Sleep Apnea

Sleep apnea is a sleep disorder characterized by interruptions in breathing during sleep. These interruptions, known as apneas, can be caused by the relaxation of throat muscles and the collapse of the upper airway, leading to a temporary cessation of breathing. Sleep apnea can result in poor sleep quality, daytime fatigue, and other health complications.

Sleep apnea can have serious health consequences, including an increased risk of heart disease, stroke, and other medical conditions such as diabetes, gerd, obesity, etc…. Therefore, it is essential to diagnose and manage it effectively as soon as possible.

During a dental consultation for sleep apnea, Dr. Issa will assess whether dental-related factors are contributing to the condition. During the consultation, she will inquire about your sleep patterns, symptoms, and medical history. She will also examine the oral cavity and throat structures to identify potential anatomical issues.

Dental treatment for Obstructive Sleep Apnea includes the oral appliance (Mandibular Advancement Device – MAD). This custom-fitted device repositions the lower jaw and tongue to help keep the airway open during sleep, reducing apneas.

The mandibular advancement device can be a great treatment option for patients intolerant to CPAP. Tongue retaining devices are designed to hold the tongue in place to prevent it from blocking the airway, helping to maintain regular breathing.

Changes in sleeping position are recommended to reduce the severity of sleep apnea, as some people experience more severe symptoms when sleeping on their backs.

Lifestyle changes are recommended such as weight management, alcohol and sedative avoidance, and good sleep habits (sleep hygiene) are promoted.

It is important to note that the appropriate treatment for sleep apnea depends on the type and severity of the condition.

Dr Issa works closely with medical doctors and sleep apnea specialists such as a pulmonologist or an ENT to ensure the best outcome.

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The Epworth Sleepiness Scale

The Epworth Sleepiness Scale is widely used in the field of sleep medicine as a subjective measure of a patient’s sleepiness. The test is a list of eight situations in which you rate your tendency to become sleepy on a scale of 0, no chance of dozing, to 3, high chance of dozing. When you finish the test, add up the values of your responses. Your total score is based on a scale of 0 to 24. The scale estimates whether you are experiencing excessive sleepiness that possibly requires medical attention.

How Sleepy Are You?

How likely are you to doze off or fall asleep in the following situations? You should rate your chances of dozing off, not just feeling tired. Even if you have not done some of these things recently try to determine how they would have affected you. For each situation, decide whether or not you would have:

  1. No chance of dozing =0
  2. Slight chance of dozing =1
  3. Moderate chance of dozing =2
  4. High chance of dozing =3

Write down the number corresponding to your choice in the right hand column. Total your score below.

SituationChance of Dozing
Sitting and reading
Watching TV
Sitting inactive in a public place (e.g., a theater or a meeting)
As a passenger in a car for an hour without a break
Lying down to rest in the afternoon when circumstances permit
Sitting and talking to someone
Sitting quietly after a lunch without alcohol
In a car, while stopped for a few minutes in traffic
Total Score

Analyze Your Score


0-7: It is unlikely that you are abnormally sleepy.

8-9: You have an average amount of daytime sleepiness.

10-15: You may be excessively sleepy depending on the situation. You may want to consider seeking medical attention.

16-24: You are excessively sleepy and should consider seeking medical attention.

Reference: Johns MW. A new method for measuring daytime sleepiness: The Epworth Sleepiness Scale. Sleep 1991; 14(6):540-5.