Sleep apnea is a potentially life-threatening sleep disorder characterized by repeated pauses in breathing during sleep. The term sleep apnea is derived from the Greek etymology meaning "without breath". Breathing pauses can last any where from several seconds to minutes, and can happen as often as 30 times or more per hour. Ongoing disrupted breathing causes an imbalance between the carbon dioxide and oxygen levels in the bloodstream, as not enough carbon dioxide is exiting and not enough oxygen is entering the body.

Sensing this imbalance, the brain sends a message to the body, telling it to wake up to restart the breathing process. People with sleep apnea will partially wake up as they struggle to breathe and this is often accompanied by loud snoring or choking. Because people with sleep apnea don't usually fully awake during these episodes, they are often unaware they have a sleeping disorder and it can remain undiagnosed.

There are two main types of apnea; Central Sleep Apnea occurs when the brain fails to send important signals to the breathing muscles. This is a neurological disorder and must be treated with CPAP (Continuous Positive Airway Pressure). Obstructive Sleep Apnea occurs when air cannot flow the airway even though the body is trying to breathe. Obstructive sleep apnea is far more prevalent and is treatable by custom oral appliance therapy.

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Hypopnea is a partial blockage of the airway usually associated with snoring. It is considered clinically significant if there is a 30% or greater reduction in airflow lasting for 10 seconds or longer which results in fragmentation of sleep.

Apnea is a complete blockage of the airway lasting for 10 seconds or longer resulting in a 4% or more drop in blood oxygen and results in arousal from sleep

Partially Collapsed AirwayFully Collapsed Airway

It is very important to seek medical attention if sleep apnea is suspected. A sufferer can completely stop breathing numerous times per hour, and this can quickly turn into a deadly situation.Obstructive sleep apnea occurs when the soft tissue lying at the back of the throat, including the tongue collapses into the airway. This blockage prevents oxygen from entering the lungs although the body is trying to breathe.

The problem worsens as the chest region, diaphragm and abdomen fight for air. The efforts they make to obtain vital oxygen only cause a further tightening of the blockage. As carbon dioxide levels skyrocket and the oxygen levels decrease the body enters into the "fight or flight" syndrome which releases adrenaline and causes the heart to pump harder and faster. Eventually the body wakes itself up, restoring muscle tonus which gets rid of the obstruction.

Sleep apnea is highly correlated with cardiovascular conditions such as hypertension, heart disease and stroke. Other associated conditions are: diabetes, gastric reflux, cerebral vascular disease, anxiety, impotency, mood swings and nocturnal grinding of the teeth (bruxism).

Sleep apnea does not "go away", and it tends to get worse over time especially with weight gain. It requires consistent treatment to help avoid the onset of the previously mentioned chronic conditions.

What does treatment of Sleep Apnea Involve?

Initially, an overnight sleep study or polysomnogram must be done to establish if apnea is present and how severe it is. After reviewing the sleep study results Dr. Callender can offer many different treatment options which depend largely on the severity of the apnea and the health of the patient. We may advise the patient to halt certain habits that aggravate sleep apnea such as smoking, alcohol consumption and use of sedatives.

CPAP is traditionally used to keep the airway open and for severe sleep apnea must be tried before a custom oral appliance can be approved through the insurance.