Sleep Disorders

 

Odontostomatology’s relation with sleep

Sleep Disorders

There are programmes for doctors, general practitioners, and oral health professionals for treating respiratory sleep disorders with oral devices, how to approach and treat nocturnal bruxism, and the relation between orofacial pain, temporomandibular Joint Disorder and sleep disorders. In Portugal, there are dentists certified by the APCMS (Portuguese Association of Chronobiology and Sleep Medicine).

 What is sleep apnoea?

Apnoea is defined as the short or extended cessation of airflow during sleep due to the closure of the respiratory tract. With this closure of the respiratory tract, oxygen in the blood decreases. Faced with this situation, the brain response is to stop sleep and wake you up.

It consists of periods of respiratory arrest that can last around 10 seconds. It affects more middle-aged men than women of the same age. It is a disease that can be fatal in some cases.

The noise that a person makes while sleeping might be the only symptom of a disease with serious potential health risks.

What are the causes of sleep disorders?

The main causes are being overweight (fat closes the pharynx), alcohol or tobacco consumption, and pressure from the tissue surrounding the throat. Anatomical problems may exist, such as an atrophied, reversed, or even an oversized amygdala.

The space between the tongue and palate closes and stops the airflow.

What are the symptoms of sleep apnoea?

Extremely loud and heavy snoring while the person is sleeping, which is caused by closure of the respiratory tract. To breathe again, a person will wake up, but only for a short period of time, which is  why there is no memory of this event. A person can wake up 400 or 500 times during the night. It can happen suddenly and be associated with the feeling of suffocation. In the morning, the person may feel a headache, irritability, anxiety, and suffer from memory loss.

Consequences:

The person will have fatigue and daytime sleepiness due to the reduction of oxygen in the blood. It increases the risk of heart disease and stroke. Experts believe that this disease may cause mental diseases. Apnoea also causes irritability, muscles pain, and sexual impotence.

How is it diagnosed?

The patient should be assessed in advance by the doctor, using medical history and clinical registry. In addition, there will be an assessment of the x-rays. Prevention and the first diagnosis are possible through oral medicine.

Polysomnography is another test carried out with a sleeping patient. This exam measures the pattern of sleep with tests and the variations are shown in graphics.  For this purpose, the person is connected to sensors in a specialised clinic while sleeping.

Why treat this condition in a dental clinic?

Recent studies show that there is a relation between dental decay and SAHS (Sleep Apnoea and Hypopnoea Syndrome). It affects 25% of the population and entails a number of risks for health. APNIA system is a device that allows diagnosis and subsequent treatment. It consists of an electronic device that performs the sleep study, a diagnosis software, and an intraoral device to treat the patient. By using this device, dentists will detect chronic snoring and treat sleep apnoea.

How can sleep apnoea be treated with dentistry?

Besides the above-mentioned electronic device, it is also possible to use another device recommended by the dentist to facilitate breathing. This is called an intraoral device. To produce this device, mouth moulds are sent to a prosthesis-specialised laboratory to be made.

How will an intraoral device relieve apnoea?

The aim of this device is to maintain the mandible in an appropriate position, preventing snoring or apnoea, and providing a peaceful night. This intraoral device locks the mandible and forces the tongue to stay in the correct position without invading respiratory tract space.

There are various types of devices and each one of them is adjusted specifically to each person. Most of them are made of acetate and consist of a stainless steel or titanium clip.

CPAC (Continuous positive airway pressure) is a small pump that delivers a continuous supply of compressed air to you through a mask, which helps the breathing process during sleep. This silicone mask is placed over the nose and has a fan that prevents your respiratory tract from closing.

Conclusion about the benefits of this device and the oral dentistry of sleep:

Sleep pathologies and their diagnosis are studied by interdisciplinary oral medicine. Through specialised professionals, Vita Centro together with other fields of medicine offers the most suitable treatment.

By using oral sleep medicine, you will have the first diagnosis to prevent sleep disorders.

Intraoral devices will be able to solve minor or moderate cases of sleep apnoea. The patient can sleep, using this device to relieve the apnoea.

The most severe cases are treated with uvulopalatopharyngoplasty surgery, which is a procedure that removes excess tissue in the throat to make the airway wider.

Recommendations for patients with apnoea:

  • Control your weight and exercise regularly.
  • Do not drink alcohol.
  • Cut down on smoking.
  • Sleep on your side and avoid sleeping on your back. Elevate the head of your bed.
  • Treat respiratory tract infections.