Sleep Apnea and Snoring

What are Sleep-Related Breathing Disorders?

Sleep-related breathing disorders are a fancy phrase for a group of disorders that occur when the airway closes off to varying degrees and disrupts sleep. Snoring, Upper Airway Resistance Syndrome and Obstructive Sleep Apnea are a few of these disorders.

Snoring can disrupt sleep quality for both the snorer and the bed partner.  Not at all surprisingly, many of our patients come to us because the bed partner noticed the problem.  Snoring doesn't just make it hard for those around you to sleep, but has also been linked to other health problems.

Upper Airway Resistance Syndrome (UARS) occurs when the airway closes off slightly during sleep and makes it harder to breathe.  The body reacts by opening the airway and often coming out of deep, restful sleep.  Patients do not actually have to wake up to have poor sleep quality; often just fragmentation of the proper sleep cycle.  This is very stressful to the body, and patients with UARS often have many other autoimmune problems.  These symptoms include asthma, allergies, acid reflux, irritable bowel syndrome, temporomandibular disorders, anxiety, and others.  Getting a proper night's sleep allows the body to heal properly during the right amount of normal sleep stages.

Obstructive Sleep Apnea (OSA) occurs when a person stops breathing while sleeping. This can occur hundreds of times a night and for long periods of time. Untreated, sleep apnea can cause high blood pressure and other cardiovascular disease (stroke), memory problems, weight gain, impotency, heartburn, depression and headaches. Moreover, untreated sleep apnea may be responsible for job impairment and motor vehicle crashes (According to the American Sleep Apnea Association).

There are 3 types of sleep apnea: obstructive, central and mixed. Obstructive is the most common and occurs when the airway gets blocked, usually by the soft tissue of the throat. Central sleep apnea happens when the brain fails to signal the muscles to breath. Mixed sleep apnea is a combination of the two.

I could tell a difference immediately. I now dream every night, multiple times. I feel more rested and my blood pressure has been reduced”

Melissa

Oral appliances are used to position the mandible forward and thus reduce or eliminate soft tissue blockage of the airway during sleep. There are various types of oral appliances the can be fabricated by dental professionals. Some of the appliances in our office are:

  • The Narval
  • The SomnoDent
  • The Herbst
  • The TAP
  • The SUAD

The decision on what type of appliance to use is made after a thorough assessment of your teeth, jaw joints, muscles, range of motion, health and dental history, radiographic examination (x-ray), medical insurance (certain insurances have restrictions on the type of appliances that can be used), and other factors.  Our office has many demonstration models and we will work together to find the appliance that fits your situation the best. There is not a "one-size-fits-all" appliance, so we feel our background with many appliances is very helpful in achieving success.

Dr. Dan Bruce is a Diplomate of the American Board of Dental Sleep Medicine, a distinction held by only a small percentage of dentists across the country.  To learn more about this process, visit www.abdsm.org.

Follow-Up Care

One of the most important factors in the success of a sleep appliance is follow-up.  While we can never guarantee success with an appliance, we will try everything we can in terms of adjustments to make the appliance work.  Research shows about 2/3 of all patients get a benefit from wearing an oral appliance.  If the treatment is not completely successful, we will work with your referring doctor and our referral network in order to give you the tools to manage your sleep apnea.

How do I know if I have sleep apnea?

Risks factors for sleep apnea include excessive daytime sleepiness or fatigue, excess weight around your neck, increased age, and certain anatomical features.  Anxiety, depression, and headaches are often seen in patients with sleep apnea.  Our office has a screening form or you can talk to your physician about sleep apnea and discuss your symptoms. Your physician may then recommend a sleep study, in which a team will monitor your sleep cycles and look for signs of apnea such as the amount of oxygen in your blood and periods where you stop breathing. You can then decide whether an oral appliance or CPAP is right for you.

Looking for more information on obstructive sleep apnea treatment options? Visit Boise Dental Sleep Therapy.

Please contact us for more information about sleep apnea and oral appliance therapy or visit these links for more information on sleep apnea and treatment alternatives:

Incredible! I have not been as rested and have not had the resulting energy after a night's sleep until using the Somnomed! Not even from my CPAP machine - not even close. Finally!! Great sleep. Thanks, Dr. Dan!”

Rodney

Educational Links

Does insurance cover oral appliances?

Oral appliances are a dental solution for a medical problem, so your medical insurance is billed. The good news is most insurance companies (including Medicare) provide coverage for oral appliances when certain criteria are met.

If you think you have sleep apnea or if you are snoring, please talk to your physician to see if an oral appliance is for you. You can also see us if you have questions about how to proceed. Testing and diagnosis is becoming easier, so there are many good reasons to take action to improve your sleep and overall health. If you decide to have an oral appliance made or need more information, contact us for an appointment.