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Sleep Apnea

Sleep apnea is a sleep disorder characterized by pauses in breathing during sleep.  The individual with sleep apnea is rarely aware of having difficulty breathing, even upon awakening. Sleep apnea is recognized as a problem by others witnessing the individual during episodes or is suspected because of its effects on the body. Symptoms may be present for years, even decades without identification, during which time the sufferer may become conditioned to the daytime sleepiness and fatigue associated with significant levels of sleep disturbance. Some other symptoms of sleep apnea may include dry mouth, sore throat, snoring and irritability.

Obstructive sleep apnea (OSA) is a common sleep apnea caused by obstruction of the airway. It is characterized by pauses in breathing during sleep. These episodes, called apneas (literally, "without breath"), each last long enough that one or more breaths are missed, and occur repeatedly throughout sleep. In obstructive sleep apnea, breathing is interrupted by a physical block to airflow, despite the effort to breathe.

Snoring is almost a uniform finding in an individual with this syndrome, but many people snore without having apnea. Snoring is the turbulent sound of air moving through the back of the mouth, nose and throat. The loudness of the snoring is not indicative of the severity of obstruction, however. If the upper airways are tremendously obstructed, there may not be enough air movement to make much sound. Even the loudest snoring does not mean that an individual has sleep apnea syndrome. The sign that is most suggestive of sleep apneas occurs if snoring stops. If it does, along with breath, while the persons' chest and body tries to breathe - that is literally a description of an event in obstructive sleep apnea syndrome. When breathing starts again, there is typically a deep gasp, and then the resumption of snoring.

Some treatments for the patient with mild sleep apnea involve lifestyle changes, such as avoiding alcohol or muscle relaxants, losing weight, and quitting smoking. Many people benefit from sleeping at a higher degree of elevation of the upper body as if in a recliner. Doing so helps prevent the gravitational collapse of the airway.  Often the patient will require therapy in addition to these lifestyle changes.

One treatment which revolutionized the management of obstructive sleep apnea is continuous positive airway pressure (CPAP). A continuous positive airway pressure (CPAP) machine is used mainly by patients for the treatment of sleep apnea at home. Obstructive sleep apnea occurs when the upper airway becomes narrow as the muscles relax naturally during sleep. This reduces oxygen in the blood and causes arousal from sleep. The CPAP machine stops this phenomenon by delivering a stream of compressed air via a hose to a nasal pillow, nose mask or full-face mask, splinting the airway (keeping it open under air pressure) so that unobstructed breathing becomes possible, reducing and/or preventing apneas and hypoapneas. This treatment however is not liked by many patients and can be uncomfortable and hard to get used to.  For this very reason, Dr. Pominville has an alternative to the CPAP machine.

Dr. Pominville, specializing in sleep disorders can prescribe Oral Appliance Therapy (OAT). The oral appliance is a custom made small mouthpiece much like an orthodontic retainer that prevents the tongue from falling back in the throat while sleeping and thus blocking the airway.

There a only a small number of dental practices in the US that are qualified to manage Sleep Apnea and Dr. Pominville and his staff are among this small number.  We adhere to the American Academy of Sleep Medicine guidelines for the correct treatment of our patients who have interrupted breathing while they sleep.