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shwetha rodrigues ddS

AIRWAY centered DENTISTRY

shwetha rodrigues ddS AIRWAY centered DENTISTRYshwetha rodrigues ddS AIRWAY centered DENTISTRYshwetha rodrigues ddS AIRWAY centered DENTISTRY

Treating the underlying causes

Treating the underlying causes Treating the underlying causes Treating the underlying causes
Understand

WHAT IS obstructive SLEEP APNEA - OSA?

End state of SLEEP DISORDERED BREATHING

how did we get here?

 The Greek word “apnea” literally means “without breath.” There are three types of sleep apnea: obstructive, central, and mixed. Of the three, obstructive sleep apnea, often called OSA for short, is the most common. 

                                                                  

 

TRADITIONAL TREATMENTS 

They work to reduce the symptoms of Sleep apnea and they require a lifetime of intervention.

traditional treatment options

snoring appliance

managing sleep apnea

managing sleep apnea

  • Nasal strips
  • Snoring devices
  • Laser treatments
     

managing sleep apnea

managing sleep apnea

managing sleep apnea

  • C-PAP 
  • ORAL DEVICE - Mandibular advancement device 

surgery

managing sleep apnea

surgery

  • Upper airway stimulation (UAS) 
  •  Uvulopalatopharyngoplasty (UPPP) 
  • Nasal surgery 
  • Maxillomandibular advancement surgery 

prevent, treat and reverse sleep apnea

Vivos System


An important breakthrough in sleep and airway medicine

A multidisciplinary therapeutic protocol for the treatment of sleep disordered breathing including mild-to-moderate obstructive sleep apnea.

Learn more

dangers of uncontrolled obstructive sleep apnea

high blood pressure

If you already have it, sleep apnea can make it worse. When you wake up often during the night, your body gets stressed. That makes your hormone systems go into overdrive, which boosts your blood pressure levels. Also, the level of oxygen in your blood drops when you can’t breathe well, which may add to the problem.


In patients with OSA and high blood pressure, the best treatment strategy presumably involves combining OSA treatment with blood pressure medication. This solution is likely to be more effective in lowering both nighttime and daytime blood pressure levels than either treatment alone. The result may be a considerable reduction in cardiovascular risk.

cardiovacular disease and endothelial dysfunction

Obstructive Sleep apnea (OSA) has been independently associated with endothelial dsyfuction which may explain the increased risk for cardiovascular and all-cause mortality in this population. 

One possible mechanism for the development of endothelial dysfunction in OSA is through the cyclical pattern of hypoxia and re-oxygenation. This creates a haemostatic imbalance in which nitric oxide bio-availability is reduced and pro-inflammatory and pro-thrombotic forces prevail. 

Furthermore the repair capacity of the endothelium to protect itself against this increased damage is diminished. All of these pathways contribute to vascular disease which ultimately gives rise to adverse cardiovascular consequences.

How are Depression and Sleep Related?

Depression and sleep are closely connected. Almost all people with depression experience sleep issues. In fact, doctors may hesitate to diagnose depression in the absence of complaints about sleep.

Depression and sleep issues have a bidirectional relationship. This means that poor sleep can contribute to the development of depression and that having depression makes a person more likely to develop sleep issues. This complex relationship can make it challenging to know which came first, sleep issues or depression.

Sleep issues associated with depression include insomnia, hypersomnia, and obstructive sleep apnea. Insomnia is the most common and is estimated to occur in about 75% of adult patients with depression. It is believed that about 20% of people with depression have obstructive sleep apnea and about 15% have hypersomnia. Many people with depression may go back and forth between insomnia and hypersomnia during a single period of depression.

Sleep issues may contribute to the development of depression through changes in the function of the neurotransmitter serotonin. Sleep disruptions can affect the body’s stress system, disrupting circadian rhythms10 and increasing vulnerability for depression.

snoring

 Light, infrequent snoring is normal and doesn’t require medical testing or treatment. Its main impact is on a bed partner or roommate who may be bothered by the occasional noise.

Primary snoring occurs more than three nights per week. Because of its frequency, it is more disruptive to bed partners; however, it is not usually seen as a health concern unless there are signs of sleep disruptions or sleep apnea, in which case diagnostic tests may be necessary.

OSA-associated snoring is more worrisome from a health perspective. If OSA goes without treatment, it can have major implications for a person’s sleep and overall health. Unchecked OSA is associated with dangerous daytime drowsiness, and serious health conditions including cardiovascular issues, high blood pressure, diabetes, stroke, and depressio

Risk of motor vehicle accidents

 Studies finds that obstructive sleep apnea is associated with a significantly increased risk of motor vehicle accidents.

 Results show that patients with sleep apnea were nearly 2.5 times more likely to be the driver in a motor vehicle accident, compared with a control group of other drivers in the general population. Further risk analysis found that severe excessive daytime sleepiness, a short sleep duration of 5 hours or less, and use of sleeping pills were independent predictors of increased crash risk in patients with sleep apnea. 

Acid reflux / GERD and Sleep Apnea

  About 60 percent of people with sleep apnea have chronic acid reflux, also known as gastroesophageal reflux disease (GERD). Acid reflux occurs when the lower esophageal sphincter remains open and gastric acid backflows into the esophagus. Common symptoms of GERD include heartburn, chest pain, a sour taste in the mouth and bad breath. However, it is possible to have GERD and not experience symptoms at all.


One of the basic tenets of obstructive sleep apnea is its’ strong association with acid reflux. There have been tons of studies describing how obstructive sleep apnea can aggravate reflux and vice versa. 

Studies have shown that treating OSA can help reflux symptoms and treating reflux can lower OSA severity scores. Vacuum-like negative pressures created in the chest wall from apneas is a simple explanation for this condition. What comes up is not only acid, but bile, digestive enzymes and bacteria. 

There are documented reports of pepsin (a digestive enzyme) in middle ear, sinus and lung washings. Imagine what these substances can do to your teeth, especially if you are a mouth breather with lower levels of saliva which has alkaline properties.  

Diabetes and Sleep Apnea

 72% of diabetes patients have either OSA or insomnia.

Up to 40% of patients who currently have OSA have diabetes.

One study found 86% of obese patients with type 2 diabetes also had OSA.

Obesity around the abdomen/middle (apple shape) is a common risk factor for type 2 diabetes and OSA.

Snoring is independently associated with a doubled risk of developing diabetes after a 10 year period.

OSA and Metabolic Function

  • Several studies have shown a link between OSA and insulin resistance/glucose intolerance even when controlling for obesity.
  • Other studies have found a correlation between the severity of hypoxia (too little oxygen due to apneas) and the degree of insulin resistance.
  • Sleep deprivation studies have shown an increase in glucose intolerance in healthy subjects.

Why the link between Diabetes and OSA?

  • Drops in oxygen
  • Inflammation of body tissues and cells
  • Reduced sleep time/diminished sleep quality

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