Sleep Apnea Treatment
Sleep apnea, a disruption of breathing while asleep, is a particularly tricky sleep disorder – 90% of people who have sleep apnea don’t know that they have it! Although episodes of choking or gasping for air might occur hundreds of times throughout the night, you may not have any recollection of struggling for breath.
Usually it is the bed partner who first notices that the person is struggling to breathe. If left untreated, this common disorder can be life-threatening.
Snoring occurs when the airway is partially or completely blocked. An example would be a tongue that falls back as we drift off into deep sleep. As the diameter or size of the airway passage is getting smaller, it results in snoring.
Apnea literally means “no breath”. There are three types of apnea: obstructive, central, and mixed; of the three, obstructive is the most common. Despite the difference in the root cause of each type, in all three, people with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times during the night and often for a minute or longer.
Obstructive sleep apnea (OSA) is caused by a blockage of the airway, usually when the soft tissue in the rear of the throat collapses and closes during sleep. In central sleep apnea, the airway is not blocked but the brain fails to signal the muscles to breathe. Mixed apnea, as the name implies, is a combination of the two. With each apnea event, the brain briefly arouses people with sleep apnea in order for them to resume breathing, but consequently sleep is extremely fragmented and of poor quality.
Sleep apnea is very common, as common as adult diabetes, and affects more than twelve million Americans, according to the National Institutes of Health. Risk factors include being male, overweight, and over the age of forty, but sleep apnea can strike anyone at any age, even children. Yet still because of the lack of awareness by the public and healthcare professionals, the vast majority remain undiagnosed and therefore untreated, despite the fact that this serious disorder can have significant consequences.
Signs and Symptoms of Sleep Apnea
Should you be worried? Well, to answer that, first analyze some signs and symptoms of sleep apnea sufferers. Common side effects of sleep apnea patients are:
- Heart attacks, irregular heart beats or stroke
- High blood pressure
- Decreased libido
- Headaches, sore throat, or dry mouth in the mornings after waking up dry mouth
- Gastroesophageal reflux disease (GERD)
- Impaired concentration
- Learning disabilities
- Daytime sleepiness, including falling asleep at inappropriate times, such as at work, school, or while driving a car
- Frequent cessation of breathing (apnea) during sleep. Your sleep partner may notice repeated silences from your side of the bed
- Choking or gasping during sleep to get air into the lungs
- Loud snoring
- Sudden awakenings to restart breathing
- Waking up in a sweat during the night
- Feeling unrefreshed in the morning after a night’s sleep
- Chronic sleepiness
A simple test can be taken that will grade this last symptom called the Epworth Sleepiness Scale, as well as a Sleep Observers Questionnaire, which should be filled out by anyone who regularly observes the potential sleep apneic. Not all apneics will score high, but if you do, it is a very good sign of OSA (obstructive sleep apnea).
Is snoring the same as sleep apnea?
Snoring and sleep apnea are not the same thing. Snoring is simply a loud sound that you make during breathing while asleep if there is any obstruction in your airway. While it may be unpleasant for your sleep partner, snoring is not in itself a harmful condition. On the other hand, people with sleep apnea are deprived of oxygen due to a complete blockage of airways, which can have a major impact on health.
Snoring does often accompany sleep apnea, but just because you snore does not mean you have sleep apnea.
Signs and symptoms associated with Obstructice Sleep Apnea that are seen at night include:
- Dry mouth
- Sleep restlessness
- Witnessed Apnea (stopped breathing that last over 10 seconds)
In our office, we treat snoring and sleep apnea with a unique approach. Dentists now can provide you with a home monitor to help you (and us) assess whether or not sleep apnea should be a concern. The gold standard for treatment of sleep apnea was for a long time the CPAP machine, however, in many cases it is now an oral appliance.
Over time studies have shown that only a minority of CPAP owners are still compliant after one year. If you are one of the non-compliant, we can fabricate an oral appliance that will help open your airway and reduce the severity of your sleep apnea.
These appliances reduce sleep apnea associated health risks without the need for surgery, medications, or other therapies.
Causes and Risk Factors of Obstructive Sleep Apnea(OSA)
When you have obstructive sleep apnea, your throat collapses during sleep, blocking the airway and preventing air from getting to the lungs. Generally, your throat muscles keep the throat and airway open.
Causes and risk factors of sleep apnea:
- Shape of head and neck may create a smaller than normal airway.
- Large tonsils or adenoids or other anatomical differences. (A deviated septum, enlarged tongue, or receding chin can also create difficulties breathing during sleep)
- Being overweight or obese (although almost 50% of people with sleep apnea are not obese)
- Throat muscles and tongue relax more than normal during sleep. (This can be due to alcohol or sedative use before bedtime, but not necessarily)
- Snoring – Snoring can cause the soft palate to lengthen, which in turn can obstruct the airway.
- Smoking or exposure to secondhand smoke
- Nasal congestion, nasal blockages, and nasal irritants
- Family history of sleep apnea – No specific genetic marker for sleep apnea has been discovered, but obstructive sleep apnea seems to run in families. This may be a result of anatomic abnormalities that run in the family
- Other disorders and syndromes – Hypothyroidism, acromegaly, amyloidosis, vocal cord paralysis, post-polio syndrome, neuromuscular disorders, Marfan’s syndrome, and Down Syndrome
- Other physical conditions, such as immune system abnormalities, severe heartburn or acid reflux and high blood pressure. It isn’t clear whether the conditions are the cause or the result of sleep apnea
Effects of sleep apnea on health
What happens when you stop breathing during sleep?
If you have sleep apnea, you stop breathing during sleep, and the balance of oxygen and carbon dioxide in the blood is upset. This imbalance stimulates the brain to restart the breathing process. The brain signals you to wake up so that the muscles of the tongue and throat can increase the size of the airway. Then, carbon dioxide can escape, and oxygen can enter the airway. These waking episodes are necessary to restart breathing (and to save your life), but because of them, you become sleep-deprived.
Sleep apnea has serious health consequences and can even be life-threatening. The main effects of sleep apnea are sleep deprivation and oxygen deprivation.
Both the person with sleep apnea and the bed partner suffer from sleep deprivation. A bed partner may lose an hour or more of sleep each night from sleeping next to a person with sleep apnea. Along with the apnea episodes, the person afflicted with sleep apnea may have additional trouble sleeping caused by side effects of the condition, including a frequent need to get up and urinate during the night, and excessive nighttime sweating.
Some trickle-down effects of sleep deprivation are a compromised immune system, poor mental and emotional health, irritability, and slower reaction time, among other problems.
When you stop breathing, your brain does not get enough oxygen. Drastic problems can result from the oxygen deprivation of sleep apnea, including heart disease, high blood pressure, sexual disfunction, and learning/memory problems.
Depression and sleep apnea
Approximately one in five people who suffer from depression also suffer from sleep apnea, and people with sleep apnea are five times more likely to become depressed. Existing depression may also be worsened by sleep apnea. While it is not clear whether the apnea causes the depression or vice-versa, studies show that by treating sleep apnea symptoms, depression may be alleviated in some people.
Diagnosing sleep apnea
For a dentist to diagnose sleep apnea they will examine your mouth and nose to look for obstructions as well as studying x-rays, or a CT scan of the head and neck.
If your dentist suspects sleep apnea, he or she will likely recommend an overnight sleep study. These diagnostic tests now can be done at home or in a sleep center. These sleep tests provide the information needed to diagnose sleep apnea by measuring how frequently you stop breathing.
Polysomnography is the diagnostic test that records a variety of body functions during sleep, such as the electrical activity of the brain, eye movement, muscle activity, heart rate, respiratory effort, air flow, and blood oxygen levels. These tests are used both to diagnose sleep apnea and to determine its severity.
The Snoring & Sleep Apnea Treatment… SomnoDent MAS™
The clinically validated treatment for sleep apnea and snoring that fits in the palm of your hand. Its unique design permits the user to open and close their mouth normally making it very comfortable to wear. Read how it works.
A Proven Way to Stop Snoring
Unlike other snoring treatment devices on the market, the SomnoDent MAS™ is a precision instrument which is custom designed for each person to help them stop snoring.
A Practical Treatment for Sleep Apnea
Snoring is more than just a noisy social nuisance. It may be a sign of a serious underlying condition known as Obstructive Sleep Apnea. The SomnoDent MAS™ can treat mild to moderate obstructive sleep apnea.
An Alternative to CPAP
Many patients often find CPAP uncomfortable or intolerable. The SomnoDent MAS™ can be a more attractive option.
SomnoDent MAS™ for Sleep Apnea Sufferers
Is the SomnoDent MAS™ for you?
The SomnoDent MAS™ is an effective treatment both mild to moderate obstructive sleep apnea.
OSA is characterized by repeated cycles of partial or complete collapse of the upper airway during sleep. This results in a cessation or reduction of breathing and a decrease in blood oxygen levels resulting in typically unremembered awakenings.
The severity of OSA is defined by the number of these occurrences per hour of sleep. These episodes of obstruction , and resultant awakening of the OSA sufferer occur five or more times per hour, potentially causing marked sleep disruption.
OSA is generally defined as being in the Mild to Moderate level where the SomnoDent MAS™ could be an effective treatment for you
The levels of OSA severity are generally defined as follows:
Type of OSA
Number of Occurrences per Hour
5 to 15
15 to 30
- The SomnoDent MAS™ is clinically validated for the treatment of snoring and OSA.
- The SomnoDent MAS™ has helped people who have tried other OSA treatments and been unsuccessful or have not complied with their CPAP treatment.
- The American Academy of Sleep Medicine recommend oral appliances as a first line treatment for snoring and mild to moderate OSA.
Research and clinical trials
Research and clinical trials using earlier models of the current model of SomnoDent MAS™ conducted by the Department of Respiratory and Sleep Medicine at St George Hospital, Sydney have found a high level of acceptance and tolerance amongst patients’s and concluded that the SomnoDent MAS™ is a viable alternative to CPAP in the treatment of OSA.
Treatment of Obstructive Sleep Apnea and Snoring
A Clinically Tested Oral Device
The SomnoDent MAS™ is an oral appliance, which fits over the upper and lower teeth, much like a sports mouthguard. However unlike a sports mouthguard it is a precision-made, clinically-tested medical device.
It is highly effective (in most cases) in stopping snoring and treating obstructive sleep apnea in the mild to moderate range.
The medical term for your lower jaw is ‘mandible’ and an oral appliance worn over the teeth is a ‘splint’, hence the name SomnoMed Mandibular Advancement Splint, or SomnoDent MAS™.
(Mandibular advancement splints are also known as mandibular advancement devices (MADs) or mandibular repositioning appliances (MRAs).)
Three Good Reasons to Choose the SomnoDent MAS™:
- It’s comfortable. It is the most comfortable and discreet mandibular advancement splint available.
- It’s effective. Its effectiveness to treat snoring and mild to moderate OSA has been clinically validated. (Note: success in all cases cannot be guaranteed.)
- It’s good value. Given the quality, comfort, likelihood of success, manufacturer’s warranty and long life of the appliance, it provides true value for money.
SomnoDent MAS™ is Comfortable to Wear
You won’t find a more comfortable MAS. Why? Because it is tailor-made to fit your mouth; it does not impinge on your tongue inside your mouth; you have normal open and close jaw movement; you can even close your mouth and lips to avoid a dry throat.
New users sometimes feel some discomfort in the first few days of wearing it, but in the majority of cases, such discomfort passes quickly
How the SomnoDent MAS™ Works
What Causes Snoring and Sleep Apnea?
When the airway narrows or partially collapses snoring results, which is the sound of tissues vibrating. Where there is complete collapse, you have an incidence of sleep apnea, which is when breathing stops altogether.
What the SomnoDent MAS™ does
The SomnoDent MAS™ positions your lower jaw slightly forward of its natural position, which has the effect of tightening the soft flesh (or ‘tissue’) at the back of your throat, which prevents it from collapsing.
The patented fin-coupling mechanism on the lower arch of the SomnoMed splint ensures that your lower jaw (mandible) remains in the correct position, whether you sleep with your mouth open or closed – or open your mouth for any other reason, such as to take a drink.
This freedom to move your jaw up and down, without compromising the effectiveness of the device, is a unique feature of the SomnoDent MAS™.
How the SomnoDent MAS™ Stops Snoring
Sometimes when we sleep, the muscles that hold the airway open relax and partially collapse, obstructing the flow of air slightly. Air passing through the partially collapsed airway can cause a vibrating sound known as snoring.
What the SomnoDent MAS™ does
The SomnoDent MAS™ is for the effective treatment of snoring and for the more serious condition of obstructive sleep apnea.
Snoring as an Indicator of Obstructive Sleep Apnea
Snoring can create irritability and mood swings and subsequent relationship problems.
Snoring may however, be the sign of a serious condition known as Obstructive Sleep Apnea (OSA). While not everyone who snores suffers from obstructive sleep apnea, SomnoMed suggests that if you have been heard to gasp for breath or have sudden spells of drowsiness during the day, then you should obtain a referral to a qualified specialist.
Mark Bailen D.M.D.
Jerome Bodner D.D.S.
Alan Solowsky D.D.S.
Yung Lin D.M.D.
Catherine Prado D.M.D.
Victor Yeh D.M.D.
Alan Solowsky D.D.S.
Yung Lin D.M.D.