Obstructive Sleep Apnea

What is Obstructive Sleep Apnea?
Apnea, which means “want of breath” in Greek, is a complete cessation of breathing during sleep. Apnea happens when tissues at the back of your throat (such as your tongue, tonsils or throat) relax and block the flow of air during sleep. When you stop breathing, your brain sends a “breathe” message to your body which causes you to inhale more strongly in order to get a breath. While you may not consciously wake up from this, your body is unable to achieve a level of deep, restful sleep. An episode of apnea lasts more than 10 seconds. Those with severe cases of apnea may stop breathing many times during one night’s sleep.

Obstructive sleep apnea affects millions of adults and children in the United States alone. It becomes more common as people reach middle age and beyond. Symptoms for sleep apnea include snoring, daytime sleepiness, high blood pressure and a high Body Mass Index.

Am I a candidate for Obstructive Sleep Apnea?
The only way to diagnose obstructive sleep apnea is through an overnight sleep test which can be done at a sleep center of through a home sleep test. The Stop Bang questionnaire can be used as a screening tool to help determine the likelihood of you having obstructive sleep apnea. STOP BANG was developed as a simple-to-use 8-point questionnaire in screening moderate-severe obstructive sleep apnea.

How Does STOP BANG Work?

Answer the following questions:

S – Do you Snore? Yes | No
T – Do you feel Tired, fatigued or sleepy during daytime? Yes | No
O – Has anyone Observed you stop breathing during your sleep? Yes | No
P – Do you have or are you being treated for high blood Pressure? Yes | No
B – BMI (Body Mass Index-approximately 30 lbs overweight) Yes | No
A – Age > 50 yr Yes | No
N – Neck circumference > 15.75″ (40 cm) Yes | No
G – Gender: male Yes | No

If you answered YES to two or more questions on the STOP BANG questionnaire you are at high risk for Obstructive Sleep Apnea. It is recommended that you seek expert medical advice.

Treatment: Sleep Apnea can be treated using several methods, including the use of lifestyle changes (to reduce symptoms), oral or dental appliances, surgery, and positive airway pressure (PAP). PAP is the most common and effective treatment for OSA. With PAP, air constantly flows through your nose, moves into your throat and the slight air pressure keeps your airway open. A PAP system typically has three main parts: a flow generator, which filters room air and produces positive air pressure; a mask or nasal piece which delivers the filtered, pressured air to your airway; and an airflow hose which connects to the other pieces.

Oral appliance therapy involves the selection, fitting and use of a specially designed removable oral appliance that maintains an open, unobstructed airway in the throat when worn during sleep. Custom-made oral appliances are proven to be more effective than over-the-counter devices. Dentists with training in oral appliance therapy are familiar with the various designs of appliances and can help determine which is best suited for your specific needs. A board certified sleep medicine physician must first provide a
diagnosis and recommend the most effective treatment approach. A dental sleep medicine specialist may then provide treatment and follow-up.

How Oral Appliances Work (Mandibular Repositioning Devices or MRD’s)

  • Repositioning the lower jaw, tongue, soft palate and uvula
  • Stabilizing the lower jaw and tongue
  • Increasing the airway space

Advantages of Oral Appliance Therapy

  • Oral appliances are comfortable and easy to wear. Most people find
    that it only takes a couple of weeks to become acclimated to wearing
    the appliance.
  • Oral appliances are small and convenient making them easy to carry
    when traveling.
  • Treatment with oral appliances is reversible and non-invasive