Dental Sleep Therapy

Snoring is normal, but it can be evidence of a possible life threatening disorder called Sleep Apnea or Obstructive Sleep Apnea (OSA).

Sleep Apneais a mild to moderate decrease of 40% or more in airflow while a person is breathing. This is due to partial obstruction or collapse of the airway.

Obstructive Sleep Apnea – is a complete obstruction or collapse of the airway, resulting in no airflow for 10 seconds or more. This results in an oxygen desaturation greater than or equal to 4%.

STATISTICS OF OBSTRUCTIVE SLEEP APNEA:

  • 70 % of the U.S. population that have OSA, are undiagnosed and untreated
  • An estimated 50,000 people die in the U.S. year because of undiagnosed OSA
  • Untreated OSA can take up to 12-15 years off your life.
  • OSA increases risk of early death by 46%

HEALTH RISK OF OBSTRUCTIVE SLEEP APNEA:

Studies have shown that undiagnosed and untreated OSA can lead to the following health risk.

  • Nocturnal Strokes
  • Nocturnal Heart Attacks
  • Arrhythmias
  • Type II Diabetes
  • Hypertension
  • High Blood Pressure
  • Excessive Pressure on the Heart, Lungs, etc.
  • Nocturnal Depletion of Oxygen to the Brain
  • Memory Loss
  • Daytime Sleepiness
  • Weight Gain

Normally, air passes through the nose and past the flexible structures in the back of the throat such as the soft palate, uvula and tongue.  During sleep the muscles relax and the airway stays open.  Snoring is created by the vibration of the pharyngeal soft tissues and the epiglottis as air passes through an airway that is too small to allow for smooth, unrestricted flow.

Snoring:

What’s the big deal, every snores?

Not everyone, but it is estimated that over 80% of Americans snore.

  • Most all cases are a result of a Sleep Disorder
  • Over 70% of the time loud snoring is indicative of a greater problem

This problem is a very common Sleep Disorder called “SLEEP APNEA”

What Is Sleep Apnea?

Sleep apnea (AP-ne-ah) is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep.

Breathing pauses can last from a few seconds to minutes.  They may occur 30 times or more an hour.  Typically, normal breathing then starts again, sometimes with a loud snort or choking sound.

Sleep apnea usually is a chronic (ongoing) condition that disrupts your sleep.

Three Types:

  • Central
  • Obstructive (collapse)
  • Mixed

Obstructive Sleep Apnea (OSA) is a situation in which the entire upper or lower airway is blocked causing air flow to stop.

FACT: Untreated OSA can take up to 12-15 years off your life.

  • Smoking takes only 7-10 years
  • Type II Diabetes takes 5-10 years
  • OSA Increases risk of early death by 46%

OSA is comprised of two types of events

  • Apnea – 100% flow limitation for at least 10 seconds
  • Hypopnea – Partial airflow blockage accomanied by a decrease in oxygen saturation of at least 4%

Diagnosis is made using the Apnea/Hypopnea Index or AHI

Mild OSA: 5-15 AHI

Moderate OSA: 15-30 AHI

Severe OSA: 30 > AHI

Oral Sleep Appliances are indicated ONLY for mild to moderate Obstructive Sleep Apnea.  Severe OSA requires CPAP (Continuous Positive Air Pressure)

RDI – Respiratory Disturbance Index:  Apneas + Hypopneas + RERAs per hour of sleep.  This index is identical to the AHI but also adds the number of RERAs so its typically a higher number.  Frequently this number is used interchangeably with AHI

  • 5-20 = Mild
  • 21-40 = Moderate
  • 40+ = Severe

RERA stands for “Respiratory Effort Related Arousal, “an elevated RERA index with a normal AHI is typically given a diagnosis of UARS (Upper Airway Resistance Syndrome).

How Common is OSA?

  • 70% of Americans are undiagnosed and untreated
  • 18% of men and 8% women between the age of 30-70 suffer from some level of OSA.
  • Of those, less than 25% have been successfully treated.

The most common type of treatment is CPAP (continuous positive air pressure)

Although highly effective, patients are frequently non-compliant with CPAP

Compliance Problems With The CPAP:

  • Limiting for the patient
  • Does make noise, but is becoming quiter
  • Consistent maintenance
  • Inelegant – It Isn’t Sexy!
  • 40-62% of individuals refuse this treatment
  • 40% abandon treatment during the first six months

There is another treatment for OSA, which is Oral Sleep Appliance Therapy.

An oral sleep appliance is much like a retainer or night guard.  It gently shifts the lower jaw forward, and opens the lower airway.

The use of a Morning Re-Positioner is needed to help the patient’s mandible be restored to its proper position & alignment.  The Morning Re-Positioner is worn in the morning for 15 to 30 minutes after the patient has removed their Oral Sleep Appliance.

The Morning Re-Positioner is heated in hot water and molded onto the upper and lower arch by the clinician.

  • Causes the condyle to transition back into the TMJ socket
  • Restores the patient’s natural bite
  • Needs to be worn every morning!

Sleep Diagnostic Methods:

  • Polysomnography

– In order to diagnose Sleep Apnea or other sleep disorders, a patient must undergo a polysomnography (sleep study).  This is typically done in a sleep lab, requiring the patient to spend the night in-lab, while the polysomnography (PSG) equipment records his/her physiological data.

  • Home Sleep Study

– Today with technological advancements a sleep study can be performed at home and is called a Home Sleep Study.  The patient self-administers the HSS, and is able to spend the night in the patient’s own bed in familiar surroundings.

– The typical cost of a home sleep study is only a fraction of the cost of an in-lab sleep study and typically yilds simlilar results in the diagnosis or Obstructive Sleep Apnea.

Our office as a courtesy will also verify and file your medical insurance (if any) to determine if your benefits will cover the Sleep Therapy.

Please contact our office to schedule a consultation today and begin the process to a better future!