Patient #102 came to our office for relief from his snoring which was keeping his wife awake.  Further questioning revealed that he was suffering from a significant amount of daytime fatigue and sleepiness.   To rule out the existence of obstructive sleep apnea, we sent him home with a Watch PAT home sleep monitor.  

Patient #102 is a classic example of someone who would never get a diagnosis of obstructive sleep apnea if evaluated by a sleep lab. Patients like this do not meet the minimum criteria for obstructive sleep apnea but still have a significant amount of upper airway collapse (heard as snoring) through the night which results in significant sleep fragmentation.  In other words, while they do not stop breathing during sleep and their oxygen levels do no drop, they have to labor to breath through a partially collapsed airway.  This is much like trying to breathe through a very narrow straw.  This is a very unrestful sleep.  To see the results of his initial home sleep test click on the image below.

Initial home sleep test

Patient #102 is joining a long list of patients we have treated who had a sleep study and were told they had no problem.  However, after sleeping with their oral appliance to eliminate the snoring that was effecting the sleep of their bed partner, these patients report feeling better.  Since everyone reacts to sleep deprivation in different ways, the reports from these patients vary.   Most will say that they awaken more refreshed.  However, many of these patients report a significant reduction of daytime sleepiness and fatigue as did this patient as illustrated by the following chart.

The Epworth Sleepiness Scale is a subjective assessment of daytime sleepiness.  The Fatigue Severity Scale measures fatigue as perceived by the patient.  Notice the dramatic improvement in both daytime sleepiness and fatigue as experienced by this patient with oral appliance therapy.  Not only has this patient’s life been enhanced by this therapy, but his bed partner is now sleeping better with the elimination of his snoring.

This entry was posted on Sunday, November 23rd, 2008 at 9:40 am and is filed under Featured Patient. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.