Is it possible to find a family where no one is snoring at night? Grandfather or an uncle or granny….We all have observed and made fun of them sometime or other.
WHY SHOULD ORTHODONTISTS CONSIDER TREATING SLEEP APNEA?
Well, the incidence is increasing in recent times thanks to our sedentary life style and increased incidence of obesity.
Snoring occurs due to blockage of air passage mainly during sleep . Which in scientific term is Obstructive sleep Apnea (OSA )
OSA is an upper airway disorder that is characterized by recurring interruptions in normal sleep patterns due to pharyngeal obstruction
It mainly has anatomical reasons. While we sleep the tissues and muscles relax and so does the tongue. Due to this relaxation and gravity the tongue falls back and blocks the air passage which is just behind it.
This blockage of airway stops the oxygen supply to the brain. And brain raises an alarm and alerts the muscles to open the air passage. This blockage lasts from neon seconds upto 30 seconds in advanced stage.; disturbing sleep partially to completely .
This is a repetitive process As brain remains without Oxygen during these periods, and since sleep is disturbed several times during the night, such patients drift into sleep during the day.
The symptoms of OSA can be very revealing. The obvious one is, of course, snoring, but some less obvious symptoms include daytime sleepiness, impaired intellectual function, insomnia, depression, irritability, and poor workplace performance.
OSA can be a fatal disease if left undiagnosed. This is primarily due to the circulation of unsaturated blood during the night, which can cause cardiopulmonary changes, congestive heart failure, and strokes. Daytime sleepiness can also lead to fatal motor vehicle accidents
If a patient is suspected of having OSA, the diagnosis is confirmed by an overnight polysomnography (PSG), commonly referred to as a sleep study.
Once a sleep study is undertaken, the resulting data is the Respiratory Disturbance Index (RDI). This is a somewhat complex index that measures the number of apnic (total cessation of breathing) and hypopnic (shallow breathing) events per hour of REM and non REM sleep. For example, someone who has an RDI of 30 has 30 apnic or hypopnic events an hour. The range of RDIs is as follows: RDI < 5 Normal; RDI 5-15 Mild; RDI 15-30 Moderate; RDI > 30 Severe.
Obstructive Sleep Apnea (OSA) often first surfaces during a visit to a general physician or ENT specialist. Yet, it’s the sharp eye of an orthodontist during a routine examination that frequently brings this condition to light.
The go-to treatment prescribed by physicians is the CPAP machine—a device designed to deliver continuous airflow to keep airways open. While effective for moderate to severe OSA, CPAP therapy comes with challenges. Up to 70% of users struggle with compliance due to the discomfort of the mask, the disruptive hum of the machine, and social awkwardness. For children, long-term CPAP use may even hinder midface development. Add to this the litany of side effects—headaches, a dry throat, and nasal irritation—and it’s no surprise many patients find the solution intolerable. What’s more, CPAP addresses symptoms, not the root cause of OSA.
Surgical interventions offer another path, particularly for children when paired with palate expansion and lifestyle changes. Among these, uvulopalatopharyngoplasty (UPPP)—a procedure targeting the soft palate and the uvula—stands out as a common choice. But this surgery is far from perfect. It’s invasive, expensive, and accompanied by the risks typical of major procedures. Recovery is painful, and recurrence of OSA remains a significant concern.
The search for effective, patient-friendly solutions continues, as both practitioners and patients navigate the complexities of treating OSA.
The rise of obstructive sleep apnea (OSA) in recent years reflects the toll of modern living. Our increasingly sedentary lifestyles, coupled with the growing prevalence of obesity, have turned this once-overlooked condition into a widespread health concern.
At its core, OSA is far more than just loud snoring. Scientifically, it’s an upper airway disorder caused by repeated blockages in the air passage during sleep. These blockages disrupt the natural flow of oxygen to the brain, triggering a cascade of interruptions to normal sleep.
The anatomy of the issue lies in what happens when we drift off. As muscles relax, so does the tongue. With gravity’s influence, the tongue can fall back and obstruct the narrow airway behind it. This blockage halts oxygen flow, prompting the brain to sound an alarm, forcing the muscles to react and reopen the airway. While this relief comes, the blockage can last anywhere from mere seconds to 30 seconds in severe cases, leading to fragmented sleep that is anything but restorative.
This cycle repeats through the night. With every interruption, the brain is starved of oxygen, and the body is denied restful sleep. The consequences spill over into the day—daytime sleepiness becomes a constant companion, and patients may experience reduced focus, impaired intellectual function, insomnia, depression, irritability, and even a decline in workplace performance.
The dangers of untreated OSA go far beyond sleep disturbances. The lack of oxygen during the night leads to the circulation of unsaturated blood, increasing the risk of severe cardiopulmonary changes, congestive heart failure, and strokes.
Remember, OSA is not just about lost sleep—it’s about reclaiming the quality of life and safeguarding long-term health.
