Is snoring disrupting more than just your partner’s peace and quiet?
It’s one of life’s closed door little secrets: many couples don’t share the same bed and it is not because they don’t like each other! Good quality sleep is so important that this may seem the only option. Poor sleep equates to a life less than it can be. Irritability, frustration, depression, difficulty concentrating at work and impaired memory become your new normal and it can creep up so insidiously that you put it down to stress or ageing or that you just need a holiday! (…You probably do need a holiday however there could be more to it!)
Snoring causes disrupted sleep for the bed partner and the snorer. Sometimes it may appear that the snorer has no trouble sleeping. They fall asleep “as soon as their head hits the pillow!” But that snoring may be leaving clues to a much more serious problem – sleep apnoea.
If you have sleep apnoea, even mild sleep apnoea, your airway is closing off repetitively while you sleep. When your airway closes off you can’t breathe. Your blood oxygen drops, your blood pressure rises, your heart slows down in a desperate attempt to conserve the rapidly diminishing oxygen until the blood sensors detect that you are in grave danger and partially rouse you from your sleep so that you take some breaths. As you rouse your heart races, you over breathe, your blood pressure increases even further and you drift off to sleep again only to have this same sequence repeat over and over again – sometimes hundreds of times per night. No wonder people with sleep apnoea are at high risk of dying from heart attack or stroke! In fact you are at a higher risk of dying from all causes. Sleep apnoea can rob you of years, if not decades, of your life.
As many as 80% of people with sleep apnoea do not know it. I am on a mission to change that! No more band aids. No more drugs to treat the outcome of sleep apnoea without treating the cause. We only get one life and this one is not the dress rehearsal. Diagnosis and treatment is easy compared to the consequences and prevention is so much better than the cure.
Call us today. Let’s rule out sleep apnoea, put some peace back into your bedroom and add some good quality years to your life!
Why is this important?
Many people don’t get treated for snoring or sleep apnoea because they think
- “Just” snoring (not important)
- Don’t want to have to wear the “machine’ (CPAP)
- Too noisy
- Difficult to travel with etc
Many people are not aware of the use of oral appliances to treat sleep apnoea and snoring. An oral appliance (or mandibular advancement splint or device) gently holds the lower jaw forward when you sleep. This opens up the airway to allow you to continue to breathe normally and in most cases can quieten down any snoring, commonly stopping it completely.
Some patients have told us that their bed partner was worried on the first night of ‘quiet” that they had stopped breathing because it was so quiet. Of course after confirming they were sleeping soundly, they got on enjoying their peace and quiet!
You will not hear me criticise CPAP. That machine has saved so many lives and if you need it, a whole new world of well-being awaits you. It is the gold standard for treating severe sleep apnoea for people who have serious medical conditions that put them at high risk for dying. The down side of CPAP is that many people who need it don’t use it on a regular basis or stop using it all together. If you are one of the people, please come to see us because studies have shown that the increased usage of an oral appliance, and orofacial myofunctional therapy, offsets the better control of the airway that is achieved with CPAP and the medical outcomes are similar even for severe sleep apnoea sufferers.
If you have sleep apnoea – the important thing is to be treated.
What are some health consequences associated with untreated sleep apnoea?
If you have sleep apnoea, every time you go to sleep you start to suffocate over and over again and your emergency stress system has to save you or you will die. When your emergency stress system gets switched on repeatedly, when it should be turning down during normal sleep, your health starts to suffer. Not only is your sleep fragmented and of very poor quality, you may develop:
- Memory and mood changes
- Feeling tired or sleepy
- Not waking refreshed
- High blood pressure
- High cholesterol
- Heart attack
- Weight gain
- Difficulty losing weight
- Neck pain
- Macular degeneration
- Many people with Alzheimer’s Disease have sleep apnoea
- And many other health consequences
Sleep apnoea is a serious medical condition with serious health outcomes. 80% of people with mild to moderate sleep apnoea do not know it. I am on a mission to change that. That is why I have embarked on this campaign:
- To raise awareness
- To screen people for sleep apnoea
- To facilitate referrals as necessary
- To explain different treatment options available
- To provide the most comfortable and effective oral appliances for those who would benefit from them
- To follow-up to ensure best treatment outcomes
- To work with and communicate with your healthcare providers
As you know, the only way to rule out high blood pressure is to take a measurement, and this is the same with sleep apnoea. You cannot assume that you have or do not have sleep apnoea without a test – called a sleep study.
- This can be done in a sleep centre or
- In your own bed
- We can help organise one for you
A sleep physician then makes the diagnosis and recommendations for treatment.
There are different levels of severity and increased severity means a higher risk of disease or death but all levels carry risk and in general sleep apnoea worsens with time, age and weight.
AHI (Apnoea-Hypopnoea Index) or RDI (Respiratory Disturbance Index) is the standard method of scoring and determining the level of sleep apnoea.
AHI or RDI:
- <5 Normal
- 5-15 Mild
- 15-30 Moderate
- >30 Severe
For patients with severe sleep apnoea, CPAP (continuous positive airway pressure) – often referred to as ‘the machine’ is the gold standard.
For patients with mild to moderate sleep apnoea, a carefully constructed adjustable oral appliance which optimises the airway and supports the jaw by an appropriately trained dentist, can be a successful alternative. There has also been some recent research that shows that orofacial myofunctional therapy (mouth and throat exercises) if used adjunctively with an oral appliance or CPAP, improves outcomes and compliance.
This therapy is often referred as:
- Oral Appliance Therapy or
- Mandibular Advancement Device or Appliance
Many different dental appliances have been developed over the years to treat sleep apnoea but the best ones have the following features:
- Custom made
- Physiologic / balanced jaw position determined
- Not just a protruded (forced forward) position
- This is dependent upon the training of the dentist not the appliance
- Supports jaw at a comfortable position
- Titratable i.e. it can be adjusted if necessary to achieve a final optimal position that maintains the airway and manages the sleep apnoea and / or snoring
- Can open mouth and speak if necessary
- Takes up minimal space for the tongue which is extremely important for the control of the sleep apnoea
- Comfortable to wear
- Your treatment is followed up to ensure the sleep apnoea is under control
- This is extremely important because in rare circumstances, the sleep apnoea could actually worsen with an oral appliance
- Continued monitoring and measurement is essential for correct management of your sleep apnoea.
- This is the standard of care with Dr Anne-Maree Cole and Dr Susan Gibbs
Considering the pros and cons of all the available appliances that have been developed over the years and the methods of determining the best position for the jaw, Dr Cole and Dr Gibbs believes in ‘no compromise’. When you are at your most vulnerable – asleep and lying down, suffering a condition over which you have no control and that could lead to your early death or disability, you want everything working in YOUR favour.
Dr Cole and Dr Gibbs have studied extensively in the area of Sleep Medicine. Dr Cole has completed a Masters Degree in Science (Sleep Medicine) through the University of Sydney. Currently she lectures internationally and nationally to medical and dental practitioners in Dental Sleep Medicine, the Physiology of Occlusion (Neuromuscular Dentistry) and Controlled Arch Braces (jaw development orthodontics). She has been invited as an editor on Dental Sleep Medicine for the international peer reviewed journal Cranio. It is obvious that she is passionate about providing the very best care to her patients.
There is no pill for sleep apnoea yet patients are given pills all the time for the symptoms without determining the root cause of the problem. Dr Cole believes in treating the root cause and helping you take control of your health issues.