Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts. If you snore loudly and feel tired even after a full night's sleep, you might have sleep apnea.
The main types of sleep apnea are:
Obstructive sleep apnea, the more common form that occurs when throat muscles relax
Central sleep apnea, which occurs when your brain doesn't send proper signals to the muscles that control breathing
Complex sleep apnea syndrome, also known as treatment-emergent central sleep apnea, occurs when someone has both obstructive sleep apnea and central sleep apnea
The signs and symptoms of obstructive and central sleep apneas overlap, sometimes making it difficult to determine which type you have. The most common signs and symptoms of obstructive and central sleep apneas include:
Episodes in which you stop breathing during sleep — which would be reported by another person
Gasping for air during sleep
Awakening with a dry mouth
Difficulty staying asleep (insomnia)
Excessive daytime sleepiness (hypersomnia)
Difficulty paying attention while awake
How Is OSA Treated?
Your sleep doctor will discuss treatment options with you. These options include continuous positive airway pressure (CPAP) therapy, oral appliance therapy, and surgery.
CPAP therapy involves wearing a face mask connected by tubing to a constantly running machine.
Oral appliance therapy uses a mouth guard-like device - worn only during sleep - to maintain an open, unobstructed airway.
Surgical options include a variety of procedures. All have varying side effects and rates of success.
Research shows that oral appliance therapy is an effective treatment option for snoring and obstructive sleep apnea.
An oral appliance is worn in the mouth only while you sleep and fits like a sports mouthguard or an orthodontic retainer. Oral appliances support your jaw in a forward position to help maintain an open upper airway.
Many patients consider a sleep apnea appliance to be more comfortable to wear than a CPAP mask. Oral appliances also are quiet, portable, and easy to care for.
If you and your doctor decide that oral appliance therapy is the best treatment option for you, then your doctor will prescribe for you to receive a custom-made sleep apnea appliance. You also will receive a referral to a qualified dentist who can provide oral appliance therapy. More than 100 oral appliances have received FDA clearance. Your dentist will recommend the device that is best for you. Many medical insurance plans cover oral appliance therapy.
Is Treating OSA Important?
Treating obstructive sleep apnea is incredibly important to your health. When left untreated, sleep apnea often causes excessive daytime sleepiness or fatigue, as well as morning headaches and memory loss. Sleep apnea also is a threat to your safety as it increases your risk of drowsy driving and workplace accidents. Untreated sleep apnea raises your risk for serious health problems. These include:
High blood pressure
Chronic acid reflux
A dentist can be consulted throughout the process of OSA diagnosis and treatment for patients across the lifespan. The spectrum of dental care with patients diagnosed with OSA (or at high risk for the condition) may include a comprehensive oral examination, evaluation of oral anatomy and the appropriateness of providing oral appliance therapy, and other considerations.
Health history-taking can be supplemented with the use of one or more of the OSA-specific screening questionnaires, including the STOP-Bang Questionnaire and others. OSA may be considered in dental patients who report sleepiness as a common symptom. Appropriate evaluation and patient assessment, including a thorough medical and dental history, are important steps to help identify individuals at risk for clinically significant OSA. Patients determined to have a significant risk of OSA (e.g., through a screening questionnaire like STOP-Bang) may be referred to a physician or sleep specialist for further evaluation.
When conducting a standard evaluation of the patient’s oral cavity, dentists are ideally positioned to identify oral or craniofacial abnormalities or other anatomical factors (e.g., abnormalities or deviations in oral structures and tissues) that are common signs of OSA or potential risk for the condition. Features within the oral cavity that can be evaluated include a large tongue, retrusive jaw, or enlarged tonsils (grade 3 or higher associated with increased risk of OSA). A manual examination of the TMJ muscles and region is also recommended for evaluation of normal joint function and any associated pain. Dentists may also evaluate patients for airway obstruction in accordance with the Mallampati Scale, as well as neck circumference and severe overjet.
Patients can be educated about the strong association between OSA and systemic hypertension, coronary artery disease, and increased risk of stroke, atrial fibrillation, and type 2 diabetes. Obstructive sleep apnea is commonly linked with obesity, and increased body weight is associated with a higher risk for OSA and increased progression and severity of the condition. When appropriate, patients suspected of having OSA should be referred to their primary care physician or sleep specialist. Some patients may benefit from seeing a registered dietician for nutritional counseling.
Generally, dentists are advised to maintain a high level of awareness when evaluating or treating patients who present with signs or symptoms suggestive of OSA (e.g., excessive daytime sleepiness; breathing pauses during sleep that are accompanied by snorting or gasping).
Patients with OSA may be advised to visit their dentist regularly for a thorough assessment of their dental and periodontal condition, as well as fabrication and maintenance of properly fitted oral appliances that can be used safely over time.
Any question please ask us. Make an appointment for a regular check-up at Empower Your Smile.