Dental Sleep Apnea Therapy
Ridgewood Dental Associates
Dr. Mark F. Samani is an expert of Sleep Apnea and Snoring treatments. A Diplomat of the American Academy of Dental Sleep Medicine with 20 years' dental experience, Dr. Samani has treated sleep cases of all degrees.
What is Obstructive Sleep Apnea (OSA)?
Sleep Apnea is a serious and very common medical disorder that causes the body to block air passageways and interrupt breathing during sleep. The muscles in the throat relax and the tongue may fall back and block the airway as you sleep. The ribs expand and the diaphragm contracts in an effort to breathe but no air is exchanged. In the blood, oxygen levels drop and carbon dioxide levels climb. The brain senses the emergency and sends adrenaline out to the entire body causing awakening which flexes the muscles and creates a stereotypical resuscitative gasp. People with Sleep Apnea typically snore loudly with pauses, followed by stopped breath and a snort. This can happen hundreds of times per night, and you may wake up feeling unrested.
Sleep Apnea is categorized by how often airway obstructions occur. A mild case experiences obstructions less than 15 times per hour. A moderate case is less than 30 obstructions per hour and severe cases are more than 30 obstructions per hour.
Research has shown that Obstructive Sleep Apnea can cause excessive daytime sleepiness, memory loss, headaches, irritability, depression, decreased sex drive and impaired concentration. When left untreated, sleep apnea can lead to heart attack, hypertension, stroke and even sudden death while asleep. There are also links between obstructive sleep apnea and metabolic disorders (diabetes). Men and women of any age or body type can have sleep apnea, but the disorder progressively worsens with age and weight gain.
A sleep medicine physician uses an overnight sleep study to detect and diagnose sleep apnea. Once a patient is diagnosed, Dr. Samani works with the sleep physicians to treat sleep apnea through Oral Appliances Therapy (OAT). Ridgewood Dental Associates assists patients in the selection and fitting of an oral appliance and provides long-term follow-up care.
Signs of Sleep Apnea:
Listed below are some common signs of sleep apnea:
- Unintentionally falling asleep during the day
- General daytime drowsiness
- Unrestful sleep
- Heavy snoring
- Gasping or choking in sleep
If you are suffering from these symptoms, you may have Sleep Apnea. Contact Ridgewood Dental Associates today to further assist you in recognizing your condition and determining your treatment options.
Initial treatments include weight loss and positional sleeping, followed by oral appliance therapy, c-pap (constant positive air pressure) or possibly surgery. Weight gain or loss can have a noticeable change in respiratory disturbance. A 10 % loss in weight will reduce disturbance by 26%. Conversely, a weight gain of 10% will increase disturbance by 32%. In some cases, a change in sleep position (staying off your back) can improve sleep quality and there are means by which you can train yourself to sleep on the desired position.
The OSA treatment option most prescribed is c-pap (constant positive air pressure). With c-pap, ambient room air is pumped through the nose via a mask and inflates the air passageway in an attempt to prevent any obstruction from occurring. While c-pap can be very effect, the limitation of its usefulness is patient compliance. Reports of 50% compliance after 4-6 months are common in studies.
Oral Appliance Therapy (OAT) is the Sleep Apnea and snoring treatment of choice in our practice. With dental appliances much like an orthodontic retainer or sports mouth protector, they are custom made to fit comfortably and maintain an open airway. There are two basic types of appliances; mandibular advancement appliances (MAA) and tongue retaining devices (TRD). The mandibular advancement appliances work by holding the jaw in a slightly forward position. This position works by three means: first, it does not let the mandible fall back and obstruct the airway; second, by holding the mandible forward, the appliance indirectly holds the tongue in a forward position not allowing it to fall back and obstruct the airway; and third, the forward position creates a new muscular baseline for the muscles at the side of the neck, not allowing them to collapse the airway. The tongue retainers directly hold the tongue forward through the use of a bulb. The appliances significantly aid oxygen intake and help to provide normal sleep for snorers and those with OSA. Success rates for oral appliance therapy are not as high as that of c-pap; however, when taking compliance into consideration, the overall success rates for both treatment modalities are comparable. There are limitations to every treatment option as well as side effects, which should be reviewed prior to treatment.
Several surgical approaches have been developed to resolve Obstructive Sleep Apnea, some with more success than others. The two surgery types recommend for the resolution of Obstructive Sleep Apnea are Orthagnathic Surgery (jaw advancement surgery) and Tracheotomy. Both surgeries have been proven to resolve the condition on a long term basis. Both surgeries are, however, rather invasive and would need to be considered only after other treatment alternatives have not worked.
Snoring is extremely common and, in many cases, relatively harmless. Nearly everyone snores at one time or another. Occasional light snoring is of little concern, whereas loud and habitual snoring may be a sign of Obstructive Sleep Apnea. The volume of snoring depends on the person, but about half of loud snorers have some form of Sleep Apnea.
Snoring is a sound that occurs in the upper airway as you breathe in air. The unmistakable sound is a sign that your airway is partially blocked, usually by soft tissue in your throat. The flow of air causes the soft tissue to vibrate, creating sound, which comes out of your nose, mouth or both.