Sleep Apnea Treatment in the Shelby Twp, Macomb County, Michigan

January 28, 2011 by · Leave a Comment


At The Gentle Dentist we try to have relevant dental information that can change the lives of those who live in the Shelby, Sterling Heights and Washington areas of Macomb County, Michigan.

Obstructive Sleep Apnea (OSA) is a Medical condition where the airway of a person is physically blocked and breathing is interrupted during sleep. Many times this is related to snoring, but when the snoring sounds stop and the person is struggling to get a breath in but can’t they eventually snort, partially waking up enough to breath again.  Obstructive Sleep Apnea is caused by the relaxation of the muscles of the throat during the sleep cycle. If there is more soft tissue present than there is room then it physically obstructs and closes off the wind pipe to where no breath can get in even though there is the physical exertion to do so.  What typically happens is that the snoring will be sporadic and then you can observe the sufferer struggling for breath and finally after about 10-60 seconds of attempting to breath in they finally make a loud sound and then catch their breath. Each time this happens it is called an “episode”.  Each episode encountered the person experiences a surge of epinephrine (adrenaline) which speeds up the heart, blood pressure  increases and constricts the blood vessels.

Effects of Obstructive Sleep Apnea: This psychological activity wakes the person up enough where they can breathe.  Unfortunately, during the night when one needs the rest they are constantly woken up which has a huge impact on daily living.  Not only is the person chronically exhausted but they may suffer from a host of chronic illnesses.  This sporadic breathing is associated with an increased risk of cardiovascular disease, stroke, high blood pressure, arrhythmia, diabetes, sexual dysfunction and sleep deprived driving accidents .

Obstructive Sleep Apnea Diagnosis: Mild sleep apnea is when there are 5-15 episodes per hour, Moderate from 16-30 and severe greater than 31 episodes per hour.  These readings and a proper diagnosis can only be made by a sleep physician at a sleep lab.  These sleep studies require the patient to spend the night and they are hooked up to many sensors and devices that accurately measure eye movement, blood pressure, blood oxygen, brain wave activity and respiration.  The “lab” looks just like a nice hotel room and is very comfortable.

People who are more at risk are as follows:  obesity BMI >30, large neck circumference (16 inch in women, 17 inch in men), enlarged tonsils and large tongue volume and small lower jaw. Some treatments involve lifestyle changes, such as avoiding alcohol or muscle relaxants, losing weight, and quitting smoking.  Because Detroit is noted for being the fattest city in America this information is pertinent for our community in particular.

Obstructive Sleep Apnea Treatment: After there has been a proper diagnosis from a sleep doctor there are modifications in life style and behavior which should be considered first which are mentioned above.  Next using a Continuous Positive Airway pressure (CPAP) is the gold standard.  This is a face mask that is hooked up to a small pump that provides humidified air which is pressurized to go into the lungs.  This is the best treatment, but there are many who don’t like using it because of the inconvenience, appearance and uncomfortableness.  Compliance is the most critical aspect of undergoing treatment and if the device works great but is not used there is no benefit.

An option that other dentists and we have in our Shelby Township dental office  is to provide an oral appliance that is used during the sleep. This device is custom made to fit your mouth and works by moving the lower jaw forward during sleep to open up the airway and provide more opening for air to flow down the trachea.  If you have taken CPR and remember when you grabbed the lower jaw and moved it forward in an attempt to get a breath in; this is the same concept.  The benefit of this device is that it is portable, is more comfortable and we find our patients more compliant using this device compared with the CPAP.

For more information on how to improve your sleep and life please give our Shelby Township dental office a call at (586)247-3500 or email me at DrAntolak@TheGentleDentist.com.

Dr. Antolak practices sedation, implant and general dentistry since 1987 in Shelby Township and in the Sterling Heights area and is a member of the Academy of General Dentistry, American Dental Association and the American Academy of Dental Sleep Medicine.

Filed Under: Dental Videos, General Dentistry, Health Implications, Sleeping Disorders Tagged With: , , ,

Mouth Breathing and its effect on your body

January 18, 2011 by ·

Mouth breathing:

  1. Can increase asthma, high blood pressure, heart disease and other medical problems
  2. Reduces the levels of oxygen exchange in the blood/lung interface. The lungs extract oxygen from the air we breathe primarily on the exhale. Because the nostrils are smaller then the mouth, air exhaled through the nose creates back pressure when one exhales. It slows the air escape so the lungs have more time to extract oxygen from them.
  3. During sleep, it predisposes one to loud snoring and irregular breathing and can lead to a serious condition called Sleep Apnea and heart conditions.

Nose Breathing:

  1. Proper nose breathing reduces high blood pressure or hypertension and stress for most people. Kind of like a speed control (governor) on a car engine.
  2. The nostrils and sinuses filter and warm the air going into the lungs. The mouth breather bypasses this.
  3. Maintaining a keen sense of smell is very important for enjoying life and for safety and social acceptance.  There are receptors in the nose, known as olfactory bulbs, are direct extensions of a part of the brain known as  the hypothalamus. This extension regulates the heartbeat, blood pressure, thirst, appetite, and of course, the cycles of sleeping a waking. The hypothalamus is also responsible for generating chemicals that influence memory and emotion.
  4. Lessening of the common cold is another good reason for nose breathing. The mucous (white blood cells that kill germs) membrane lining the nose extends all the way from the inner linings of the nostrils down the trachea to the bronchi the directly enters the lungs. Germs get caught and die in the mucous.

Long term mouth breathers experience difficulty in swallowing pills, increased gagging response, increased mucous production and other difficulties.

Mouth breathers do not adjust the way they swallow as an infant.  Typically infants project their tongues out to swallow and transition at around 8 months old so that their tongue is positioned along the top of their palate when swallowing.  Pacifiers and thumb sucking also affects the tongue position during the developmental years. If they aren’t removed early enough the tongue continues to push out beyond the front teeth preventing normal jaw and teeth development.  The relationship of the upper and lower teeth is also affected since they have to accommodate the tongue.  I have seen in adult patients the affects of this and it is almost impossible to change the jaws without surgery.  They usually have an open bite on their front teeth so that when they bite together the front top teeth don’t overlap the lower front teeth.  This is not cosmetically appealing and it has negative effects on the health of the jaw joint.

Allergies also are responsible for the mouth breathing tendencies.  The pharynx (back of throat) swells blocking off the nasal passage preventing smooth airflow through the nose.  It is important to determine what children are allergic to as soon as possible so that the destructive forces of mouth breathing are minimized.

As an adult it is best to retrain yourself to nose breathe during the day.  There are devices you can put in your mouth at night to retrain your tongue and help with nose breathing.  In fact, I had a patient the other day who was having a very difficult time breathing.  His CPAP breathing machine wasn’t functioning properly and I had him a Breathe Rite Strip to enlarge his nasal passage.  He was shocked at the difference he felt and the ease in which he could breathe.

Our human bodies have been designed so intricately that the smallest change in our function can effect so many other facets of how we function and our overall health.  If you have any questions please call me at (586)247-3500 or email me at DrAntolak@TheGentleDentist.com

Dr. Antolak treats his dental patients in a relaxed, friendly atmosphere where you are treated like a guest in the home.  He specializes in cosmetic dentistry, implant dentistry and general dentistry using sedation dentistry if necessary for his high fear patients. He has been treating patients for the past 21 years.

As A reminder: The thermostats are being turned up and it is a good idea to have a humidifier in you room where  you sleep since this significantly helps with dry mouth, sore throats, and adds to the efficiency of heating your home.  I was reminded of this at a recent visit to a nursing home and recommended that a humidifier would help increase the comfort of sleeping for the patient.

Filed Under: Dental Emergencies, General Dentistry, Mouth pain, Nutrition, Oral Conditions Tagged With: , , , , , , , ,

Shelby Dentist: Snoring and the Effects on Others- Causes and Treatment Options

May 2, 2010 by ·

Snoring: Causes and Treatment options to help with this Social Problem

During a recent Boy Scout outing my son Matthew and I went to Muskegon to sleep on the World War II submarine USS Silversides.  This is quite an experience spending the night on such a vessel.   I have such an appreciation for what the men who served in the war did for our country some 65 years ago and the sacrifices they gave.  If you are in the area take some time to explore this great piece of history.

During the night sleeping in a confined setting with others I experienced what many have to deal with every night—SNORING!!!  I had quite a sleepless night sleeping next to a man who snored after every breath.   I gave him my business card and told him that I can help him with a snoring appliance that I will later describe.  It became apparent to me what I needed to write my monthly article on.  There are a few observations I made here that I think snorers need to hear and appreciate.

Those who snore without a stoppage of breathing are usually not affected by their actions.   Even though there is nothing they can consciously do about their actions it remains an obtrusive act to others.   Even with the use of ear plugs the sound can penetrate and keep others awake.

This act of snoring can lead to embarrassment and feeling of hopelessness to those who snore.

Being married to one who snores can have a effect on the marriage because it keeps the other spouse up at night creating resentment and exhaustion for them.  Many partners of snorers decide to sleep in separate rooms, and the resulting lack of bedtime chatting and physical intimacy can lead to a strained relationship. The person who snores often becomes isolated and frustrated about a problem they seemingly have no control over.

Negative Physical Consequences of heavy snoring and sleep apnea:

Deep snoring can lead to a more physically serious problem called sleep apnea. Sleep apnea is when one stops breathing during one of the snoring cycles.  As one goes into a deeper level of sleep the muscles in the back of the throat get more relaxed and eventually close off the airway.  They will eventually gasp for air after a 10-15 second episode of not breathing because the brain senses a decrease in blood oxygen.  During this oxygen deprivation the body produces a surge of adrenaline deposited into the blood stream which raises blood pressure and gets the heart to pump harder.  The person can develop systemic problems like diabetes, chronic fatigue, high blood pressure and a whole host of other problems from this potentially serious problem.

Causes of snoring out of our control:

  • Heredity – A narrow throat, a cleft palate, enlarged adenoids and other physical attributes which contribute to snoring can be hereditary.
  • Being middle-aged or beyond – As you age, your throat becomes narrower, and the muscle tone in your throat decreases.
  • Being male - Men have narrower air passages than women and are more likely to snore.
  • Allergies, asthma, a cold, or sinus infections – Blocked airways make inhalation difficult and create a vacuum in the throat, leading to snoring.

Remedies:

  • Lose weight – Losing weight is often a very effective cure for mild to moderate snoring. Even a little bit of weight loss can reduce fatty tissue in the back of the throat and decrease snoring.
  • Sleep on your side – If you sleep on your back and snore mildly, sleeping on your side might cure your snoring altogether.
  • Elevate your head – Try elevating the head of your bed four inches, which may make breathing easier and encourage your tongue and jaw to move forward. Sleep without a pillow (or with a specially designed pillow) to make sure your neck muscles are not crimped.
  • Avoid certain foods, alcohol and medications before bed – Alcohol and certain medications increase relaxation of throat and tongue muscles, which makes snoring more likely. Sleeping pills or tranquilizers may help you sleep, but they will also relax your muscles and increase the chance of snoring. High-fat milk products or soy milk products cause mucus to build up in the throat which can lead to snoring as well.
  • Clear your nasal passages – Having a stuffy nose makes inhalation difficult and creates a vacuum in your throat, which in turn leads to snoring. Nasal decongestants or nasal strips may help you breathe more easily while sleeping. Antihistamines can help with allergies, but will relax throat muscles and cause snoring.

If these remedies don’t  help then you could be a candidate for an acrylic oral appliance that we make which keeps the lower jaw pushed forward and thereby opening the soft palate and keeping the tongue in a more forward position.  This is an effective approach to snoring cessation and will also help with those relationships that have been effected by this condition.

Dr. Antolak practices comprehensive, implant and cosmetic dentistry in Shelby Township, Michigan.  To contact the office call (586)247-3500 or email at DrAntolak@TheGentleDentist.com.

About The Author

Dr. Robert Antolak, DDS graduated from the University of Michigan in 1987 with his Doctor of Dental Surgery degree. He is dedicated to providing the highest quality and appropriate cosmetic, sedation and general dentistry in the most comfortable and gentle way possible. Because being a dentist has been a lifelong dream, Dr. Antolak has a passion for the profession. He enjoys helping people feel better about their smiles and therefore their self-image with dental implant and cosmetic dentistry. His Dental Practice is located in Shelby Township, Michigan.  For more information visit The Gentle Dentist.

Filed Under: Health Implications, How to choose a dentist, Oral Conditions Tagged With: , , , , , , , , , , , , , , , , , , , , ,
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