Snoring, Sleep Apnea, Breathing

By Arthur M. Strauss, DDS

Ever fall asleep in a chair and wake up with a gasp? Thats from your tongue dropping back and blocking your throat and choking you. Perhaps you felt your heart fluttering or pounding. Or, maybe you blocked that out.

Ever notice somebody, having fallen asleep sitting back in a chair, snoring and notice a silent pause in the snoring that may last from seconds to more than a minute and is followed by a snort? The silent period of this pause or cessation of breathing is caused by the back of their tongue blocking their throat. This is referred to as obstructive sleep apnea. Apnea is defined as transient cessation of breathing.

You might notice struggling or convulsing of their throat and chest as their body struggles to suck in air during the choking period, even though the person remains asleep through the whole process and resumes snoring after it. We call this struggle one of “fight or flight”, an “adrenalin” response. The breathing rate, heart rate and blood pressure tend to increase. And, there is a correlation between sleep apnea, heart attack and stroke. According to news reports obstructive sleep apnea has been suspected as the cause of the famous football player, Reggie White, dying in his sleep.

Even before the throat is blocked the adrenaline is helping compensate for the narrowing throat as the tongue muscle progressively relaxes as we progressively relax further and further into deeper sleep. And even during the day when distracted or relaxed, as when laughing, we may witness ourselves snort as the tongue drops back and instantaneously blocks the throat.

Medical intervention for this includes nasal CPAP that works like a vacuum cleaner in reverse blowing air down the throat, or surgery to cut away throat or tongue tissue or resect (cut and reconnect) the tongue muscle connection to the jaw bone. And, while dental intervention can include jaw surgery, it most often involves designing and fitting special mouthpieces that look like orthodontic retainers or athletic bite guards to reposition the tongue to stay out of the throat while they are worn.

Specially trained dentists familiar with more than 100 varying mouth piece designs successfully provide this oral appliance therapy.