“Achieving Health Heights”

David C. Suh DDSJune 2013

“Life is a journey”

“Education is a continual journey with unlimited resources”

“It is very easy to be a top 1%, because everyone wants to be mid 50%”

L. D. Pankey

“Do it RIGHT first time, then you don’t need to do it TWICE”

L.D. Pankey

DO YOU SNORE?

Has someone ever told you that you snore, or stopped breathing in the middle of the night?

Have you ever been told that you possibly have sleep apnea?

Millions of people have been told that they snore or have sleep apnea and have never been properly diagnosed.

Are you one of them?

SLEEP DISORDERS -Points- Past 20 years, importance of sleep has become more recognized

as integral to overall health

- Quantity of sleep is important; quality is more important

- SDB (Sleep Disorder Breathing) affects people of all ages, genders, body types

and different health conditions – typical profile is no longer valid:

i.e., males, over 40, overweight, etc.

SLEEP DISORDERS EFFECTS

The human body needs at minimum 7-8 hours of sleep per night. When the body is unable to do so it becomes extremely hazardous to your health. SDB related to some of most chronic, growing, deadly and costly diseases in the world:

Heart disease

Diabetes

Hypertension

Obesity

Cancer

Hypoxia (found in Sleep Apnea) results in 4.8x higher incidence of cancer mortality (Source: Wisconsin Sleep Cohort Study)

Most people with diabetes have Sleep Apnea

Sleep DeprivationSleep deprivation, or failure to get enough sleep can be caused by several things and has many severe medical consequences. Some of the side effects of sleep deprivation include:IrritabilityConfusionMemory problemsBlurred VisionDiabetesDepressionAnxiety

Most Common SymptomsSNORING

Excessive Daytime Sleepiness

Hypertension (High Blood Pressure)

Other Symptoms

Acid Reflux (GERD – Gastro Esophageal Reflux Disease)

Morning Headaches

Diabetes

Sexual Dysfunction

Social Problems

Contributing Factors

Obesity & Large Neck Circumference

Menopause

Mouth Breathing

What is Snoring?

Snoring is simply the act of breathing, usually through an open mouth, in such a way as to cause vibration of the airway tissues. The reverberating tissues is what gives a loud, unpleasant sound.

Snoring is not a diagnosable illness, but it is a medical symptom that millions of people suffer from. Snoring is the #1 sign/ symptom of Obstructive Sleep Apnea.

Open Air Way V.S.

Snoring

Normally, air passes through the nose and past the flexible structures in the back of the throat such as the soft palate, uvula and tongue. During sleep the muscles relax but, normally, the airway stays open.

Snoring is created by the vibration of the pharyngeal soft tissues as air passes through an airway that is too small to allow for smooth air flow

●What snoring looks like

Obstructive Sleep Apnea (OSA) is a situation in which the entire upper airway is blocked causing air flow to stop.

OSA is comprised of two types of events

Breathing is impaired (hypopnea) or completely stopped (apnea) due to an obstruction in the upper airway.

Diagnosis is made using the AHI: (Apnea Hypopnea Index) tells how many times per hour a person had a respiratory event.

– Total number of Apneas + Hypopneas # of hours of sleep

AHI 5-15 AHI 15-30 AHI > 30

Mild Moderate Severe

Pediatric OSA

Pediatric Obstructive Sleep Apnea

Usually caused because of enlarged tonsils and adenoids. Narrow maxillary arch and mouth breathing are contributing factors.

Often seen in children who are smaller, less developed and underweight because of a disruption in the nighttime secretion of growth hormone.

Complications of Obstructive Sleep Apnea in children

ADD / ADHD• One study concluded that nearly 50% of ALL ADHD could be eliminated if

children habitual snoring and sleep related breathing disorders were effectively treated.

– Poor growth and development– Orthodontic problems– Increased chance of OSA as an adult

Enlarged Tonsils & Adenoids

A common cause of snoring and sleep apnea in children. Large adenoids alone may promote more unhealthy mouth breathing. Large tonsils encroach on the oral pharynx from the side and cause obstruction leading to snoring and sleep apnea.

A large tongue can play a role in restricting the airway. A large tongue, when relaxed, is more likely to fall back and cause obstruction in the airway

Tongue

Uvula

Airway Blocked

Tongue

Uvula

Airway Blocked

Tongue

Uvula

Airway Blocked

Excessive Fat in the Neck/ Throat

Fat deposits and excessive fat in the neck or throat can cause a restriction leading to snoring and possibly sleep apnea.

NOTE: A neck circumference of 16” or greater for women, and 17” for men indicates increased likelihood of airway obstruction due to neck size.

SmokingSmoking irritates tissues and causes inflammation

of the airway and uvula which leads to a more restricted airway. The longer you smoke the smaller your airway becomes. The smaller the airway the higher chance of Sleep Apnea.

OSA COMMON CONDITIONS

Memory Loss

Morning headaches

Irritability

Depression

Decreased sex drive

Impaired concentration

(Source: American Academy of Dental Sleep Medicine)

Family History

Studies have shown that a family history of Snoring and OSA increase likelihood of occurrence. This is most likely due to genetic traits and upper airway/facial abnormalities that may be passed on.

Hypertension

Stroke

Cancer

Heart attack

Sudden death while sleeping

(Source: American Academy of Dental Sleep Medicine)

OSA SERIOUS CONDITIONS

Treatment Options

● CPAP- (continuous positive airway pressure)

● Bi-PAP● ORAL APPLIANCE

CPAP / BI-PAP

Bi- PAP

Oral Appliance

Lamberg Sleep Well

Adjustable Dorsal FDA approved

●Do I snore with a CPAP?

“It is very easy to be a top 1%, because everyone wants to be mid 50%”

L. D. Pankey

“Do it RIGHT first time, then you don’t need to do it TWICE”

L.D. Pankey