Snoring and Obstructive Sleep Apnea

Share on facebook
Share on twitter
Share on linkedin
Share on pinterest

Is the sound of snoring or sudden gasps for air keeping you or your partner up at night? You may actually be the lucky one.  The snorer may have a serious underlying medical condition, one which poses real harm if not addressed.  Poor sleep can lead to daytime fatigue, irritability, poor behavior, trouble with relationships and increased health problems. People who chronically lack sleep are also more likely to become depressed. Sleep disorders, deprive you of a “good night’s sleep”, chronic daytime exhaustion and long-term cardiovascular stress. Heavy, loud snoring can be a sign of a more serious health problem called sleep apnea.

The signs and symptoms of sleep apnea include snoring, excessive daytime sleepiness, gastro esophageal reflux disease (GERD), mood swings, impotence, morning headaches, insulin resistance, decreased mentation, glucose intolerance, increased risk of auto accidents and an overall decreased quality of life.  Cardiovascular consequences include hypertension, congestive heart failure, myocardial ischemia and infarction and stroke.

Sleep apnea is a serious disorder in which your breathing stops repeatedly while you sleep.  These breathing stops are called “apneas” and may happen hundreds of times a night.  Obstructive Sleep Apnea (OSA), the most common type, happens when the airway becomes blocked during sleep.  A blockage is usually caused by the soft tissue in the back of your mouth collapsing and closing during sleep.   Relaxed throat muscles, a narrow airway, a large tongue or extra fatty tissue in the throat can also block your airway.  A partial or complete closure of the upper airway during sleep, from a few seconds to more than a minute, depletes the blood of oxygen and disrupts sleep.

The American Academy of Sleep Medicine estimates that more than 18 million Americans have OSA, with 80 to 90 percent being undiagnosed and untreated.  OSA is diagnosed by physicians who read the raw data from a full sleep study (polysomnogram) or a home sleep test (HST).

There are several treatment options available for Obstructive Sleep Apnea.  Continuous positive airway pressure, or CPAP, pneumatically “splints” the upper airway open during sleep.  Although CPAP is the current preferred treatment among physicians, it is a real inconvenience to wear – the mask, hoses, leaks and noise often result in poor compliance.  Surgical options for the treatment of OSA include operating on any part of the upper airway, basically from the nose and mouth down to the Adam’s apple.  Surgical interventions are normally reserved for patients on which conservative measures have failed.  Oral appliance therapy continues to gain popularity as an alternative to CPAP and surgery.  Oral appliance therapy (also called dental device therapy) aims to reposition the mandible, tongue and pharyngeal structures, thereby preventing collapsibility of the upper airway during sleep.  Patients tend to prefer oral appliances to CPAP in most randomized trials.  In fact, a literature review in February 2006 of Sleep states: “Oral appliances (OAs) are indicated for use in patients with mild to moderate OSA who prefer them to CPAP therapy, or who do not respond to, are not appropriate candidates for or who fail treatment attempts with CPAP.”

While CPAP has been known to be the “gold standard” among physicians, custom-made, adjustable dental devices have been shown to be as or more effective than CPAP at treating non-severe OSA.  To find out more about dental device therapy in treating OSA, please contact our office to schedule a complimentary consultation with Dr. Pope.