What Kind Of Doctors Diagnose And Treat Sleep Apnea?
Do you suffer from loud snoring, headaches, and/or excessive daytime sleepiness? Symptoms like these and others may be associated with a serious and potentially life-threatening sleep disorder called obstructive sleep apnea (OSA).
Timely diagnosis and treatment are paramount, but what kind of doctor should you see if you suspect you have OSA? Your choice is important because OSA can be difficult to diagnose.
In fact, up to 80 percent of people with mild to moderate OSA go undiagnosed. And although common risk factors such as being an overweight, middle-aged male raise a reg flag, you can’t go by these alone. OSA can occur in both men and women of all ages, including people of normal weight.
Doctors That Help Treat Obstructive Sleep Apnea
OSA keeps you from getting good, quality sleep that is essential to your physical and mental health and wellness. With OSA, your breathing repeatedly stops and starts during sleep, resulting in a decreased oxygen supply to vital organs.
This usually occurs when the soft tissue in the back of the throat collapses or narrows and blocks the upper airway. Your brain, sensing an interruption in breathing, momentarily awakens you to reopen your airway and restart breathing.
Discussing symptoms with your doctor so you can be appropriately diagnosed and treated can improve your quality of life and may even save your life. OSA is tied to a host of chronic health conditions, including underlying coronary disease and cardiovascular risk factors such as diabetes, hypertension, and heart failure.
Sleep dentists such as Dr. Katherine S. Phillips, are board certified by the American Board of Dental Sleep Medicine and work closely with sleep medicine physicians and other medical specialists to treat OSA. Dentists like Dr. Phillips create individualized treatment plans that include customized oral appliances worn during sleep.
These appliances, which fit like a sports mouth guard, support the jaw in a forward position to help maintain an open upper airway. Research shows that oral appliance therapy can be an effective treatment option for mild to moderate OSA. Moreover, patients who are good candidates for oral appliance therapy often prefer it to using a CPAP (continuous positive air pressure) machine to treat their OSA. Unfortunately, CPAP is known to have problems with adherence, with many patients eventually abandoning the device.
Primary Care Physician
A primary care doctor such as an internist, family medicine physician, or geriatrician will likely be the first medical professional you talk with about your symptoms. While some primary care doctors diagnose and treat mild OSA cases, many refer patients to a sleep medicine specialist for testing and diagnosis.
You may also be referred to another specialist, such as an ENT (otolaryngologist), who can determine if anatomical abnormalities are the cause, to a neurologist to determine if underlying neurological problems exist, or to a sleep medicine dentist.
Sleep Medicine Physicians
Sleep medicine doctors are usually trained in a medical specialty such as internal medicine, pulmonology, otolaryngology, or neurology, then complete additional training in sleep medicine. Physicians who have undergone special training and certification in diagnosing and treating sleep disorders (insomnia, sleep apnea, etcetera.) are typically associated with an accredited sleep lab where diagnostic sleep studies are conducted.
Their credentials may include completing a medical subspecialty fellowship in sleep medicine, having completed a sleep medicine certification program offered by a medical specialty board such as the American Board of Internal Medicine, or board certification by the American Board of Sleep Medicine (available until 2006).
Ear, Nose and Throat Doctors (Otolaryngologists)
Sometimes OSA is caused by anatomical anomalies such as an abnormally narrow airway, nasal passages that cause an obstruction, or tonsils or adenoids that obstruct breathing. After a physical exam, an ENT may order imaging tests to get a better look at these structures to ultimately determine if you are best treated by a surgical or nonsurgical solution, or a combination.
Pulmonologists (Breathing/Lung Doctors)
Pulmonologists are medical specialists that focus on the health of the respiratory system. These physicians are very familiar with sleep disorders, including OSA, and manage other diseases such as COPD, asthma, and other breathing disorders that may be related to sleep apnea.
Neurological disorders and OSA may coexist, and there can be a bidirectional relationship. In fact, people with neurological conditions such as Parkinson’s disease, myotonic dystrophy, ALS, MS, and myasthenia gravis can be at a higher risk of OSA. A neurologist can also determine if your OSA is caused by an underlying and potentially undiagnosed neurological condition.
How Do Doctors Diagnose Sleep Apnea?
When you see a medical professional for OSA, be prepared to discuss your symptoms and answer questions. The doctor will also review your medical history, medications you take (certain medications can cause the muscles and tissues in the throat to relax and narrow the airway), and perform a physical exam.
Usually, a diagnostic sleep study will be performed at an accredited sleep lab where you will be monitored while you sleep. Typically, polysomnography, a noninvasive, gold standard test is recommended. As you sleep, it records various body functions, such as the electrical activity of the brain, eye movement, muscle activity, heart rate, respiratory effort, air flow, and blood oxygen levels.
Other types of studies are available depending on your situation and symptoms, including in-home sleep studies that utilize a device to measure airflow, blood oxygen saturation, and breathing patterns while you sleep. Once an OSA diagnosis has been made, you may be treated by your sleep medicine physician or referred to one of more specialists for treatment taking a multi-disciplinary approach.
When Should I See a Specialist?
If you have persistent OSA symptoms, including but not limited to those below, it’s a good idea to see a specialist or ask your primary care physician for a referral to one as soon as possible.
Chronic Loud Snoring. Understanding why you snore is the first step toward getting the right treatment so you can enjoy a more restful, healthful night’s sleep. Common causes that are associated with OSA include:
- Excess Throat and Neck Tissue. Bulky, fatty throat and neck tissue and poor muscle tone are often linked to being overweight or obese and can lead to airway narrowing.
- Age. The normal aging process can cause throat and tongue muscles to sag and relax, blocking your airway.
- Anatomical Anomalies. Problems with your nose and throat anatomy tied to snoring include a deviated septum, a narrow throat, a cleft palate, and enlarged adenoids and/or tonsils.
Excessive Daytime Sleepiness. In OSA, the airway becomes blocked during sleep which causes you to wake up to restart breathing. This can happen hundreds of times each night which deprives you of sound, restful sleep.
Unexplained Headaches. Headaches, especially in the morning upon waking, can be associated with OSA. These headaches may be triggered by the low oxygen and high carbon dioxide levels that occur during repetitive OSA episodes during sleep.
Waking Up Short of Breath, Gasping or Choking. When throat muscles become so relaxed that they block your airway, you may wake up abruptly gasping for air or choking.
Contact Us for an Obstructive Sleep Apnea Consultation
If you know or suspect you have obstructive sleep apnea, find out how Dr. Katherine S. Phillips can help you find relief. Schedule an appointment today. As a board-certified sleep dentist who holds a Master of Science in Orofacial Pain, her practice is dedicated to treating sleep disorders, including obstructive sleep apnea, as well as TMD. She will develop a customized treatment plan to best meet your individual needs.
By: Dr. Katherine Phillips, DDS, MS