Does your spouse snore? Do you? Most people are reluctant to admit it - as if it were a pox or something embarrassing! Okay - maybe sometimes it is – like when falling asleep on an airplane or in the theatre and then waking up abruptly to a snorting sound only to find everyone looking at you!

Even at that, snoring is considered the "cosmetic" aspect of a wide array of sleep problems called "sleep Disordered Breathing". Many believe snoring is innocuous and innocent, except for the annoyance it perpetrates upon the ears of those who have to put up with it. Snoring is really just the "tip of the iceberg" and by itself is not dangerous to one’s health. But its big brother – sleep apnea is!

Obstructive sleep apnea is the momentary stoppage of air movement for more than ten or twenty seconds caused by frequent closures of the airway during sleep.

Snoring is the more obvious manifestation of many sleep problems, the most notable of which is Obstructive Sleep Apnea (OSA). Snoring and sleep apnea almost always go together, but they are still two separate conditions. Snoring is the vibration sound that is created by in-and-out air movements at the back of the throat when the tongue and jaw relaxes during sleep. Obstructive sleep apnea is the momentary stoppage of air movement for more than ten or twenty seconds caused by frequent closures of the airway during sleep.

Many people are unaware they have sleep apnea. After all –they’re sleeping! But when you think about it, one-third of your life is spent sleeping. If you are not getting the restful sleep your body needs, then your body doesn’t have the rest or health that it should. The 10-20 second air obstructions can occur up to 20 to 30 or even more than 90 times per hour! The dangers of snoring and sleep apnea are often underappreciated, overlooked and left untreated.

The symptoms and related medical conditions
of OSA include:

The bottom line is that sleep apnea is basically repetitive episodes of suffocation! If you’ve ever had the chance to watch a person with sleep apnea stop breathing and then struggle to get a breath again, over and over all night long without them even being aware of it – it is a very painful experience to watch and one not easily forgotten.

The momentary cessation of breathing during sleep produces an "arousal" wherein the oxygen staved brain awakes just enough to command the muscles of the throat to momentarily open so that a gasp of air can occur… after which the sleeping person drifts back to a lower state of relaxation – only to repeat the cycle endlessly all night.

Emerging science is now confirming that sleep apnea is a dangerous health condition which is tightly connected with many serious health problems. As noted above, these include heart disease, stroke, diabetes, obesity, and high blood pressure to name a few.

Another obvious consequence of sleep apnea is the daytime tiredness associated with obstructive sleep apnea. This profoundly affects safety while driving, attentiveness at school or in the workplace, as well as general energy levels through the day. According to recent studies people with mild sleep apnea have 300-500% increase in motor vehicle accidents involving serious injuries. Certainly legal liability is now being considered as people with diagnosed sleep apnea who fall asleep at the wheel and cause fatal traffic accidents are being viewed with renewed scrutiny.

People who suffer from snoring and sleep apnea are deprived of necessary oxygen while they sleep. While it may not seem like a serious problem because the sleeping person eventually arouses and wakes sufficiently to take the necessary breath of air, the lack of oxygen to the body can have lasting effects. Sometimes the body can experience as much as a 50% reduction in the amount of blood oxygen saturation.

Many people are puzzled at why sleep apnea is so tightly associated with significant medical conditions such as heart disease. The scientific connections between sleep apnea and is many associated diseases is due to the bursts of oxidative stress and production of systemic inflammation which occurs as the oxygen levels rise and fall in the blood stream. This cycling lack of oxygen leads to many health problems as a consequence of increased inflammation proteins that are generated and then put into the bloodstream. Also disruption in sleep cycle creates hormonal and metabolic consequences.

Obstructive Sleep Apnea Treatments

Treatments for obstructive sleep apnea are threefold: 1)- CPAP - Continuous Positive Airway Pressure), 2)- surgery, and 3)- oral appliances which can be used to advance the lower jaw forward to open and support the airway.

CPAP is considered the "gold standard" for sleep apnea treatment because when it can be tolerated it is very effective in preventing the cyclic effects of sleep apnea. However, there is one small problem – many people absolutely HATE it! The official term is "CPAP Intolerance"!

For most people it amounts to a love-hate relationship! But for too many, it is mostly hate! They view it like wearing a F-15 fighter pilot’s mask through the night. Some estimates are that approximately half of the people with CPAP refuse to wear or use it, or use it less than necessary, which leaves them completely without treatment for this deadly condition!

Surgery is usually only done as a last resort or if there are obvious problems with the nasal passage or with tonsils and adenoids which must be removed to clear up problems with the natural airway. Other surgeries reshape the soft palate and throat in an attempt to create more room, and are only performed today when absolutely necessary. The reason? Time and experience has shown that they are only marginally effective, if that!

This leaves oral appliances as the only other viable treatment option for sleep apnea. A "MAD" (mandibular advancement device) oral appliance is the "new kid" on the block, having just recently been approved by the American Academies of Sleep Medicine and Dental Sleep Medicine for mild to moderate obstructive sleep apnea. Because of this, many health professionals are yet unaware of their existence or how they work to help resolve sleep apnea airway issues.

Patients who refuse to use or have problems with their nightly CPAP therapy and who elect to have an oral appliance to help open their airway, almost universally rave about the great sleep they enjoy and are so glad they don’t have to fight their CPAP. Of course, oral appliances aren’t for everyone, but for traveling executives and business persons, people who spend time in the outdoors, or people who simply need to have an alternative to CPAP – an oral appliance is a welcome alternative.

Your Dental Sleep Medicine dentist will carefully fit and adjust your appliance and will work with a sleep physician and/or use home monitoring equipment to properly titrate the right settings for optimal nighttime breathing.

Sleep apnea oral appliances can certainly help you restore the "breath of life" to a tired and wearied body starving for a good nights sleep.

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