This man is in his middle 50's, just when high blood pressure, strokes, heart disease and diabetes usually begins. Anyone this age and above is just waiting for the doctor to tell him it is pill-taking time. Because of my experience in screening for apnea, I was quite sure this man had breathing issues, especially at night, and I wanted to make sure the physician addressed it, so I brought up the issue. He smiled and said, "To tell you the truth, my wife is making me go to this appointment because she is tired of my snoring."
I asked him what he would do if someone tried to choke him as he slept. I had asked and Army Special Forces veteran patient the day before, and his immediate answer was, "Your eyes and throat would be gone." His response is a perfect example of the fight-or-flight response when danger approaches. You either fight or flee. Either way, when danger approaches, adrenaline is released, putting the body on high alert.
I use the choking analogy because it brings home the seriousness of sleep apnea. Apnea simply means to quit breathing. No breathing, no oxygen, and without oxygen, death occurs within a few minutes. No oxygen not only starves the body's tissue, it created the fight-or-flight response, and this increases blood pressure. Increased blood pressure causes heart and stroke problems. Everything becomes a vicious cycle when a person cannot get enough oxygen. Oxygen is the No. 1 drug the body needs.
This patient also said he just couldn't see himself sleeping strapped with a mask and tethered to a machine. He felt if he had a sleep study, he would go home with a CPAP. He was unaware he could wear a dental appliance that is FDA-approved and is recommended treatment of mild to moderate sleep apnea. We showed him what they look like, and he was pleased.
Dentists, with special training in sleep dentistry, can make a sleep appliance that holds the jaw forward. When the jaw is forward, the tongue follows and opens up the airway, allowing the needed oxygen. It also allows much more room for the tongue. These devices work extremely well and, in many cases, can totally replace the CPAP.
Dentists cannot diagnose sleep apnea, but they can and should screen for it. I work with special trained sleep physicians and sleep clinics. If we make a patient a sleep device, it is imperative to prove that it is effective. The first step is to know if the patient is getting enough oxygen or not. We do this by sending a small wrist band pulse oximeter home with the patient after the appliance is delivered. The next day, I plug it into the computer to check the night's oxygen level. If the percentages are not above 90, I adjust and check again.
Once the results look good, this information is sent to the sleep physician, and then another and hopefully last formal sleep study is performed and read by the physician.
Please remember that oxygen is life's No. 1 drug. Without it you die, and with too little oxygen, you are tired, run down, and quite frankly, sicker than you think you are. When the doctor or spouse talks about it, pay attention.
If you think you can order your anti-apnea products over the internet without the help of the medical/dental profession, you are playing Russian roulette.
-By Mac Lee