and reduce fatigue.
Also, mandibular advancement devices will reduce snoring, which will give you peace of mind knowing that you are not interrupting the sleep of the people sharing the bedroom with you, such as your spouse.
Dentists only provide remedies to manage sleep apnea. In severe cases, you might require the help of a doctor specializing in sleep apnea to treat the condition.
Find a Skilled Sleep Apnea Dental Expert Near Me
A dentist who is certified in sleep medicine will detect the presence of an obstructed airway while conducting routine dental exams, and then, depending on how serious the condition is, recommend you consult a doctor. If your condition is mild to moderate, an expert dentist will suggest treatment options, including inexpensive tongue retainers and mandibular devices, which offer quick and effective solutions.
At Lasting Impressions Dental Spa, we can detect early signs of sleep apnea and recommend effective treatment solutions based on the cause and symptoms of your condition. Call us today at 818-751-5100 to learn more about the causes and treatment for adult sleep apnea in Encino, CA.
