Dental specialties
Snoring and sleep apnea
Although snoring is often associated with good sleep, it can be linked to a serious health problem: sleep apnea. We discuss snoring and sleep apnea in this post.
Although snoring has historically been associated with sleeping well, the reality is that behind every snore there may be a major health problem: sleep apnea. We answer everything you need to know about snoring and sleep apnea in this article.
What is snoring? It’s NOT sleeping well
Snoring has traditionally been associated with restful sleep, but it can be quite the opposite.
Snoring occurs because air passes with difficulty through the upper airway and causes the soft tissues to vibrate. The sound comes from the throat, palate, uvula, tongue, and walls of the mouth. In other words, it’s a sound, but that sound is warning us that air may not be passing through as it should. However, there’s a difference between simple snoring and when it’s accompanied by sleep apnea or hypopnea.
What are sleep apneas and hypopneas?
In general terms, apnea is a complete cessation of airflow during sleep while hypopnea is a partial reduction. These pauses can vary in duration, from a few seconds to even two or three minutes in exceptional cases, and usually end with a louder snore or a gasp.
TYPES OF SLEEP APNEA
Although the concept is used generically regardless of its cause, we can distinguish two types of apnea and both deserve attention.
Obstructive sleep apnea (OSA)
Obstructive sleep apneaIt is a physical or mechanical problem. It occurs because the muscles at the back of the throat relax too much, the tongue falls back, or the soft tissue collapses, physically blocking the passage of air. OSA is the most common form of apnea.
Central sleep apnea
Central sleep apnea is an alteration in the respiratory control of the central nervous system. In this case, the throat doesn’t close completely; instead, the brain doesn’t properly send the signal to the respiratory muscles to move and the cycle stops. Central apnea is often associated with other conditions, such as heart failure, stroke, or the use of certain medications like opioids.
Snoring, a very common problem
Snoring is a spectrum within sleep-related breathing disorders whose main manifestations are snoring and apnea. According to the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR), snoring affects 49% of middle-aged men and 25% of middle-aged women in Spain. Regarding sleep apnea, the same SEPAR states that around 1 – 1.3 % of the Spanish population is diagnosed and receiving treatment for sleep apnea, but underdiagnosis is very high and the estimated actual prevalence is much greater. If we look at modern global estimates, the data are even more striking. An analysis published in The Lancet estimated that around 936 million adults aged 30 to 69 worldwide may have obstructive sleep apnea.
Snoring also affects children
Although it may seem like a very adult problem, but it can also affect children. Childhood obesity or having large tonsils or adenoids can contribute to this disorder in young children. And although it may seem like just snoring, it can lead to sleep deprivation, behavioral problems, poor concentration, mouth breathing, or even an increased risk of hypertension in the future. Therefore, tonsil and adenoid surgery is one of the most common options in pediatrics when indicated.
Causes of snoring and sleep apnea
So why do some people snore and others don’t? Why do some have sleep apnea and others don’t? The main explanation lies in the upper airway. When we fall asleep, all the muscles relax, and if the patient has a narrow throat, a tongue that falls back, a very collapsed soft palate, a retracted jaw, or certain anatomical features that favor the closure of the airway, that passage through which the air enters narrows even more, and then snoring or even apnea appears.
Risk factors
Among the most important risk factors are the overweight, age, nasal congestion, alcohol, tobacco, use of certain sedatives, family history, menopause, heart failure, or neurological disorders. In addition, there are certain craniofacial anatomical characteristics such as retrognathia or a narrower airway that can influence this type of disorder.
Snoring and its relationship with physiognomy
There is an important relationship between facial structure and snoring. The size of the tongue and palate matters, as does the relationship between the maxilla and mandible; even the bite and facial structure can give us clues. That’s why sleep dentistry exists, a specialty focused on the diagnosis and treatment of sleep-related problems. Because often the problem isn’t just how you sleep, but also how your airway is structured. Therefore, dentists must be trained to detect signs and symptoms of sleep-related breathing disorders and participate in the management of oral appliances when indicated.
Symptoms of sleep apnea
Another problem with sleep apnea is the difficulty patients have in recognizing their condition, especially if they sleep alone. Various medical societies list the following as typical signs: loud snoring, dry mouth, observed pauses in breathing, waking up with a feeling of suffocation, excessive daytime sleepiness, morning headaches, irritability, and difficulty concentrating. If the patient sleeps with someone, in addition to loud snoring, the companion may hear strange silences, snorting, or the sensation that the patient is choking.
Health consequences of snoring
Beyond that possible irritability and feeling of tiredness, it should be noted that apnea is associated with cardiovascular problems, high blood pressure, poorer metabolic control, impaired quality of life, and a higher risk of accidents due to drowsiness. This is not a coincidence; each pause in breathing forces the body to react and increases physiological stress, an episode that, if repeated night after night, can have consequences.
How is OSA diagnosed?
So, how is it diagnosed? The first step is to suspect it, the second is to investigate it. In most cases, a home study with portable devices that record parameters overnight: oxygen saturation, pulse, apneas and hypopneas, snoring, and posture are all assessed. This data is used to classify the severity of sleep apnea. Generally, apnea is considered mild when there are between 5 and 14 events per hour, moderate between 15 and 30, and severe above 30. While many mild cases can be managed in a dental office with an appropriate approach, severe cases are usually referred to a sleep unit.
How to treat sleep apnea and snoring
It is important to keep in mind that not all patients will need the same thing nor should they be treated in the same way: this depends on each case, the severity, the anatomy, the weight, and whether or not the person tolerated certain therapies.
The CPAP machine, the most effective treatment
The most well-known treatment is CPAP, a machine that delivers pressurized air through a mask to keep the airway open and prevent collapse. It remains the standard treatment in many moderate and severe cases, especially when the most effective control of apnea is desired. The problem is that not everyone tolerates it well; some people don’t adapt to it and abandon it.
Intraoral devices can also help
Sleep health specialists may also refer the patient to a dentist or orthodontist for a custom-made oral appliance. These appliances can slightly advance or hold the jaw in position while sleeping, preventing the airway from closing too much. These are like modern, comfortable, and adjustable splints. It is important to emphasize that these are custom-made and require follow-up by a dentist, so any splint bought online will not work. These are indicated for treating mild to moderate apnea or for patients who are intolerant to CPAP machines.
Surgery to treat sleep apnea
In some cases, surgery may also be necessary. For example, if there are very large tonsils, marked anatomical alterations, or situations in which palate surgery or maxillomandibular advancement is considered or other approaches depending on each patient. As we have already mentioned, tonsil and adenoid surgery can be especially relevant in children who suffer from snoring for this reason.
Other recommendations for patients with snoring
In addition to these professional treatments, there are a number of habits that can help patients with this problem. Losing a few pounds can make a world of difference if you are overweight, but measures such as the following also help: sleep on your side, reduce alcohol consumption at night, quit smoking, exercise, and treat nasal congestion.when it exists.
Treatment of snoring and sleep apnea in A Coruña
If you snore heavily and/or suffer from sleep apnea and live in A Coruña or the surrounding area, our dental medical center specializes in this type of disorder. Book an appointment with no obligation
Other specialties
Dental Implants 
Orthodontics 
Periodontal Diseases
Oral Surgery
Dental Prothesis
Cosmetic Dentistry
Endodontics
Pediatric Dentistry
TMJ Dysfunction
Snoring and Sleep apnea
Sedation
Oral Health Considerations