What is Obstructive Sleep Apnea (OSA)
Sleep apnea is essentially your body choking on itself and causing repeated episodes of partial or complete suffocation sometimes lasting a minute or more. These choking and suffocating episodes repeat constantly throughout the night causing a myriad of health complications including increased risk of stroke, heart attack and even death. The cause of this collapse in the airway is usually due to the soft tissues in the mouth , tongue or throat closing down and blocking airflow during sleep. The first sign of this is usually snoring which happens when you are attempting to breathe through a narrow airway. If left untreated snoring often escalates to full OSA where the narrow airway is now completely blocked. Nearly 1 in 4 adults over 30 are unknowingly suffering from at least mild sleep apnea.
Are You at Risk?
- Do you snore loudly (louder than a person talking or loud enough to be heard through closed doors)?
- Do you often feel tired, fatigued or sleepy during the day?
- Has your spouse or bed partner ever observed you stop or pause breathing in your sleep?
- Do you have or are you being treated for high blood pressure?
- Are you overweight or obese?
- Are you over 50 years old?
- Is your neck circumference greater than 16 inches?
- Are you male?
If you answered yes to two or more of the above questions then you should have your sleep health evaluated. Please take a moment and fill out our sleep health evaluation online; test results are available to you immediately.
Our practice specializes in fitting patients with a custom fabricated oral appliance to manage sleep apnea. The appliance works by holding your mandible (lower jaw) in a precise open and forward position and by doing so all the soft tissues in your throat and neck are no longer able to collapse and cause the nighttime choking and suffocating episodes. The appliance we make will be custom made for your teeth and will fit much like a sports mouth guard. Oral appliances are a very comfortable and easy to use solution for managing sleep apnea and snoring and they are also an excellent alternative to CPAP therapy for patients who find it difficult to tolerate. In 2015 the American Academy of Sleep Medicine issued updated practice parameters recommending the use of custom fabricated oral appliances made by specially trained dentists for patients with snoring and sleep apnea who prefer the mouthpiece over CPAP or who have tried CPAP and are unable to continue daily use.
Oral Appliance Therapy is a good option for…
- People with Primary Snoring
- People with mild to moderate apnea or people with severe apnea who are unable to tolerate or refuse to try CPAP
- People with healthy, disease-free teeth
- People who want to travel without having to bring a CPAP machine
Advantages of Oral Appliance Therapy:
- Appliances are easy-to-wear and comforatble to use
- Appliances are small, noiseless, and barely noticable
- Appliances are convenient to travel with
- Appliances don’t bother bed partners
- Appliances reduve sel-consciousness that many report feeling with CPAP use
- Appliances are not permanent; use can be discontinued anytime
- Appliances are typically covered by medical insurance and medicare
Am I a Candidate for an Oral Appliance?
Most people are great candidates for an oral appliance. The only way to tell for sure would be to come in for a complimentary consultation at our office. When you come in we will test your airway using our Eccovision Acoustic Diagnostic Imaging system and we may also send you home with a portable sleep apnea monitor. Once everything is reviewed the doctor will discuss treatment options with you.
Not all Oral Appliances Are the Same
At our practice we work with the Respire line of oral appliances. These devices are manufactured to strict standards and are FDA cleared specifically to manage Sleep Apnea. Additionally, we use state-of-the-art acoustic imaging technology to ensure your jaw is held in precisely the correct position with the appliance. “at home appliance kits” and other bulky non-custom devices may claim to help with snoring but are not nearly as comfortable or successful as the appliances we use.
CPAP is the traditional gold standard for the management of sleep apnea. CPAP stands for Continuous Positive Air Pressure and it works by pumping room air through a hose into a nasal mask that is strapped to the patients head. Constant pressure in the airway pushes the collapsible tissues out of the way and maintains and open/stable airway.
While highly effective at managing sleep apnea CPAP has proven to be difficult to tolerate for many patients and a large majority of CPAP users are “non-compliant” within 6 months. If you are having a hard time wearing your CPAP every night please contact us, there are other options and it is imperative that you do something to manage your OSA.
There are a few surgical options designed to reduce or remove excess tissue in the airway. Our doctor will review and discuss these options with you if indicated.
Frequently Asked Questions
How does the appliance work to help snoring / sleep apnea?
“The appliance moves the lower jaw forward and holds it there while the patient sleeps. In doing this, the tongue is also pulled forward and is prevented from falling back occluding the airway.”
– Dr. Marc Levin
How effective is the Respire Medical appliance?
“I have treated patients from mild to severe OSA and have seen excellent results with the use of this appliance. I’ve been able to greatly reduce snoring, especially to low decibel levels if not eliminated and most importantly have reduced AHI sleep scores significantly. I’ve even been able to convert severe OSA patient to mild levels with less apneas.”
– Dr. Richard Dunn
Can an appliance be made for someone with dentures?
“You may be able to make an oral appliance successfully over edentulous ridges with an appliance if the ridges are good, using a design like the Respire, where there is no pull between the two arches.”
– Dr. Robert Korngut
How long does it normally take to adapt to the appliance and is it comfortable?
“On average, it take patients a few weeks to adapt to wearing the appliance. Once the initial period of getting used to wearing the appliance is over, patients report that the appliance is comfortable to wear.”
– Dr. Marc Levin
Sleep Health Test
A powerful online tool that analyzes responses to questions about body type, symptoms of daytime drowsiness, snoring and another sleep and health conditions associated with OSA, the ARES™ Screener is a validated predictor of OSA risk and OSA severity. The results can be used to rapidly screen large populations to determine a prior probability of OSA. The results are also used to supplement the physiological data obtained in the ARES™ Sleep Apnea Study.