Obstructive sleep apnea (OSA) is a chronic condition in which your muscles relax during sleep and your soft tissue collapses and blocks your airway. As a result, repeated pauses in breathing occur, ranging from just a few seconds to more than a minute. A person with OSA may have these episodes hundreds of times over the course of one night, which subsequently reduce the oxygen levels in the body. These pauses in breathing send signals to your brain which disturb your sleep and often cause you to wake up. In the United States alone, about 25 million adults have OSA.
It is common for people who have sleep apnea to not be aware of it. Despite clear signs and symptoms people can go undiagnosed with OSA for an average of seven years. During those seven years patients reported visiting their physician 17 times and a specialist about 9 times. When OSA goes undiagnosed or is left untreated, people can begin to experience a range of worsening symptoms and health conditions.
While many people will visit an ENT specialist for treatment, dentists are the first line of defense against sleep apnea. People are likely to visit their dentist at a regular six-month dental appointment before a physical exam with their physician. Dentists work closely with physicians to treat snoring and OSA. Once a sleep study has been performed and it was determined that an oral appliance is what’s best for you, you will come in for your exam. At your first visit, your dentist will talk to you about benefits of treatment, explain possibilities of treatment, potential side effects and cost of therapy. Then a complete evaluation will follow. It will include examination of your jaw, your teeth, oral cavity and airway; possibly new X-rays of your mouth will be required.
Many patients prefer using a sleep apnea appliance to a CPAP machine. In comparison with a CPAP machine, oral appliances are quiet, comfortable, portable and easy to use and maintain. If you have been diagnosed with mild to moderate sleep apnea, an oral appliance is usually the best choice for you. In some severe cases of sleep apnea, if compliance with a CPAP machine is low, an oral appliance can be a great option.
There are more than 100 types of oral appliances that have been approved by the FDA. Your dentist can recommend the type of appliance that is best for you. A custom-fit oral sleep appliance can drastically improve your sleep, which will restore your day time alertness. Patients often report that this can be a life-changing treatment. In addition, oral appliance therapy is covered by many medical insurance plans.
Oral appliances are custom made for each individual patient using digital or physical impressions and models of your teeth. These models are sent to a specialized dental lab where the appliance will be made. Once it is ready, you will need to return to your dentist to adjust the appliance to maximize its comfort and effectiveness. Your sleep study may be repeated to check and verify the effectiveness of the appliance.
Effective oral appliances are always custom fit and need to be adjusted over time for maximum efficacy. Therefore, an annual assessment with your dentist is necessary. These visits are important for your long-term treatment success.
Treating snoring or OSA with oral appliance therapy can help you feel like a new person. You will most likely find that your symptoms and quality of life can improve dramatically when you commit to your treatment nightly. Through better sleep, patients experience more energy and feel sharper throughout the day. Oral appliance therapy promotes a healthier heart, body, and mind. You may find that your partner begins to sleep better too!
Severe, untreated sleep apnea can even increase your risk of death without existing comorbidities.
Sign and symptoms of OSA often include snoring, gasping, and/or choking sounds during sleep. OSA can affect both men and women, but is more common in men. Other factors such as a narrow airway, misaligned jaw (retrognathic mandible), vaulted palate, and/or large tonsils increase the risk of developing sleep apnea.
Dentists can play a critical role in the screening, diagnosis, and treatment of sleep apnea.
How is OSA diagnosed and treated? First, a thorough evaluation is necessary. This may include an overnight sleep study at home with a home sleep apnea test or a test at a sleep center. The sleep specialist will interpret the results to make a diagnosis.
Your sleep doctor will discuss treatment options with you. They may include CPAP (continuous positive airway pressure) therapy, an oral appliance, and sometimes surgery.