Could You Have Sleep Apnea?

By Dr. Phillip C. Hall, DDS Do you snore when you sleep? Do you wake up gasping for air? Do you get morning headaches or daytime sleepiness? If so, you may be suffering from sleep apnea, a condition in which you stop breathing during the night.  Left untreated, this condition can cause serious associated medical problems like stroke, heart attack, diabetes, weight gain, or even death. Proper diagnosis for sleep apnea is made by a physician, and traditionally treated with a C-PAP machine. This machine works to keep the airway open while a person sleeps by delivering room air via a mask to the nose or face under various amounts of pressure. Even though great advances have been made, most people find C-PAP use very trying and often end in non-compliance. C-PAP compliance failures occur for various reasons, including claustrophobia, feeling of air in the stomach, noise of the machine or mask, pain or deformity from mask, annoyance of transporting device, dry nose or mouth, and irritation to ears because of air pressure. Still, for most severe sleep apnea sufferers, C-PAP is the treatment of choice if the client is compliant. For the past ten years, sleep physicians have become more accepting of oral appliances for the treatment of sleep apnea.  In fact, treatment guidelines now support a prescription of oral appliances as a first-line treatment choice for mild to moderate sleep apnea. What is an oral sleep appliance? Oral sleep appliances are devices that are worn in the mouth. Most patients are able to sleep with their mouth closed while wearing an oral appliance, and they generally do not have any attaching lines or electrical components. Although C-PAP therapy can be more therapeutic than an oral appliance if a person religiously wears their C-PAP machine, studies show that oral appliance wearers are more compliant more of the time, thus rendering it more effective. How does an oral appliance work? By use of the special attachments between the upper and lower parts of the oral appliance, the lower jaw can be moved forward and held in position while the patient sleeps, keeping the airway open. My expertise as a dentist is to determine a therapeutic position of the lower jaw that will keep the airway open at night and not cause pain in the jaw joint or its associated muscles.  The tongue muscle is one of the major offenders in obstructing the airway.  By holding the jaw forward, the back of the tongue is brought partly out of the airway.  The slight tension this causes on the associated muscles in and around the airway, also help to improve or lesson the severity of the patient’s apnea. Am I a good candidate for an oral sleep appliance? If you have your natural teeth, or a good-fitting denture with at least the lower denture being retained by implants, you are likely a good candidate.  If you have jaw or TMJ issues, the majority of the time I can incorporate the treatment of your sleep apnea and your jaw joint problems in the fabrication of your oral appliance. The severity of your apnea may make oral appliances less effective than a C-PAP.  With this noted, combination treatment, meaning wearing a C-PAP device and an oral appliance simultaneously, can lower the C-PAP pressures, making C-PAP compliance more tolerable.  Of course, if you are a C-PAP failure, oral appliance treatment is your only alternative, even though the treatment results are less than optimal. How can I obtain a sleep appliance? You can request a referral from your physician to see a dentist such as myself, who has received special training to treat patients with sleep apnea. They will fit you for an oral sleep appliance and adjust it to ensure comfort, working closely with your physician to maximize its effectiveness. If you have any questions, please make a no-charge consultation appointment with my office and I will assess your circumstances, and make the necessary referral and/or request to a sleep physician.    

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