Dr. Mark Cruz of Dana Point joins doctors from around the world for a series of discussions in a "Multi-Disciplinary Airway Collaborative" he co-developed. The purpose of the forum is to create an ongoing conversation about the relationship between the structure and function of the human airway and facial development. Doctors from various disciplines, from dentistry to orthodontics, contribute research, knowledge, and theories to real-time recorded conversations available on Dr. Cruz's website at http://www.learnairwaydentistry.com/spreecast-videos.html
In Episode 15, Dr. Cruz invites Dr. Keith Thornton of Dallas, Texas, to discuss the neuromuscular influences on obstructive sleep apnea. Dr. Thornton, Diplomat of the American Board of Dental Sleep Medicine, specializes in temporomandibular joint dysfunction.
Dr. Thornton defines sleep disordered breathing as, "a disorder of breathing during sleep only or significantly affected by sleep." In general, the patient has little or no difficulty with breathing while awake. Therefore, sleep disordered breathing is not a true sleep disorder, according to Dr. Thornton.
Dr. Thornton classifies three types of sleep disordered breathing, their levels of severity, and treatments available. The types are:
- Mechanical sleep disordered breathing - This is the inappropriate collapse of the pharynx during sleep, which can include snoring and obstructive sleep apnea. Treatments available include oral appliance therapy, CPAP (continuous positive airway pressure), and a combination of the two, as well as surgeries and tracheotomies. This is the least severe type.
- Chemical sleep disordered breathing - Central sleep apnea falls into this category. Treatments available include CPAP, VPAP (variable positive airway pressure), oral appliance therapy, a combination of them, and oxygen devices. Many pulmonologists believe that mechanical sleep disordered breathing can be remedied when the chemical effects are reduced. A normal pressured CPAP can help smooth out a chemical reaction.
- Neuromuscular sleep disordered breathing - This occurs when there is paralysis of an involuntary muscle (the diaphragm) or lack of adequate tidal volume requiring ventilation at night. This is the most severe type, and a ventilator, tracheotomy, or a combination of the two may be used to treat it.
Do you want to learn more about sleep disordered breathing? If so, consider scheduling an appointment with Dr. Cruz. Call (949) 661-1006.