Obstructive sleep apnea is a serious condition affecting millions. The most obvious symptoms are snoring, tiredness and gasping during sleep. CPAP is the gold standard of treatment for sleep apnea and adverse effects can be averted with treatment. Unfortunately the majority of patients do not tolerate CPAP. Oral appliances are a comfortable alternative for treatment of sleep apnea and snoring. Studies hhave shown that most patients prefer dental appliances over CPAP when offered a choice.
Oral appliances are considered a first line of treatment for mild to moderate sleep apnea and an alternative to CPAP for severe apnea when patients do not tolerate CPAP. Patients who are CPAP intolerant or who just can't stand CPAP can learn more about Dental Sleep Medicine at http://www.ihatecpap.com
Recent papers by Dr Peter Cistulli suggest that increased compliance with apnea treatment with oral appliances balances any advantages CPAP may have for many patients.
The current paper by Dr Lavie in Israel outlines how oxidative stress can be a common link in many of the known morbidities related to sleep apnea. Intermittent hypoxia and reactive oxygen species (ROS) are the cause apparent of oxidative stress and are the central aspects of this disorder according to Dr Lavie. The damage on a molecular basis results in altered cellular function promoting inflammation and endothelial dysfunction. According to Dr Lavie the apnea and resultant hypopnea results in Oxidative stress that is an intimate component in obesity, sympathetic activation cortisol and adrenal problems and metabolic disorders such as hypertension.
For your convenience the Pub Med abstract is include below.
Eur Respir J. 2009 Jun;33(6):1467-
Molecular mechanisms of cardiovascular disease in OSAHS: the oxidative stress link.
Lavie L, Lavie P.
Lloyd Rigler Sleep Apnea Research Laboratory, Unit of Anatomy and Cell Biology, The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel. lenal@tx.technion.ac.il
Obstructive sleep apnoea/hypopnoea syndrome (OSAHS) is a highly prevalent breathing disorder in sleep that is an independent risk factor for cardiovascular morbidity and mortality. A large body of evidence, including clinical studies and cell culture and animal models utilising intermittent hypoxia, delineates the central role of oxidative stress in OSAHS as well as in conditions and comorbidities that aggregate with it. Intermittent hypoxia, the hallmark of OSAHS, is implicated in promoting the formation of reactive oxygen species (ROS) and inducing oxidative stress. The ramifications of increased ROS formation are pivotal. ROS can damage biomolecules, alter cellular functions and function as signalling molecules in physiological as well as in pathophysiological conditions. Consequently, they promote inflammation, endothelial dysfunction and cardiovascular morbidity. Oxidative stress is also a crucial component in obesity, sympathetic activation and metabolic disorders such as hypertension, dyslipidaemia and type 2 diabetes/insulin resistance, which aggregate with OSAHS. These conditions and comorbidities could result directly from the oxidative stress that is characteristic of OSAHS or could develop independently. Hence, oxidative stress represents the common underlying link in OSAHS and the conditions and comorbidities that aggregate with it.
