When the upper airway repeatedly collapses during sleep, causing cessation of breathing, Obstructive Sleep Apnea Syndrome (OSAS) occurs. Dr. Bertrand De Silva discussed OSAS at a session of the Airway Focused Dentistry Mini-Residency. The course was co-developed by Dana Point dentist, Dr. Mark A. Cruz.
Dr. De Silva is Diplomate of the American Boards of Internal Medicine, Pulmonary Medicine, Critical Care Medicine & Sleep Medicine and medical director of the Sleep Center at St. Jude in Fullerton, Calif. As an Intensive Care Unit doctor, he has 50 beds in the ICU. Of all the patients in the ICU, he said 50 percent of them have sleep apnea.
Only 15 percent of the patients with this condition are diagnosed, and only 1.5 percent of them are diagnosed during a medical encounter.
There is also a four to six-fold increase in death at four years. Dr. De Silva addressed the potential near- and long-term consequences of untreated sleep apnea. Near-term consequences include automotive accidents, excessive sleepiness, neuro-cognitive and performance deficits, and decreased quality of life. Long-term consequences include hypertension, heart disease, heart attack, stroke, impaired glucose tolerance, diabetes, and sudden death.
Dr. De Silva explained motor vehicle crash statistics to illustrate the importance of treating sleep apnea. Motor vehicle crashes are the leading cause of injury morbidity and mortality. Sleep-related accidents comprise 15 to 20 percent of all motor vehicle crashes and are more common than those related to alcohol and cellular phone or text use combined.
Driver fatigue causes up to 20 percent of accidents on monotonous roads. Sleep related accidents tend to be more severe.
The Orange County Transportation Authority conducted a study amongst all of its bus drivers. The average weight gain of a bus driver was 100 pounds in five years. Over 70 percent of the bus drivers had symptoms of OSAS.
Dr. De Silva’s presentation was titled “A cry for help.” Dr. Cruz was among the many doctors who attended the course trying to find solutions to OSAS, a growing problem affecting so many adults.