What is Sleep Apnea?

Sleep apnea is a breathing problem that occurs among millions of Americans while they sleep.  The word “apnea” simply means no breathing.  An apnea is an event where a person stops breathing.  There are different forms of sleep apnea, and the most prevalent form is Obstructive Sleep Apnea or OSA.  As the name implies, this form of sleep apnea occurs when something is obstructing the airway.

Symptoms of obstructive sleep apnea include loud snoring, gasping or choking sounds during sleep, restless or fitful sleep, poor quality of sleep, and daytime tiredness.

Another form of sleep apnea is Central Sleep Apnea, in which the brain malfunctions and fails to send the appropriate signals to the body to breathe during sleep.

Why is Sleep Apnea Treatment Important?

Suffering from sleep apnea means not breathing well at night, which leads to decreased blood oxygen levels during sleep.  When the brain detects a lower than normal amount of oxygen, its attempts to improve oxygen levels put stress on various areas of the body.  Instead of getting the rest it needs to recuperate for another day, the body is “working” all night.

In addition to not getting adequate rest during sleep, patients with sleep apnea often suffer a higher risk for diseases like diabetes, cardiovascular disease, GERD (acid reflux), asthma, and depression.  Sleep apnea does not cause these diseases, but it does make them worse in a person who already has them.

In contrast to kids with sleep apnea, sleep-related breathing disorders can be treated with the Healthy Start Program. Sleep apnea in adults is a disorder that is treated and managed rather than cured.  By treating sleep apnea, the body can obtain normal levels of oxygen in the blood and get proper quality of sleep.  This also combats the increased risk from other diseases.  Treating sleep apnea improves the body’s ability to manage other health problems.

How Do Dentists Treat Sleep Apnea?

Obstructive sleep apnea involves a closure or blockage of the airway.  There are many ways to open the airway in an OSA case, and traditional treatments include CPAP (Continuous Positive Airway Pressure) devices, surgeries to enlarge the airway, and oral appliance therapy.  OSA may be a disorder that involves various areas of the body, so it also requires a multidisciplinary approach to treatment.

Diagnosis of obstructive sleep apnea may take place through a primary care physician or a sleep physician.  Treatment can involve the sleep physician, ENT, oral and maxillofacial surgeon, and/or a dentist, depending on the type of treatment chosen.

How Do Oral Appliances Treat Sleep Apnea?

Many people are unable to tolerate the use of a CPAP machine to treat their sleep apnea.  Others simply do not want to wear a cumbersome breathing machine.  An alternative treatment is oral appliance therapy using a mandibular advancement device. This type of oral appliance, as the name implies, functions to advance the mandible or pull the lower jaw forward.

Three of the risk factors for obstructive sleep apnea are obesity, large neck circumference, and a poor relationship of the upper and lower jaws. In obesity and large neck circumference, the extra weight on the neck presses downward when someone lays down, and that pressure can close off the airway.  In problems with jaw relationship, the lower jaw has an improper position that is too far back, limiting the size of the airway and making it smaller than normal. These risk factors can be overcome by physically pulling the lower jaw forward, which in turn brings the tongue forward and opens the airway to allow for proper breathing.

The sleep apnea appliance uses its intimate fit on the upper and lower teeth and a connection between them to position the lower jaw forward in relation to its “normal” sleeping position.  This forward pressure opens the airway, allowing the smooth passage of an adequate amount of air as you sleep.

What Can I Expect from a Sleep Apnea Appliance?

To make your sleep apnea appliance, your dentist will take detailed molds or high-definition intraoral scans of your teeth, as well as the way your upper and lower teeth fit together.  With precise measurements, a dental laboratory fabricates the sleep appliance according to the dentist’s instructions.  You return for a second visit to receive your appliance, with explicit instructions for care and use.

You can expect an adjustment period.  It is not likely that you will wear your new appliance and sleep all night immediately.  Most people need to take some time to get used to the feeling of this type of appliance and the position into which it places the lower jaw.  The best thing you can do to adjust quickly is wear the appliance during an hour of TV watching or a chore.  This will help your mouth get used to the sensation of wearing a dental appliance.

You can expect some increased salivation at first.  Your body thinks that new things inserted into the mouth are food, and it salivates in response.  Again, you train your body to know that this appliance is not food by wearing it consistently.

You can expect improved sleep and a happy bed partner.  When properly adjusted and consistently worn, your sleep apnea appliance will open your airway, eliminate snoring, and improve your overall health!