Sleep Apnea and Snoring Clinic – Penrith

In a person suffering from Sleep Apnea OR sleep disordered breathing, the AIRWAY COLLAPSES in on itself when the person breathes in and out, shutting of the airway either completely or partially.

Millions suffer from sleep disorders; most people with sleep disorders do not know it.

Untreated sleep apnea can:
• Increase the risk of high blood pressure, heart attack, stroke, obesity, and diabetes
• Increase the risk of, or worsen, heart failure
• Make arrhythmias, or irregular heartbeats, more likely
• Increase the chance of having work-related or driving accidents

• Headaches (migraines, tension headaches, cluster headaches)
• Jaw joint pain, joint sounds, muscle tenderness in the face, limitation of mouth opening
• Worn teeth caused by Bruxism (clenching or grinding of teeth)
• Neck and back pain
• tiredness/fatigue and irritability in the mornings and during the day
• Snoring
• Excessive daytime sleepiness whilst sitting and reading or watching TV, or in a car whilst stopped at a traffic light, or lying down in the afternoon etc.
• Poor memory
• Reflux problems (acidity)

In Children
• Bedwetting
• Crooked teeth
• Worn teeth caused by bruxism (grinding or their teeth)
• Headaches
• Hyperactivity (ADHD)
• Mouth breathing
• Dry Lips

There are 3 categories of sleep disordered breathing
1. snoring (the mildest form)
2. upper airway resistance syndrome
3. obstructive sleep apnea

Snoring is often a cry for help. Modern medicine has been ignored this night time distress signal until recently.
Snoring is a clear signal that an airway is blocked.
• Enlarged tonsils and adenoids easily block airways in children and in some adults.
• An underdevelop jaw which often caused by in correct swallowing and mouth breathing, this mean the tongue muscles is weak, in turn the pharynx (the throat) muscle is also weak which can result in jaw drops and thus block the air way when sleeping
Snoring often signals the presence of dangerous night time sleep disorders. Sleep disorders are known to be an independent risk factor for a number of diseases, including hypertension, cardiovascular disease, cerebrovascular disease (strokes) and diabetic insulin resistance.
Snoring has been found to be a predictor of poor school performance. Children that snore were also more likely to require later tonsil and adenoid removal.

Sleep Apnea
There are 2 major types of sleep apnea
Obstructive Sleep Apnea (OSA) is a complete cessation of breathing during sleep for at least 10 seconds. During an episode of OSA, the entire upper airway is blocked causing airflow to stop. This disrupts sleep as a lack of oxygen results. The person awakens repeatedly as a result of making an effort to breathe in the presence of a lack of oxygen.
Central Sleep Apnea is defined as a period of 10 seconds without airflow due to lack of stimulus form higher levels of the brain and the apnea can be longer periods of time.
Mixed – Combination of the 2 above
Risk factors for sleep apnea include obesity, increasing age, male gender, family history, alcohol, sedative use, smoking, hypertension, breathing disorders such as asthma, menopause, and anatomic abnormalities of the upper airway. A further risk factor is malocclusion (bad bite) and bruxism.

Initial evaluation is done using an Epsworth Sleepiness Scale.
Definitive diagnosis is made using an overnight sleep study called Polysomnogram (PSG). The persons sleep is monitored and measured throughout the night. Sleep Disordered Breathing is further divided in problems of nasal origin and those with oral airway problems.

The 3 treatment options of sleep apnea are:
1. CPAP (Continuous Positive Airways Pressure) machine: made up of an air pump and a mask which are joined by a tube. When use, it opens up the airway with positive pressure and has been found to be effective in moderate or severe OSA. Research found that compliance is very poor. In young person, compliance to CPAP therapy can cause under developed mid face. This is due the pressure from wearing the strap to hold the mask, wearing many hours during sleep over months and years, the facial bone under the mask can be pushed in.
2. Surgery is helpful where there is an anatomical obstruction such as enlarged tonsils and/or adenoids, an enlarged uvula or nasal anatomical problems. Surgery has only been found to be about 40% effective
3. Oral Appliances are indicated for people with mild to moderate OSA who prefer them over CPAP therapy
Oral appliance therapy is non-invasive, less obtrusive than CPAP, and effective in the treatment of mild to moderate cases of sleep disordered breathing. Oral appliances must be worn overnight, to hold the lower jaw forward, prevent it to drop back and blocking the airway during sleep.
Success rates have been found to be high due to it is easier for patient to wear the oral appliances!!!


Dr Nathan Le also offer this treatment at Kempsey Dental Centre

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