Sleep Apnea

What is Sleep Apnea?

Obstructive Sleep Apnea (OSA) is a disorder that causes people to experience partially or totally blocked airways during sleep. Blockage occurs because the portion of the throat that connects to the esophagus—the pharynx—relaxes.

After some seconds the body responds to the oxygen deprivation by contracting muscles in the diaphragm and forcibly clearing the airway. This pattern of blockage/unblockage can continue off and on throughout the night, continually disrupting normal sleep patterns and resulting in the symptoms of sleep deprivation even if the person spends their “normal” number of hours sleeping.

Symptoms of sleep deprivation include daytime sleepiness, irritability, depression, weight gain, forgetfulness, accident proneness, and others. Cognitive functioning is reduced and judgement is impaired. Sleep deprived people fall asleep while driving and operating machinery (both common causes of serious and fatal accidents.)

Prolonged sleep deprivation, in turn, can lead to a number of health problems such as high blood pressure, heart disease, gastroesophageal reflux disease (GERD), strokes, atherosclerosis, irregular heartbeat, congestive heart failure, and type 2 diabetes.

Diagnosing Sleep Apnea

Diagnosis is typically established by Physician sleep specialists, who use studies (polysomnograms) conducted in sleep labs to confirm Sleep Apnea. In a sleep study the patient has monitoring devices attached which will track brain wave activity, eye movements, muscle activity in the legs, body positioning, heart rate and rhythm, blood pressure, respiration and oxygen levels.

 If Dr. Michalos suspects Sleep Apnea he will recommend that you follow up with your physician who would then refer you to a sleep specialist. A sleep study can also be self-administered in the comfort of your own home through use of a home sleep study device.

Sleep Apnea, if diagnosed, needs to be addressed. The two most effective treatments are the use of a CPAP machine, and the use of an Oral Dental Appliance.


A CPAP machine is the first line of treatment and it consists of a facial mask with hose connected to a box that delivers humidified air under pressure to the sleeper. It is an extremely effective treatment. Unfortunately many people find the mask to be too uncomfortable and the noise of the machine disturbing.  As a result there’s a high rate of patient rejection.

Oral Appliance Therapy (OAT)

Oral Dental Appliances are prescribed by dentists. As an alternative to CPAP, Oral Appliance Therapy has a high success rate. The basic idea is to prevent the jaw from moving into a position that will block the airway. OAT devices work extremely well for mild to moderate sufferers and somewhat well with severe cases of Sleep Apnea.