Snoring and Sleep Apnea are more than annoying--they can lead to serious health-related issues. For many, treatment can be successfully achieved through a simple oral appliance worn while sleeping. Grant Hensley Dentistry helps you identify if an oral appliance is right for you. If appropriate, we fit and equip you with a treatment to increase your quality of sleep and your health.
Here is an overview of why it's important to treat your sleep disordered breathing.
Quality of Sleep
The quality of your sleep affects your daily activities and has a huge impact on the overall quality of your life. If you are not getting an adequate amount of sleep during the night, then you and your body may suffer from sleep deprivation and be prone to daytime sleepiness. This may affect your:
| • Productivity and performance at work • Increase your risk for injury or illness • Cause strain in personal relationships • Be a sign of a more serious health problem |
Sleep Disordered Breathing (SDB)
Sleep disordered breathing (SDB) includes an array of breathing problems during sleep. Snoring, difficulty with breathing, and interrupted breathing are included.
Sleep disordered breathing is a spectrum of severity based on the collapsibility of the airway. Symptoms increase due to the increase in the disruption of airflow.
When the jaw opens and the tongue falls into the back of the throat, the airway narrows forcing air through the smaller opening. This creates vibrations in the throat known as snoring. Although snoring seems physically harmless, it can be a “red flag” for a much more serious and sometimes fatal condition called obstructive sleep apnea (OSA).
Obstructive sleep apnea (OSA) occurs when the airway completely collapses blocking airflow into the lungs. The harder one tries to breathe, the tighter the airway seals. This airway obstruction persists until the brain partially awakens the person. Unconsciously, he/she will close the jaw returning the tongue and throat to a normal position.
The sleep apnea cycle – falling asleep, jaw relaxing, airway collapsing, unconsciously awakening with a gasp, falling back asleep – can repeat itself one time per minute or more in severe cases. With a blocked air passage, one does not receive enough oxygen. Both the awakenings and oxygen deprivation can then trigger other health problems.
Sleep apnea can cause:
| • Chronic Sleepiness • Strokes • Heart Attack • Heartburn • Morning Headaches • Depression • High Blood Pressure • Impotence |
How do you know if you have sleep disordered breathing (SDB)? The only way to be sure is to have a sleep test performed, either at home by a qualified sleep physician or in a hospital sleep center.
The Epworth Sleepiness Scale test asks questions such as how likely you are to fall asleep in different situations (watching TV, reading, etc.). If you snore or have been told that you awake gasping for breath, or if you are sleepy during the day, you should seek advice from your healthcare professional.
Since Obstructive Sleep Apnea (OSA) is a serious medical condition, it must be diagnosed by a physician. Diagnosis is based on the results of an overnight sleep study called a Polysomnogram (PSG). Other factors determining OSA are patient evaluation and history.
Good sleep hygiene, weight loss, and exercise, are some helpful treatments a patient can practice on their own. Medical and dental treatments include Continuous Positive Airway Pressure (CPAP), Oral Appliance Therapy, and Surgery.
Continuous Positive Airway Pressure (CPAP)
 |
Continuous Positive Airway Pressure (CPAP) is pressurized air generated from a bedside machine. The air is delivered through a tube, connected to a mask, covering the nose. The force of the pressurized air splints the airway open. The CPAP opens the airway like air into a balloon; when air is blown into the balloon, it opens and gets wider. This is exactly how CPAP clears the airway. |
Oral appliances are worn in the mouth to treat snoring and obstructive sleep apnea (OSA). These devices are similar to orthodontic retainers or sports mouth guards. Oral Appliance Therapy involves the selection, design, fitting and use of a custom-designed oral appliance that is worn during sleep. With an oral appliance, throat structures move out of your air passage, allowing air to flow freely through your throat. Oral appliances may be used alone or in combination with other means of treating OSA. These means include general health, weight management, surgery, or CPAP.
| Oral appliances work in several ways: • Repositioning the lower jaw, tongue, soft palate and uvula • Stabilizing the lower jaw and tongue • Increasing the muscle tone of the tongue |
 |
In addition to Oral Appliance Therapy, dentists who are oral and maxillofacial surgeons may consider a variety of methods to evaluate, diagnose and treat upper airway obstruction. These dental specialists treat upper airway obstructive disorders by utilizing both minimally invasive procedures as well as more complex surgery, including jaw advancement. Additionally, an ENT specialist may evaluate you for other types of surgery, mainly the removal of the excess tissues in the throat. It may be necessary to remove tonsils and adenoids (especially in children), the uvula, or even parts of the soft palate and the throat.
Determination of Best Treatment
Dentists with training in Oral Appliance Therapy are familiar with the various designs of appliances. They can determine which one is best suited for your specific needs. The dentist will work with your physician as part of the medical team in your diagnosis, treatment, and on-going care. Determination of proper therapy can only be made by joint consultation of your dentist and physician and must combine objective evaluation of severity and patient preference.
Initiation of oral appliance therapy can take from several weeks to several months to complete. Your dentist will continue to monitor your treatment and evaluate the response of your teeth and jaws throughout the whole process.
 |
Sleeping with someone who snores cannot only be annoying, but it may also be detrimental to your physical and emotional health. Research shows that people who sleep next to a person who snores suffer from: |
| • Higher incidence of aches and pains • Hearing loss, especially limited to the one ear most exposed to the snoring • High levels of fatigue and daytime sleepiness • Fibromyalgia • Depression or poorer mental health • Memory impairment |
One Mayo Clinic study found that the bed partners of people who snore woke at least partially an average of 21 times per hour. This is nearly as often as the 27 times per hour that the “snorers” were awakened by their own documented sleep disorders (such as sleep apnea).
Both bed partners may be suffering from a sleep-disordered breathing and sleep deprivation although only one may have the real problem. Often those who snore do not take complaints from their bed partner seriously or act in denial, which further exacerbates the problem.
Snoring and sleep apnea are conditions inflicted during sleep. During the night, the normal tongue and jaw positions allow air to pass through the throat effortlessly. The tongue is forward, the jaw is closed and the airway is open.
When a person suffers from sleep apnea, his/her airway is blocked periodically through the night depending on the severity of the sleep apnea. The mouth is open, the tongue and soft tissue relaxes and collapses into the throat. This causes the person to snore and possibly have sleep apnea episodes.
The TAP® is based on the same principle as cardiopulmonary resuscitation (CPR). The airway must be open to allow air to pass through the throat. A constricted or collapsed airway causes snoring or sleep apnea.
The TAP® holds the lower jaw in a forward position so that it does not fall open during the night and causes the airway to collapse. The TAP® maintains a clear airway to reduce snoring and improve breathing.
