Obstructive Sleep Apnea

Obstructive Sleep Apnea 1Obstructive Sleep Apnea 2

Obstructive sleep apnea Is the most common sleep apnea diagnosis. This disorder is caused when the soft tissue on the back of your throat relaxes during sleep and blocks your airway. As airflow stops, this is called an apnea, the oxygen level in your blood drops, causing your brain to kick start the breathing process, which is accompanied by gasping or choking.

This affects how you feel when you wake up and can lead to chronic health conditions. It can even be fatal if the case is severe and left untreated. Untreated for years, research shows that sleep apnea patients may lose 20-50% of their lifespan.

CPAPCPAP is used by many sleep apnea sufferers, but for some it can be cumbersome and not all patients respond to the therapy.

There are several non-invasive, nonsurgical procedures utilized by dentists trained in dental sleep medicine. Oral appliance therapy is one of them. It can be very effective in treating patients who snore and those suffering from mild to moderate sleep apnea as well as those patients with severe sleep apnea who cannot tolerate CPAP.

Once a patient has been diagnosed with a sleep apnea condition by a physician, oral appliance therapy is often a nonsurgical option for treatment. Oral appliances are recommended in mild and moderate cases of sleep apnea, and in severe cases if patients are unable to tolerate CPAP.

Oral appliances require specific design, fabrication and customized fittings to meet individual patient needs for proper forward repositioning of the lower jaw and tongue in order to improve the opening of the upper airway during sleep for successful treatment results.


What is Snoring?

Snoring is the fluttering sound created by the vibration of tissues in the back of the throat and nose.

Vibrating tissues can include:

  • Nasal airway
  • Soft palate
  • Uvula
  • Tonsils
  • Adenoids

In 80% of cases, the soft palate is the primary contributor to the problem.

There are studies that link snoring and and cardiovascular disease.

Here at the TMJ & Sleep Therapy Centre of New England we utilize advanced technology and specialized equipment to measure the airway, predict improvement, determine appliance design, and monitor success and efficacy of the oral appliance.

Treating snoring and sleep apnea requires a team approach. Dentists are the perfect practitioner to recognize oral symptoms and signs common to sleep apnea sufferers. Dentists — by the limits of licensure — cannot make a diagnosis of Obstructive Sleep Apnea (OSA). For that you need to visit a physician.

Some of the most serious health problems related to sleep breathing problems are:

  • Heart attack(myocardial infarction)
  • Excessive daytime sleepiness
  • Hight Blood Pressure
  • Heart Failure
  • Ischemic Heart Disease
  • Stroke
  • Diabetes
  • Obesity
  • Learning and memory problems
  • Sexual dysfunction
  • Depression
  • GERD
  • Cardiac arrhythmia (irregular pulse)

Symptoms you or your sleep partner may identify:

  • Chronic loud snoring
  • Choking or gasping for air during sleep
  • Episodes of stopping to breathe
  • Morning headaches
  • Feeling unrefreshed in the morning
  • Excessive daytime sleepiness
  • Difficulty getting to sleep
  • Dry mouth or sore throat upon waking
  • Difficulty concentrating

How to improve the quality of your sleep:

  • Establish relaxing pre-sleep routines.
  • Minimize light, noise, and temperature extremes in the bedroom
  • Avoid large meals just before bed; it keeps your digestive system active and disrupts sleep.
  • Avoid strenuous exercise within 2-3 hours of bedtime.
  • Avoid caffeine, nicotine, or other stimulants within 4 hours of bedtime.
  • Don’t sleep with an animal in your bedroom.

What is bruxism?

Bruxism, also known as tooth grinding, is the excessive grinding of the teeth and/or excessive clenching of the jaw.

Effects of BruxismIt is classified now as a movement disorder. It is unrelated to normal function such as eating or talking. Bruxism is a common problem; reports of prevalence range from 8–31% in the general population. Bruxism may cause minimal symptoms, and therefore people may not be aware of the condition. Several symptoms are commonly associated with bruxism, including hypersensitive teeth, aching jaw muscles, and headaches. Bruxism may cause tooth wear, and even damage or break teeth and dental restorations such as crowns and fillings.

Bruxism as a sign of a sleeping disorder

Bruxism Effects 1

Worn down teeth due to bruxism/grinding.

Bruxism Effects 2

One classic symptom of a sleep breathing disorder.

Bruxism Effects 3

Slight wear present. A dentist should be consulted to intervene early in order to avoid further damage.


What is oral appliance therapy?

An oral appliance is a small acrylic device that fits over the upper and lower teeth.

The purpose of an oral appliance is to advance the lower jaw or tongue, moving the base of the tongue forward and in turn opening the airway. This improves breathing and reduces snoring and apnea. The appliances are comfortable and well tolerated by the patient.

Indication for oral appliances

The American Academy of Sleep Medicine has stated that an oral appliance is indicated for the treatment of mild to moderate OSA (obstructive sleep apnea).

Also for:

  • Heavy snoring
  • Poor tolerance to CPAP
  • Failure of surgery
  • Use during travel
  • In combination with CPAP

Possible side effects of oral appliance therapy:

  • Tension in the jaw
  • Sore teeth and gums
  • Excessive salivation or dry mouth
  • Slight movement of teeth
  • Loosening of dental restorations (fillings, crowns)

Different oral appliances used:

Somnodent

Somnodent

Herbst

Herbst

Panthera

Panthera

Dorsal

Dorsal

Oasys

Oasys

EMA

EMA

...and more. Sometimes, a practitioner will not refer to you if you don't use a specific appliance.

Different oral appliances used:

Somnodent

Somnodent

Herbst

Herbst

Panthera

Panthera

Dorsal

Dorsal

Oasys

Oasys

EMA

EMA

...and more. Sometimes, a practitioner will not refer to you if you don't use a specific appliance.