Sleep Apnea

What is obstructive sleep apnea (OSA)?

Obstructive sleep apnea (OSA), commonly called sleep apnea, is a sleep disorder in which a person ceases to breathe multiple times throughout the night due to partially or completely blocked airways. The condition occurs when the tongue or throat tissues intermittently relax and block the airway during sleep.

What are common symptoms of sleep apnea?

Common symptoms include snoring, frequent breaks in breathing, daytime sleepiness or fatigue, morning headaches, restless sleep, depression, frequent nighttime urination, acid reflux and irritability.

How is sleep apnea diagnosed?

A certified sleep physician will diagnose sleep apnea based on a review of family and medical history, a physical exam, and a sleep study. Sleep studies can be done in a sleep lab or at home with a portable monitor.

How is sleep apnea treated?

  • Sleep apnea treatment options include:
    • Continuous positive airway pressure (CPAP) machine
      • CPAP is the most commonly prescribed treatment for sleep apnea. The machine forces continuous airflow through your nose to prevent the airway from collapsing when muscles relax during sleep. This results in a continuous oxygen level throughout the night. Unfortunately, many wearers do not or cannot tolerate the machine for various reasons and seek alternative forms of treatment.
    • Oral device therapy:
      • A custom-fit oral device available through Good Night Dentistry is a highly effective, non-invasive option for sufferers of sleep apnea and snoring. The device fits like a sports mouth guard and is comfortable, quiet, and easily portable for travel.
    • Surgery:
      • Surgery is performed to remove or reposition the tissues in the throat to stop blockage of the airway.

What are the risks of untreated sleep apnea?

If left untreated, sleep apnea can lead to a number of serious health issues such as high blood pressure, heart disease, stroke, diabetes, dementia and depression. Daytime sleepiness can also greatly increase the risk of accidents.

How common is sleep apnea?

It is estimated that between 18 and 52 million people in the US suffer from sleep apnea. Not only does this affect older men and women, but it can also be seen in younger females and children as well. Unfortunately, the majority of sufferers may be unaware of the problem.  Approximately 90% of cases of obstructive sleep apnea remain undiagnosed or misdiagnosed as other ailments.

What can increase the risk for developing sleep apnea?

Obesity, age, the presence of enlarged tonsils or adenoids, frequent alcohol consumption, and smoking can all put individuals at an increased risk. Heredity and physical traits such as a large neck can also play a role in developing sleep apnea.

Snoring

What causes snoring?

Snoring is caused by an interruption of airflow in the nasal or throat cavity that restricts the passage of air and one’s ability to breathe easily. Poor muscle tone can cause the tongue or throat tissues to vibrate and relax and narrow the passageway.

Is snoring normal?

Snoring is a very common condition, but silence when sleeping is the norm. Occasional snoring is usually not very serious. If snoring occurs habitually, however, it will likely disrupt sleep patterns and affect quality of sleep.

How to stop snoring?

Lifestyle changes such as losing weight, minimizing alcohol and tobacco use, and regular exercise can help reduce snoring. There are also a variety of over-the-counter treatment options available–nasal sprays or cones, or special pillows–that may provide temporary relief. If snoring persists, the best thing to do is see a sleep specialist to determine the cause.

Could snoring be a symptom of a greater sleep issue?

Occasional snoring is likely not a sign of underlying problems. Frequent snoring, on the other hand, may be a symptom of sleep apnea, a sleep disorder defined by intermittent cessation of breathing while asleep.

What are the risks of untreated snoring?

Snoring can cause strain on the heart, leading to high blood pressure, heart attack, or stroke. Snoring can also cause low oxygen levels in the blood, which can lead to pulmonary hypertension.

 

Chronic snoring can also lead to health changes in your bed partner.  Loud snoring can lead to hearing loss and poor, fragmented sleep.  This can lead to weight gain, issues with sugar metabolism and high blood pressure your partner.  Chronic fatigue, lack of focus and mood change may also be seen.

 

Lastly, snoring can lead to relational problems. These can range from making it difficult to find a partner, sleep divorce (sleeping in separate bedrooms) to actual divorce.

Oral Devices

How do oral devices treat sleep apnea and/or snoring?

Oral devices support the jaw in such a way that prevents the throat muscles and tissues, and the tongue from falling back into the airway and causing obstruction of airflow during sleep.

What are the advantages of oral device therapy?

Oral devices are a highly effective, non-invasive treatment option for snoring and sleep apnea. Devices are comfortable, quiet, easy-to-wear, easy to clean, compact, and portable for travel. Many wearers find them more tolerable, and often more effective, than the CPAP machine.

Are there possible side effects of wearing an oral device?

Each device is custom-fit to the wearer by Dr. Cox and his sleep assistants to significantly reduce the possibility of a patient experiencing side effects. When they do occur, side effects are typically minor, particularly when considering the risks of leaving the disorder untreated or ineffectively treated. Side effects may include jaw or tooth discomfort, excessive salivation, or dry mouth. Changes in bite or TMJ symptoms are rare, but also possible.

How long should the oral devices last?

This depends on several factors, including the type of device, how hard you are on the device (clenching and grinding) as well as how well you take care of it.  With proper maintenance, you should expect the oral appliance to last between three to five years or longer.  Most medical insurance providers will cover a replacement device after three years.

Will insurance cover oral device therapy?

Oral devices are covered by most medical insurances. We work closely with patients and their insurance to obtain pre-authorization and to ensure that coverage amounts, including any out-of-pocket costs, are fully disclosed and understood prior to treatment. If you have a traditional Medicare plan with a separate supplemental policy, treatment is almost always at no cost to you.

Can you make a dental device just for snoring?

Yes, but only after a sleep test and diagnosis to rule out obstructive sleep apnea. Keep in mind that snoring can be one of the primary signs of sleep apnea or it can be independent of it.  Imagine if I turned a fire alarm off (snoring) but hadn’t really put out the fire (sleep apnea).

Can my physician or regular dentist make my dental sleep device?

According to the American Academy of Sleep Medicine (AASM), custom, titratable dental sleep devices should be made by a qualified dentist with advanced training in the field of dental sleep medicine.

 

Physicians can but are discouraged from making these devices. Your regular dentist may be able to make an appliance, but the difference is in the understanding of the nature of this disorder, appliance selection, and how to tailor the device to maximize effectiveness while minimizing your risk of side effects, unless they have had advanced training.

 

It is also worth noting that as of 2015, the AASM advocates that oral appliance therapy be considered as a primary treatment option for mild or moderate obstructive sleep apnea. Additionally, the updated guidelines state that in the case of severe sleep apnea, oral appliances are a primary option for the CPAP intolerant.

Can I keep seeing my regular dentist?

Yes.  At Good Night Dentistry, we do not do any general dentistry.  We will work closely with the dentist of record to assure that you get the best care possible.

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