Snoring and Obstructive Sleep Apnea (OSA), disorders that result from upper-airway obstruction have been associated with excessive daytime sleepiness, hypertension (high blood pressure) coronary heart disease, cardiac arrhythmia's, nocturnal sudden death and stroke. Snoring can be a sign of upper airway obstruction. It affects people of all ages, but is most common in overweight, middle-aged and elderly adults.
OSA and snoring are caused by anatomic airway collapse and altered respiratory-control mechanisms. Contributing structural abnormalities can include, deviated septum, nasal polyps, enlarged tongue, skeletal abnormalities, enlarged tonsils, tumors or too much fatty tissue surrounding the airway (obesity).
Oral appliances have been developed as alternatives or adjacent to weight loss, sleep position changes, continuous positive airway pressure (CPAP) and surgery for the treatment of upper airway obstruction. The aim of treatment with oral appliances includes improvement of snoring, OSA or both by one or more Mechanisms: mandibular (lower jaw) repositioning or tongue advancement, thus opening a collapsed airway allowing normal breathing.
The presence or absence of Obstructive Sleep Apena must be determined by doing a sleep study (Polysomnography) to identify those patients at risk due to complications of sleep apnea. The severity of sleep-related respiratory problems must be established in order to make appropriate treatment decisions.
A. Oral appliances are indicated for use in patients with primary snoring or mild OSA who do not respond or are not candidates for treatment with measures such as weight loss or sleep position change.
B. Patients with moderate to severe OSA should have an initial trial of CPAP because CPAP has been shown to be more effective in some cases, than oral appliances.
C. Oral appliances are indicated for patients with moderate to severe OSA who are intolerant of or refuse treatment with CPAP.
D. Oral appliances may aggravate temporomandibular joint disease and may cause dental misalignment and discomfort. Oral appliances should be made and fitted by a dentist who is trained and experienced in their use and treatment objectives.
Successful treatment of sleep apnea can lead to more energy during daytime hours, greater productivity and generally feeling better overall.
The following is a simple test that can help you determine if you may have sleep apnea:
American Academy of Dental Sleep Medicine
The only way to be sure if you have obstructive sleep apnea is to have a sleep test. This could be done at home, from a qualified sleep physician, or in a hospital sleep center. A score of 9 or above on this test is an indication that you should see your doctor.
The Epworth Sleepiness Scale
How likely are you to dose off or fall asleep in the following situations?
Choose the most appropriate number of each situation:
0= would never doze
1= slight chance of dozing
2= moderate chance of dozing
3= high chance of dozing
Sitting and Reading _______
Watching TV _______
As a passenger in a car for an hour without a break _______
Lying down to rest in the afternoon when time permits _______
Sitting and talking to someone _______
Sitting quietly after lunch without alcohol _______
In a car, while stopped for a few minutes in traffic _______
Total Score _______
A score of 9 or above indicates you may having a problem with daytime sleepiness, but below 9 does not necessarily mean you don't have a problem. See your health care professional for advice if you snore, have been told that you awake gasping for breath or if you are sleepy during the day.