Online Sleep Assessment
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Apnea-hypopnea index (AHI)
The severity of a patient’s sleep apnoea can be measured using the apnoea-hypopnea index which takes the patients apnoea events (pauses in breathing) per hour and places them into a category. The apnoea events must last for at least 10 seconds and cause oxygen desaturation in the blood.
For an adult, it is normal for up to 5 apnoea events to occur in an hour while asleep, anymore is considered suffering from a form of sleep condition. However for children, an AHI of more than 1 apnoea in an hour is considered abnormal and should be seen by a doctor.
Mild sleep apnoea: 5≤AHI<15
Moderate sleep apnoea: 15≤AHI<30
Severe sleep apnoea: AHI≥30
Who does sleep apnoea affect?
Unfortunately sleep apnoea can impact anyone, however there are factors which can increase the chances, including the following:
- Narrows airway
- Neck circumference
- Nasal congestion
- Being older
- Being male
- Use of alcohol
- Family history
- Heart disorders
- Certain medications
Symptoms and complications of sleep apnoea
- Stop breathing during sleep
- Gasping for air
- Morning headaches
- Waking up with a dry mouth
- Difficulty sleeping
- Daytime tiredness
- Difficulty paying attention during the day
- Mood changes
- High blood pressure – the sudden drops in oxygen levels overnight lead to increased blood pressure, which puts a strain on the cardiovascular system.
- Heart problems – it is known that the obstructive sleep apnoea may increase the risk of heart attacks, stroke and abnormal heartbeats. This is a major health risk as these together could lead to death.
- Liver problems – sleep apnoea can lead to liver scarring and abnormal results on liver function tests.
- Type 2 diabetes – sleep apnoea increases your bodies risk of insulin resistance, which may lead to diabetes type 2.
- Surgery complications – after having major surgery, patients who suffer from sleep apnoea are exposed to greater risks.
These symptoms and complications are all the reasons to why a person suffering sleep apnoea should seek treatment from Dr Gibbins at Dental Sleep Medicine.
Please also remember that if you suffer from sleep apnoea, it can impact your daily life in all aspects and make you dangerous while driving.
The tongue is frequently involved in Obstructive Sleep Apnoea (OSA) and TMJ and Oro-Facial Pain conditions and should not be overlooked in management. Lack of strength and tone in the tongue contributes to many jaw pain and airway problems.
Myofunctional Therapy, as used for OSA and Sleep Disordered Breathing, has been clinically proven to improve OSA by as much an 50%.
While this strategy of tongue strengthening is rarely undertaken as the only management in OSA, it is certainly a useful additional mode of treatment to use along with CPAP therapy or Oral appliance therapy, as well as various other modes of treatment.
Anybody with OSA should be instructed in terms of simple exercises they can do regularly to assist in their home-care.
Incorrect tongue posture and positioning and incorrect swallowing techniques that linger from infancy can be addressed.
- A very useful exercise for relaxing painful masticatory muscles and also to strengthen the tongue and increase the muscle-tone of the tongue, the Lateral Pterygoid and Medial Pterygoid Muscles, is to raise the tip of the tongue to the roof of the mouth and hold the tongue on the palate and scrape the tip of the tongue back to the back of the palate.
Repeat this particular exercise 20 times at least twice a day and whenever else you think of it, eg in the shower, while driving etc..
This exercise is also very useful in repositioning the head of the jaw (condyle) back into its resting position on removal of the Mandibular Advancement Device in the morning.
- Open the mouth widely and close again immediately. Repeat 20 times at least twice a day.
- For actual TMJ pain cases, an additional exercise that can be done is to place the tip of the tongue on the palate just behind the upper front teeth, hold it firmly against that spot and open the jaw as wide as you comfortably can and hold it about 5 seconds with the tongue still on the palate. Close again and simply, and repeat 2-3 times a day along with the above set of exercises.
- Tik Toks. This exercise involves sucking the tip of the tongue to the palate behind the upper front teeth and “clicking” it off the palate with the lips first in a smiling position, the TIK, and then with the lips pursed as in saying “Oooh” as the TOK position. Repeat 20 times 2-3 times daily.
- Close the lips and push the tongue firmly into the upper and lower lips and cheeks, moving the tongue from upper lip, to lower lip and both cheeks. This needs only to take 15-20 seconds each time. Repeat it 3 times each exercise session and 2-3 times daily.
- Drink sips of water through a straw with the teeth held together.
A very useful relaxation technique used in many chronic pain conditions:-
- Lie flat on the floor on your back on a gym or yoga mat, not a bed. If the neck is chronically inflexible, use a folded towel so the head is passively held neither head forward nor head backward. The eyes should face straight up.
- Tuck the chin in.
- Place the tip of the tongue on the palate just behind the upper front teeth and close the lips.
- Place one hand on the stomach and the other on the chest.
- Concentrate on regular breathing into the belly not the chest.
- Hold this position for 10 minutes, although longer is fine.
- Repeat this relaxation pose twice a day for at least 2-3 weeks although it can remain a permanent habit.
Self-administered diagnosis tests for you
The questionnaire has a score range from 0 to 8 and asks questions regarding snoring, sleepiness, breathing difficulties while sleeping and high blood pressure. Any score over 3 means there is a high risk of OSA in the patient.
OSA-50 Screening Questionnaire:
This test calculates a score between 0-10 by asking about questions related to OSA symptoms. A score ranging from 5-10 means the patient may be at risk of OSA.
Epworth Sleepiness Scale (ESS):
The ESS is a questionnaire which determines daytime sleepiness by asking 8 questions related to the chance of dozing off while performing the 8 different activities. Each question has a 0-3-point scale system and the questionnaire has a total score between 0-24. The higher your score, the higher the chance of suffering from OSA.
Please have a look at the three self-administered diagnosis test here.
In Australia, an ESS score of 8 or more, a STOP-BANG Score of 4 or more and an OSA 50 Score of 5 or more qualifies a patient to have Medicare cover part or all the cost of a Home Sleep Study. Medicare will only cover any part of the cost of a Home Sleep Study if it has not been done in the last 12 months. If you think you may suffer from sleep apnoea, please do not hesitate to contact Dental Sleep Medicine by clicking here Contact Us or calling our friendly staff on (07) 4051 4580 .