For more than 100 years the University of Nebraska Medical Center College of Dentistry has provided exceptional dental education and service to Nebraskans and beyond through premier educational programs, innovative research and clinical care.
From regular checkups and cleanings to braces and dentures, the dental college provides the highest quality patient care in all areas at affordable costs. To find out more about programs and services visit the website at http://www.unmc.edu/dentistry or call 402-472-1301.
|Ronald Attanasio, D.D.S., is a professor and director of the temporomandibular and orofacial pain section at the UNMC College of Dentistry. Dr. Attanasio has published numerous articles and book chapters including a textbook, "Dental Management of Sleep Disorders," which is the first text of its kind to focus on the role of the dental office as part of a medical team for the treatment of sleep disorders.|
|What is sleep apnea?
There are three different kinds of sleep apnea, but the most common one is called obstructive sleep apnea. Sleep apnea in itself means cessation or stopping of breathing. The obstructive sleep apnea means that the brain is telling the respiratory muscles around the lungs to continue to make an effort to breathe. However, there’s some obstruction somewhere in the nasal channel or in the throat channel that’s blocking the air from passing through. And that blockage can be various reasons. One, it may be the tonsils, it could be the adenoids, could be an enlarged tongue.
|What causes sleep apnea?
There are two channels of which the human body can breathe. One is through the nasal airway, the other is through the oral airway. Generally, we have no obstruction or blockage going through the airway channels. On some individuals, there may be some adenoid tissue that’s up towards that nasal airway that restricts the air flow, and that can cause some blockage. We also may have the presence of tonsils, and that also can cause some blockage. If there’s some extra adipose, or fatty tissue in the throat, that may also thin the airway. And then when we recline ourselves and go to sleep, gravity has a tendency to make the tongue fall back, and that restricts the airway. So now all of a sudden, if there’s a complete blockage in that air channel, that is called obstructive sleep apnea.
|How is sleep apnea treated?
There are three basic treatment methods. One is through continuous positive airway pressure, and that is considered to be the gold standard. An individual would wear a mask interface that would fit over either just the nose or the nose and the mouth, depending upon where the blockage is and how much mouth opening there is when sleeping. But there’s a breathing unit that would push air and flow through these channels and push all the obstructed tissue out of the way. Surgically can also be done as a second method to remove the blockage, either the tonsils, the adenoids and/or some of the enlarged tongue.
The third one is oral appliance therapy that helps hold the lower jaw forward to create more of an open airway space.
How do I know if I have sleep apnea?
There are basically two methods to assess that. One is going to be subjective and the other is going to be objective. With the subjective method, we’re going to depend upon a significant other or our spouse, who observes while we’re sleeping, perhaps that we’re gasping or choking for air while we’re sleeping. We may also subjectively feel that ourselves, and awaken gasping for air. We may even have dreams that we’re choking, drowning underwater, falling off a cliff, having a difficulty to breathe, and we awaken that way. So those are subjective methods. The objective method of getting some documentation and a report is spending an overnight study with a sleep lab, and that’s called a polysomnagram or a PSG. That is the official way of having a documented method of determining that one has sleep apnea.
| How do I know if the treatment has been effective for my sleep apnea?
There are going to be two methods of determining that effectiveness of treatment. One is going to be subjective – our spouse or our significant other is going to have fewer observations of us gasping or choking for air when we’re sleeping. The snoring may be reduced if there’s an associated snoring with the sleep apnea. And then there’s the subjective aspect also of ourselves, where we will awaken less during the evening. We may experience fewer or no episodes of gasping and choking for air. Another subjective method of ourselves is that we’re going to feel more refreshed and awake during the day. If we wanted objective data, then we would have to rely upon the polysomnagram, which is that overnight sleep study in a sleep center lab.
COD Fast Facts:
The UNMC College of Dentistry at a glance.
Proud History: For 13 of the past 18 years the college ranks highest in incoming GPA of any dentistry program in the USA.
Quality Education: Our students consistently shine with high board scores in both the dental and dental hygiene programs and the college offers strong residency programs in endodontics, general dentistry, orthodontics, pediatric dentistry and periodontics.
Service: Our commitment to service is evident in the strong clinical community service programs that provide outreach to underserved populations across the state.