Fort Bend Lifestyles and Homes Magazine Aug 2009: Sleep Apnea, Dental Appliances, Snoring

Tony Benson has sleep apnea. His wife, Linda, has endured his snoring for more than 20 years of their 25-year marriage. Of their sleep routine, Tony reports, “She’ll sort of punch me or kick me to wake me up. She’ll shake me.”

Sleep apnea is often described as crescendo snoring due to the fact that it starts off light and gets louder and louder. There is also choking and gasping for air that comes with the disorder. Carol says, “It’s unnerving. It scares me so much that I now listen for it and can’t sleep myself. We are both sleep deprived.”

Tony first saw his family doctor who prescribed a machine he used at night when sleeping. The Bensons hated that machine. It was bulky; it required Tony to sleep on his back; cleaning the machine was a hassle; it was difficult to travel with. Eventually, he, like most people who are prescribed the machine, quit using it altogether.

Then Tony discovered real help for his problem at an unlikely place—his dentist’s office.

Dr. Ronada R. Davis, president of the Southwestern Society of Oral Medicine (www.DDSAssociates.com), says your dentist may be able to help you get a good night’s sleep.

Dr. Davis explains: “When people snore, their airway becomes partially blocked in the back area of the throat and restricts the flow of air. The narrow passage causes vibrations in your throat, which creates the snoring sound. ”

Snoring used to be considered almost a normal phenomenon of sleeping, but researches have now discovered that it can also be a sign of a much more serious condition. The blocked airway passage can create the perfect scenario for a sleep disorder called obstructive sleep apnea or OSA, which can be a significant health problem. When your airway is blocked even slightly you are deprived of oxygen. Snorers with sleep apnea typically will snore loudly with pauses of 10 seconds or so and then resume snoring loudly all over again.

Dr. Davis warns, “The pause in the snoring is actually the person not breathing. The lack of oxygen causes the person to slightly awaken just enough to inhale adequately and then resume snoring again. This can occur several times an hour all night long. ”

Is this really something to worry about? Don’t lots of people snore? The answer to both of those questions is YES! Common side effects of OSA are:

•Heart attacks or irregular heart beats

•Impotence

•High blood pressure

•Stroke

•Heartburn

•Morning headaches

•Dry mouth

•Gastroesophageal reflux disease (GERD)

•Impaired concentration

•Depression

•Decreased libido

•Irritability

And the obvious one

•Chronic sleepiness

Recently, a condition known as “secondary snoring” has been researched and has shown to cost the bed partner of a snorer an average of 1.5 hours of sleep each night. Snoring has also been cited as a cause of divorce.

Luckily, before Tony and Linda threw their 25 years of marriage away, Tony visited his dentist where he saw a brochure in the lobby about OSA and how oral devices worn while sleeping can eliminate the problem of snoring and symptoms of OSA.

Today, there are several oral appliances that can be made by your dentist that can help keep the airway more open while you sleep. The appliance will decrease or eliminate snoring and help allow precious oxygen to reach your brain all night.

Currently, over 80 different types of sleep apnea dental devices for snoring and sleep apnea are available to specially trained dentists to treat sleep disordered breathing. At first glance, this number appears overwhelming, but upon closer examination, each of the appliances falls basically into one of two categories and the diverse variety is simply a variation of a few major themes. Oral appliances can be classified by mode of action or design variation.

•Tongue Retaining Appliances – There are very few tongue retaining devices available, but they have been well studied and shown to be effective in many patients. Tongue retainers function by directly holding the tongue in a forward position by means of a suction bulb that holds the tongue. When the tongue is in a forward position, the back of the tongue does not collapse during sleep and obstruct the airway in the throat.

•Mandibular Repositioning Dental Appliances – Manidbular repositioning appliances are by far the most numerous types on the market. They all function to reposition and maintain the lower jaw (mandible) in a protruded position during sleep. Since the tongue is attached to the lower jaw, it is felt that this serves to open the airway by indirectly pulling the tongue forward by stimulating activity of the muscles in the tongue and making it more rigid, and by holding the lower jaw and other structures in a stable position to prevent opening of the mouth. Thin shells are placed over the teeth and a device is incorporated that will pull the lower jaw forward as necessary to open the airway.

•Combination Therapy – There are devices that combine the effects of the tongue retainer and the mandibular repositioning appliance.

Oral appliances have become a first-line therapy for the treatment of snoring according to a recent article in Sleepmatters, published by

the National Sleep Foundation, and have been found to be typically more effective for people with mild sleep apnea and for non-obese people but can, for some, be effective for moderate and severe sleep apnea. The goal is to find the most comfortable and effective position for the patient.

Each oral device is custom made to fit each patient and can cost
anywhere from $1,400 to $2,500. It
is often covered by insurance. The device can cause some minor jaw discomfort in the beginning, but that usually goes away over time and with regular jaw exercises. Most patients report complete satisfaction.

Now, Tony Benson uses an oral appliance at night. He likens it to “having two sports guards in my mouth, one on the upper and one on the lower teeth. ” He connects the two using a metal hook. A key turns the jaw into position to hold the airway open.

“It’s the most wonderful thing I’ve ever had happen because it’s opened up my air passage, and I can sleep on my side or my back,” says Tony. Linda says she gets to sleep all night, and so does Tony. It’s also lowered his blood pressure, yet another reason for the Bensons to rest easier.

Your dentist may request that you have a sleep study evaluation and be seen by a medical physician who specializes in sleep disorders.

Dr. Davis urges, “Just don’t make the mistake of thinking your snoring is harmless. Years of snoring can cause multiple health problems. ”

So, the next time you visit your dentist, be sure to mention that you snore. Your body will thank you and so will your spouse!