First let’s discuss just what sleep apnea is. Let’s start by describing what obstructive sleep apnea (OSA), the most common type of sleep disorder, is. OSA occurs when a person goes to sleep lying on his or her back and the back of the tongue rests too far back in the throat area. This can cause an obstruction of the air passageway, resulting in the stopping of airflow during breathing. Erratic snoring patterns and jerky nocturnal movements usually accompany this.
This restriction results in a lack of oxygen being delivered to the brain and usually causes the person to either wake up briefly or shift so that the blockage is relieved and air can again flow. It is called an apnea event if the stoppage lasts ten seconds or longer. Repeated events like this throughout the night are defined as obstructive sleep apnea and are classified as mild, moderate, or severe, depending on the age of the patient and the number of apnea events that occur per hour of sleep. It is considered very serious if a child has even a small number of apnea events because of their immediate effects and because this progressive disorder intensifies with age.
It has been well established that OSA creates cardiovascular stress, which leads to strokes or heart attacks (with the possibility of death). OSA is also associated with many seemingly unrelated degenerative diseases, including pulmonary and systemic hypertension, diabetes, and kidney disease. Studies show that a person with OSA has an average of twelve years cut off his or her life expectancy. It is known that as many as seventy-five million people in North America suffer from OSA; because of its widespread prevalence, it is a major health problem.
In recent years, the lack of restful sleep and the resultant daytime drowsiness have been well documented. Now more motor vehicle accident deaths result from drowsiness than from drunk drivers.
OSA typically starts early in life as a mild obstruction and generally is accompanied by snoring. As the years pass by, if left unattended, the obstruction can progress into a sleep apnea problem. Although OSA is typically thought of as a problem for middle-aged, overweight males, the truth is that OSA can and does exist in a very broad range of the population. Young and old, male and female, large and small all have the possibility of OSA.
During childhood, OSA can exist because of enlarged tonsils, adenoids, or any other obstruction that results in mouth breathing. OSA has been linked as a cause of ADHD and even SIDS. When this airway obstruction is discovered, it must be removed right away, regardless of the age of the patient. A child with a deep overbite and a retruded, or recessed, lower jaw has a big, developing problem that needs correction. If the narrow upper jaw and overbite are not corrected in the ideal manner—by enlarging the constricted upper jaw and freeing up the lower jaw to come forward into the ideal position—the die is cast for OSA. The Lauson System of orthodontic treatment used with young patients has a goal is to prevent the development of OSA (and TMJ and neck problems as well) from developing later in life.
When a person has OSA, which is confirmed by an overnight sleep study at a sleep center facility with a sleep physician, the primary recommendation for a person with OSA is to use a continuous positive air pressure (CPAP) machine. This device literally pushes air through a person’s nose all night long to give him or her much needed oxygen as he or she sleeps. Although the CPAP machine can be a lifesaver for the patient, a large percentage of patients will become intolerant of its use and the machine then gathers dust in the closet, recreating the dangerous obstructive sleep apnea and reducing the person’s chances for a long and healthy life. Oral appliances made by a dental sleep specialist can work to relieve the apnea, but even these appliances can have their drawbacks. The oral appliance worn nightly can cause the jaws to shift making the teeth not fit together any more, or even cause the jaw joints to become painful. Although we do offer nighttime oral appliance treatment in our office, a more comprehensive and permanent solution does exist.
A Permanent Solution to Obstructive Sleep Apnea
Most people with OSA have a narrow upper jaw. The nasal airway can then be compromised because the same bone that is at the roof of the mouth is the same bone that is on the floor of the nasal passageway. When the roof of the mouth is constricted, then the nasal airway would also be constricted. This is the first of two chokepoints where air has to pass through to get to the lungs. Also, this narrow jaw typically will cause the lower jaw to be recessed by trapping it because of the way the teeth fit together. The recessed lower jaw causes the tongue to be confined and can recede more toward the back of the throat, the airway’s second chokepoint, creating the likelihood of Obstructive Sleep Apnea. It so happens that this classic pattern exists in almost all people with OSA.
Now for the good news: These types of structural (bone) problems can be changed. OSA does not have to be accepted as a condition a person just has to live with (or die with). The upper jaw can be expanded at any age and the lower jaw can be positioned more forward as well. This can significantly reduce or even eliminate OSA for a future life free of the dreaded CPAP machine.
Please let us know if you or a loved one could benefit from this type of treatment. We would be happy to perform a complimentary evaluation, which includes necessary x-rays. Please call us at 303-690-0100 for a complimentary consultation.