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Do you
Have Mild to Moderate Sleep Apnea?
There is a dental appliance
that is a recognized as an effective treatment for the treatment of
mild to moderate sleep apnea. This article explains what this
appliance is and how it works. This same appliance also
eliminates snoring, as mild to moderate sleep apnea and snoring g
both have the same root cause. If you have read the “Snoring
Section” of this website you need not read this article. If
you haven’t, pleas read on for information that can be of great
benefit to you.
Have you been diagnosed with
mild to moderate sleep apnea or do you suspect you suffer from this
condition?
Very often a simple,
custom made dental appliance can be an effective way to treat this
condition.
Section
One
(i) What is Sleep Apnea?
When some people fall asleep
their tongue relaxes and falls to the back of their throat, closing
off their airway either partially or fully. This can produce
the sound we call snoring which is simply the sound of air passing
through the narrowed airway.
While we sleep, if our airway
is partially closed our lungs receive a reduced amount of oxygen.
However if our airway is completely closed off (by our relaxed
tongue common in loud snorers) our lungs will not be getting any
oxygen. When our brains detect the lower levels of oxygen in our
blood it immediately awakens us just enough to take a quick breath
or two. This is why snorers sometimes wake up with a sudden gasp
for air.
Sleep
Apnea is the
complete stoppage of air entering our lungs during sleep for
at least ten seconds in adults (less time in children). So a
patient with sleep apnea will stop breathing for a full ten seconds
or more at a time.
Hypopnea is defined as an inadequate amount of
air entering our lungs during sleep caused by partial airway
blockage.
People who suffer from
sleep apneas or hypopneas can “wake-up” briefly anywhere from
several times an hour in mild cases to several hundreds of times a
night in patients who have severe sleep apnea.
During these brief awakenings
the patient may gasp for air, however they are only partially awake
and do not have any awareness or memory of the awakenings in the
morning. As you can imagine, if you are waking up several hundred
times a night to breathe this is a serious disturbance of your
regular sleep cycle. This can have potentially serious effects on
our daytime functioning and health.
(ii) Signs and
Symptoms of Sleep Apnea:
• Sleepiness during the day
• decreased ability to concentrate
• depression, irritability, sexual dysfunction
• learning and memory difficulties
• falling asleep while at work, on the phone or while driving
• higher risk of high blood pressure, heart attack and stroke
(sleep apnea is a strain on the heart and the circulatory
system)
(iii) When should
Sleep Apnea be suspected?
• if you snore heavily and
struggle to breath during sleep
• if you fall asleep during the day at inappropriate times i.e.
while driving a car, working or talking
• very often the spouse or co-workers of sleep apnea sufferers
notice there is a problem and the person with sleep apnea won’t
believe it when told
(iv)Do you have sleep
apnea or do you simply snore?
In order to stop snoring you
should first see your family doctor who may refer you to a
physician who specializes in sleep disorders. The sleep specialist
will determine if you have sleep apnea, and if so, whether it’s
mild, moderate or severe (depending on the number of times you stop
breathing each hour during sleep, or for what period of time each
night your blood oxygen levels are below normal).
Section
Two
(i) How is Sleep Apnea
Treated?
(A) If you snore and do not have sleep
apnea, or if you have been diagnosed with mild sleep apnea
Changes in certain behaviours or habits may be all that is
required:
Alcohol, tobacco or sleeping
pills all make the
airway more likely to collapse during sleep, and also increase the
length of time that people with sleep apnea stop breathing.
Eliminating the use of alcohol, tobacco and sleeping pills can
eliminate snoring or mild apnea.
Overweight people are more likely to have sleep
apnea. This is because they will often have fat deposited in their
airway causing it to narrow. So when an overweight person falls
asleep they are more likely to have a greater amount of airway
closure when their tongue relaxes and falls back. If a patient is
able to reduce their weight by ten percent this can reduce the
severity of sleep apnea in most cases.
Some patients only experience
sleep apnea when they sleep on their backs. These patients may
simply choose to use pillows or other devices to help keep them on
their sides.
In my own personal experience,
sleeping on my side stopped me from snoring, however I am more
comfortable sleeping on my back, and despite my best efforts to
sleep on my side I would usually wind up on my back during the
night and resume my snoring. Or, I even tried sewing a tennis ball
into the back of my pyjamas to prevent me from sleeping on my back,
but I would wake up during the night whenever I rolled unto my
back, which would result in interrupted sleep.
(B) If you snore or have Mild to Moderate
Sleep Apnea:
There are many different dental
appliances on the market that can effectively eliminate snoring and
mild sleep apnea. The appliance that I have used for our patients
with good success is called the SUAD dental appliance (see attached
brochure and additional information below).
These patients may also elect
to use a CPAP machine instead of a dental appliance
(see below).
(C) If you snore or have been
diagnosed with Moderate to Severe Sleep Apnea:
The best way to treat severe
sleep apnea is through the use of a CPAP Machine. This
machine will also eliminate snoring.
The CPAP unit consists of an
air blower, hose and nose piece. The patient will sleep with a mask
over their nose. The machine blows air through their nose and
creates the correct amount of air pressure to prevent their airway
from collapsing during sleep. (See attached sample for one of many
CPAP units on the market).
Advantages of
a CPAP Machine
• is very effective
• is the only available treatment for moderate to severe sleep
apnea
• the most effective alternative when a patient is not a good
candidate for a dental snoring/apnea appliance
Disadvantages of a CPAP
Machine
• Units can be somewhat noisy
for partners sleeping in the same room
• is not as portable as the dental appliance for traveling and does
require a power supply
• some patients find it uncomfortable/cumbersome to wear
Advantages of wearing a
Dental Appliance (SUAD Appliance) to treat Snoring and/or Mild
Sleep Apnea:
• Suad appliance is
very portable / can fit in a pocket or purse when traveling
• does not require an external power supply
• is effective
• silent / no motor as is the case with the CPAP machine
Disadvantages of a Dental
Appliance for Snoring / Mild Apnea:
• may not be suitable for patients with chronic pain in
their jaw (TMJ) joint
• not suitable for patients with severe gum disease and/or loose
teeth (these dental problems must be corrected before the dental
appliance can be made)
• may not be suitable for large, heavy set people who also
powerfully grind their teeth at night (this type of patient may be
better served by using the CPAP machine...this is the one type of
patient who may continually break their dental snoring
appliance...they’re tough but they do have their breaking
point
A
Personal Testimonial regarding the wearing of a Dental (SUAD
Appliance) to Eliminate Snoring and Mild Sleep
Apnea:
I have personally worn the SUAD
Appliance every night for the past two years. It has completely
eliminated my snoring, according to my wife. I have had the same
success with any other patient that we have mad the SUAD Appliance
for . The appliance is comfortable but does require a brief period
of getting use to.
The appliance is well built,
very durable and is repairable if it should break. But please, if
you do have me make you one, keep it away from your family dog
(they seem to enjoy chewing on these appliances...as my dog did)...
and out of the reach of small children who may enjoy taking the
appliance apart.
My appliance has been problem
free after two years of nightly use and I was even able to reshape
and continue to use it after our dog gnawed on it. Yes, I was
incredibly lucky to be able to salvage it and yes, I sterilized it
before reusing it (the appliance, not the dog).
Are there any other
effective ways to eliminate snoring or sleep apnea besides using
dental appliances or the CPAP unit?
Surgery is an option for some patients who
snore and/or have sleep apnea. These surgeries have the goal of
increasing the size of the airway. None of these surgeries are
completely successful or without risk.
(i) Young patients may benefit
from the removal of adenoids, tonsils, nasal polyps and the
correction of deformities of the airway.
(ii) A surgical procedure known as Uvulopalatopharyngoplasty (UPPP)
is the surgical removal of excess tissue at the back of the throat
(tonsils, uvula, and part of the soft palate) This technique only
has a 30-50% success rate and is not necessary as less invasive
methods are available.
What is your next
step?
If you snore, please consult
your physician first to discuss if you may have sleep apnea and if
a sleep study is required.
If a sleep study is required
your doctor will refer you top a sleep clinic.
REGARDLESS OF WHICH SLEEP
CLINIC YOU GO TO, IF
YOU ARE ADVISED BY THE SLEEP SPECIALIST THAT A DENTAL APPLIANCE IS
RECOMMENDED THERE IS ONE IMPORTANT PIECE OF INFORMATION YOU SHOULD
KEEP IN MIND:
I am trained in they
delivery of dental appliances for patients with sleep apnea and
snoring and have successfully treated patients with these
conditions for several years
To properly make a dental
appliance to treat these conditions the dentist should conduct a
thorough examination/assessment of you teeth, gums, bone that
supports the teeth and jaw joint (TMJ).
You should have an appliance
made that is durable, is professionally made and has a good record
of success for the treatment of snoring and sleep apnea such as the
SUAD appliance used in our office
The appliance fee should be
cost effective and reasonable.
Our appliance carries a two
year manufacturer’s warranty.
Our SUAD snoring/apnea
appliance fee is: $1140.00
(lab fee of 580 + professional
fee of 560 = $1040)
If you are not a patient of
our office we will also need to examine your teeth/gums/jaw and
take at least one x-ray film, which will add an additional
$170.
If you have dental
insurance, your insurance should cover the exam and x-ray.
Some extended health insurance plans will cover the cost of
dental snoring/apnea appliances. We can help you determine if
your plan will reimburse you.
A
good night's sleep for you and your partner is well worth the
money spent. Medical research has shown that a good night's
sleep is crucial for optimum alertness, mental functioning and
overall health. Our sleep appliance can provide many years of
sound restful sleep.
Unfortunately, I have heard
stories from some patients over the years that they were told by a
sleep specialist that they were best to see a dentist that the
sleep specialist “knew” and they wound up paying substantially more
an appliance.
If you have a
snoring/sleep appliance made in our office:
Please ask your MD or sleep
specialist for a letter stating a dental appliance is a suitable
option to treat your snoring and/or apnea (they can give you the
letter or mail/fax/e-mail it to me with your permission)
Please contact our office for a
sleep appliance consultation.
The procedure to make your
appliance is simple: models will be made of your upper and lower
teeth and as well and a few brief measurements will be made of your
particular bite
The lab then requires between 1
to 3 weeks to construct your appliance
You will return for a brief
appointment where we will give you your appliance and instructions
on its proper use and maintenance.
Patients with sleep apnea may
be asked by their sleep specialist to return for a sleep study to
ensure that the appliance has been effective in treating the
apnea.
Usually patients will provide
us feedback that their snoring has stopped; in case where it hasn’t
the appliance can be briefly adjusted while you sit in my chair and
this should do the trick.
Snoring and Sleep Apnea are
easily treatable conditions. You owe it to yourself, your partner
and other family members to get properly diagnosed and
treated.
If you should have any
questions or concerns please feel free to contact me by phone or
e-mail, or visit the contact section of our web site.
Best regards,
Dr. Jeff Shnall B Sc.,
DDS
tel: 416-691-2886
e-mail: dr.shnall@gmail.com
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