SLEEP DISORDERS: MYTHS & FACTS ABOUT OBSTRUCTIVE SLEEP APNEA Written By: Dr. Ankita Shah, 15 October 2023

Sleep-Disordered Breathing (SDB) is an umbrella term for different sleep-related breathing disorders and abnormalities of breathing during sleep that do not meet the criteria for a disorder. Sleep disorders can also be grouped according to behaviours, problems with your natural sleep-wake cycles, breathing problems, difficulty in sleeping or how sleepy you feel during the day. Some common types of breathing-related sleep disorders include:

Mouth breathing

Snoring

Upper airway resistance syndrome (UARS)

Obstructive sleep apnea

Daytime sleepiness

In this condition, the throat closes completely during sleep, making you fight and struggle to breathe. Loss of oxygen can put stress on your heart & body, waking you up numerous times during a single night, gasping for air.

The two types of sleep apnea known are central sleep apnea and obstructive sleep apnea. Obstructive sleep apnea occurs repeatedly and is caused by a blockage in the airway when soft tissue collapses (naturally) while sleeping. On the other hand, central sleep apnea is not commonly found. In this condition, the airways are not blocked. But, the brain struggles to signal the muscles to breathe.

Interesting Facts About Sleep Apnea

1) Myth: Loud Snoring and Sleep Apnea are the Same :
Fact: There’s a big difference between loud snoring and sleep apnea, though snoring can be a symptom of sleep apnea. People suffering from sleep apnea can stop breathing up to 400 times throughout the night. These intervals can last from 10 to 30 seconds and are usually followed by a snort when the breathing starts again. More often than not, people are unaware of this. This breaks the sleep cycle leaving you tired and drowsy during the day. Long-term consequences of chronic sleep deprivation may lead to a host of health problems including high blood pressure, obesity, diabetes, cardiovascular disease, and even early mortality.

2) Myth: Only Older People Are Affected by OSA :
Fact: Sleep apnea can occur from infancy and can affect people of all ages, right from children to adults. It starts with mouth breathing and progresses to noisy breathing, leading to snoring and may finally result in sleep apnea. One out of 10 children is affected by obstructive sleep apnea. Children mostly experience mild symptoms and it continues to show different signs in different age groups. Obstructive sleep apnea can be dangerous, so it is better to consult with a sleep apnea doctor if you notice any signs or symptoms of sleep apnea in any of your family members.

3) Myth: Getting a Sleep Apnea Test Is a Hassle :
Fact: Sleep apnea tests used to be a hassle back in the day, as the only option was to go to a sleep clinic for an overnight stay where you’d be attached to different machines and wires. However, thanks to modern technology, it is now possible to take the sleep apnea test at home. You need to wear a portable sleep & breathing monitoring device like a WatchPAT provided by the sleep disorder specialist at night. In the morning, return the testing equipment to the doctor’s office, who will then set up a follow-up visit to discuss the test results with you.

4) Myth: Weight Loss Doesn’t Help with OSA :
Fact: Shedding body fat helps reduce the fat in the neck & tongue, which contributes to restricted airflow. A healthy diet & exercise regime might be beneficial for overweight people suffering from OSA. It is best to talk to your doctor about starting a weight loss program to lose the extra pounds. However, while obesity is a risk factor, thin people can also develop sleep apnea, so it is not a prerequisite.

5) Myth: Surgery is the Only Cure For OSA :
Fact: A collective, multidisciplinary, holistic approach needs to be undertaken to address the condition related to sleep apnea. Oral Myofunctional Therapy, Airway Orthodontics, Breath Retraining, Correction of Tongue Function & Mobility and Orthotics (TMJ splints) – are some methods used to improve the position and function of the tongue. Airway orthodontic appliances can also help expand the upper jaw and advance the lower jaw, which helps open up the airway. It is better to talk to an expert sleep apnea doctor about the pros & cons of surgery before you choose a particular route.

6) Myth: Lying on Your Side Doesn’t Help Alleviate OSA :
Fact: Gravity plays the trick as leaning on your back pulls the tissues in your throat down where they are most likely to block your airways. Sleeping on your side will help open your throat. Plus, placing a pillow on your side can help.

7) Myth: Oral Appliances For Sleep Apnea Are Ineffective :
Fact: Oral appliances for sleep apnea are fitted into your mouth by an airway focused dentist. The mouthpiece or oral appliance in your mouth helps to ease mild to moderate sleep apnea. The device is custom-made to adjust the position of your lower jaw and tongue. You need to put this appliance in your mouth at night, and it will help keep your airway open while sleeping.

8) Myth: OSA is not a Serious Condition :
Fact: Another myth about sleep apnea is that it is not a serious condition. However, that fact is, sleep apnea puts your body in a constant sympathetic drive which affects the eyes, increases the heart rate, inhibits salivation, and leads to bronchial dilatation. It can also lead to chronic respiratory and cardiovascular diseases, high blood pressure, acid reflux & digestion issues, obesity, insulin resistance leading to diabetes and even early mortality.

9) Myth: Mostly Men Suffer From Sleep Apnea :
Fact: While men are more often diagnosed with obstructive sleep apnea, this condition affects both men & women of all ages, including children. In fact, UARS – a precursor of sleep apnea – is highest in post menopausal women. Sleep apnea does present itself differently in men and women, with men experiencing excessive sleepiness and snoring; whereas, women face more insomnia-like symptoms. While the symptoms may vary, the fact is that women do experience sleep apnea; they just go undiagnosed compared to men.

10) Myth: CPAP is an ineffective treatment for OSA :
Fact: Continuous positive airway pressure (CPAP) is an effective treatment for OSA that helps supply a steady stream of air into your airway via pipes. The CPAP machine can be adjusted until the flow is strong enough to keep your airway open while you sleep. It is a common treatment for adults with moderate to severe OSA. But it’s not the only one. There are a lot of other methods that can be used alongside CPAP to treat OSA. Some of these include Oral Myofunctional Therapy, Airway Orthodontics, Breath Retraining, Correction of Tongue Function & Mobility and Orthotics (TMJ splints).

11) Myth: OSA doesn’t block your breathing :
Fact: Yes, it does! Obstructive sleep apnea occurs when your airway gets physically blocked by your upper & lower jaw, soft palate, tongue, tonsils and/or other tissues. The air you breathe is physically prevented by the blockage caused by OSA.

12) Myth: Tongue Ties Doesn’t Cause OSA :
Fact: The tongue consists of 8 muscles, all of which are important for the complete act of swallowing and maintaining a posture of the neck and shoulders. It also plays a vital role in diaphragmatic breathing by keeping the tongue resting high up on the palate, which helps in keeping the airway wide open. However, at times, the tongue rests low in the mouth. This can be caused due to a tongue tie, low muscle tone, mouth breathing, or inadequate space in the mouth. It can cause an airway function disorder since the posterior part of the tongue falls back and narrows the airway. Airway function disorder can affect children as well as adults and includes mouth breathing, noisy breathing, snoring, UARS and obstructive sleep apnea and oral muscle dysfunction.

How Can We Help – Comprehensive Treatment Approach

The key to addressing conditions related to sleep apnea is to follow a multidisciplinary, holistic approach. We can help you treat sleep apnea through Oral Myofunctional Therapy, Airway Orthodontics, Breath Retraining, Correction of Tongue Function & Mobility (tongue tie) and Orthotics (TMJ splints). A combination of these treatment approaches can help stabilise the TMJ, improve the position & function of the tongue, expand the upper jaw and advance the lower jaw, thereby helping open up the airway.

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