Studies estimate that no fewer than 60% of men and 40% of women between forty and sixty years of age snore. Despite the fact that most people make light of snoring, in reality snoring is often a serious social problem and that significantly affect the snorer, spouse or partner. More importantly is that snoring is often a symptom of a serious, potentially life threatening medical condition called obstructive sleep apnea. Sleep apnea poses a significant health risk, remains largely undiagnosed and can lead to excessive daytime sleepiness, headaches and muscle pain, high blood pressure, diabetes, irregular heartbeat, and stroke.
Snoring occurs during sleep when the relaxed soft tissues making up the borders of the airway close together causing a partial obstruction or blockage, the vibration of these tissues together while breathing creates the snoring. Obstructive sleep apnea (OSA) occurs when the airway becomes completely blocked for a certain period of time, increasing heart rate and decreasing the critical oxygen saturation in the bloodstream. Those who suffer from obstructive sleep apnea are literally suffocating all night, but fail to realize it since they may never fully regain consciousness or remain unaware of the cause when they wake up repeatedly.
While we play a key role in initial screening and management of OSA specialized sleep medicine physicians must make the diagnosis based on overnight or home sleep studies. In very general terms patients are classified as having slight, moderate, or severe OSA. Slight sleep apnea patients stop breathing 5-15 times per hour, moderate 16-30 times per hour and severe more than thirty times per hour! Management of OSA falls into one or more of three categories. Continuous Positive Airway Pressure (CPAP), Oral Appliance Therapy (OAT) and surgical intervention to reduce occluding soft tissue. In the 2006 January issue of the Medical Journal of Sleep, specialists concluded that oral appliances were a first line treatment for sufferers of mild to moderate sleep apnea and appropriate for those patients unable to tolerate CPAP therapy. CPAP is the first line and most effective treatment for severe sleep apnea.
Obstructive apnea occurs when the tongue falls back and soft tissues surrounding the airway resulting in complete blockage of the airway for ten seconds or more. Oral appliances simply and gently reposition the lower jaw open and tongue forward to physically open the airway. They are custom designed and fabricated by a certified lab under our instruction to very precisely fit over the upper and lower teeth. The most common side effect is jaw soreness and a feeling that the teeth do not touch evenly first thing in the morning. Great care is taken to minimize and manage any potential negative side effects resulting from use of the appliance. Confirmation of the effectiveness of your oral appliance can be assumed once we have observed great improvement or complete cessation of snoring as reported by a recorder or bed partner however we strongly encourage and ask patients to conduct a follow up sleep study while wearing their oral appliance. This is the only way to directly measure the effectiveness of the treatment.
Oral appliances are only indicated for those patients suffering from obstructive sleep apnea as diagnosed by a licensed sleep medicine specialist. At Elmwood Dental Group we have worked closely with several sleep physicians in our area for over a decade in the diagnosis and treatment of sleep apnea. Common signs and symptoms of OSA include snoring, observed gasping or choking during the night, non-refreshing sleep, excessive daytime sleepiness, high blood pressure, morning headaches, irritability, and clouded memory.
For more information about sleep apnea and oral appliance therapy or to schedule a no obligation consultation, please contact Elmwood Dental Group at 585-461-4350. Dr. Baleno can discuss the basics of sleep apnea and snoring, risks associated with sleep apnea, how to go about proper diagnosis and treatment options.