Straight Teeth Talk: The dangers of sleep apnea
By Mac Lee
Dec. 3, 2013 at 6:03 a.m.
Sleep specialist Dr. Gus Sandigo and I will discuss why and how apnea can be so dangerous.
We have all visited family or friends in the hospital. They are usually hooked up to a machine that measures oxygen in the blood. The critical number for the proper amount of oxygen is 90 percent and above. With sleep apnea, oxygen levels can go way below 90 percent.
What chain of medical events can happen when the oxygen level in the blood goes below 90 percent?
Oxygen is needed in every cell in the body in order to survive and operate at full capacity. When the oxygen level drops significantly in the bloodstream, it drops everywhere, including vital organs such as the brain, heart, lungs, etc. The bottom line is that people with apnea are at risk of suffering stroke, heart attack, congestive heart failure and, most tragic of all, dying in their sleep.
People hold their breath and don't die. Why would apnea be any different?
Apnea, which can simply be defined as periods of not breathing, occurs over a period of time, night after night. For serious apneacs, it can occur hundreds of times each night with each nonbreathing event lasting up to a full minute. Imagine what that would do to an already-stressed heart.
This long-term effect of oxygen levels going up and down for eight or so hours on a daily basis creates a condition call oxidative stress. This stress creates inflammation on the inside walls of the blood vessels.
An inflamed arterial wall is going to collect plaque and continue to build that plaque until it stops the blood flow, a process called atherosclerosis. A clogged, rusted pipe goes through the same process with oxygen. No blood, no oxygen, no life.
Observers of people with severe apnea think the snoring and not breathing are signs of a person in deep sleep when, in fact, they are not only deprived of oxygen, but they are also being deprived of real sleep. Sleep deprivation is one of the reasons doctors do a daytime sleepiness test, but that is just one of many tests. Some apneacs feel great during the day.
What is the relationship between apnea and gastroesophageal reflux disorder?
They tend to go together; if a person is an apneac, more than likely they have gastroesophageal reflux disorder, in which acid is moving from the stomach to the mouth. Apneac events are not pretty things to see. The patient is straining for air, so the lungs and diaphragm are being stressed to the max.
It is thought that this pressure leaks stomach acid into the mouth. This heartburn/chest-burning feeling is also a reason people are awakened in the middle of the night.
Sleep is a complicated issue. As a sleep doctor, my goal is to help people get a good night's sleep so they remain healthy and feel good during the day. Snoring, apnea, gastroesophageal rreflux disorder, restless leg syndrome, teeth grinding and stress all effect sleep patterns. Overcoming each issue requires patients, family, physicians, sleep centers and dentists to work together.
Dentistry and apnea
Your dentist/hygienist look in mouths all day, every day, so the dental office is the perfect place to screen for sleep apnea. Those of us who have been trained in sleep dentistry know what to look for.
People who have sleep apnea are more likely to have a mix of the following conditions:
Wearing of the teeth, predominately in the front
A large tongue that fills the back of the throat
Shiny teeth with potholes in the enamel
A lower jaw that is bigger than the upper
A history of nighttime and morning headaches
A large neck
If you have any combination of the above conditions, please speak to your doctor or dentist about them.
Next month, we will discuss how dentists and doctors work together to treat sleep apnea.
Dr. Mac Lee practices in Edna. He is a international speaker to dentists and advises to Dr. Mehmet Oz. To learn more, visit drmaclee.com or call 361-782-7191.