It’s often seen as a figure in a cartoon — someone with a line of Zs floating above their head — indicating that they are peacefully asleep, and snoring. Cute and comical, but only in a cartoon. In real life, snoring can be a symptom of a serious problem called Obstructive Sleep Apnea (OSA), which the American Sleep Apnea Association estimates that about 22 million Americans have. And it’s the reason many dentists have begun asking patients about their sleep habits. How long they sleep. How well they sleep. Do they ever – or often – wake up gasping for breath.
Okay, we understand. You probably have never made a connection between how well you sleep and your oral health. Most of us don’t. Because most of us don’t need to. But the link between OSA and oral health is clear to sleep specialists as well as to dental professionals.
What is sleep apnea and what causes it?
Sleep apnea is a common breathing disorder. In fact, sleep apnea comprises 80% of the sleep disorders people experience. OSA causes your upper airway to narrow, or even completely collapse, while you sleep, cutting off the flow of air to your lungs, no matter how hard you breathe in. As you may imagine, not getting air into your lungs is a problem, which makes OSA a dangerous condition to have, especially if you don’t know you have it and it isn’t being treated. OSA is also known to contribute to several serious non-dental health conditions. Learn more.
In addition to risk factors that have nothing to do with your oral health — excess weight, family history, smoking, alcohol dependency, and use of sedatives or tranquilizers to sleep — certain characteristics of your mouth can also contribute. Having a large tongue, having intact tonsils, or exhibiting a significant underbite are all risk factors for sleep apnea that come under the purview of a dental professional.
How will I know if I have it?
One of the most common signs that you may have sleep apnea is that you snore. Loudly and persistently. We snore because the tissues in our throats relax, and when they do, they vibrate. If they relax too much, they can block your airway entirely, and cause you to wake up suddenly, struggling to breathe. Therefore, if you snore, you have sleep apnea, right? Not necessarily. You can have sleep apnea even if you don’t snore. And you can snore even if you don’t have sleep apnea. In addition, many of us have no idea how much we’re snoring until our partner tells us. Sometimes in no uncertain terms.
So, what other symptoms should you look for if you think you may have sleep apnea? In addition to snoring, sleep apnea is characterized by:
waking up in the middle of the night gasping for air
waking up frequently
chronic dry mouth or sore throat upon waking
daytime sleepiness or fatigue
difficulty getting up in the morning
depression, irritability, or forgetfulness
Of course, most of us have experienced many of these symptoms occasionally. But if the annoyances in this list are a regular part of your life, it may be because of sleep apnea.
How is sleep apnea treated by a dentist?
Sleep apnea is not a dental condition, it’s a medical one. And the most often prescribed treatment is the use of a CPAP (continuous positive airway pressure) device, which is a face mask that’s worn overnight to maintain a consistent flow of air to a person’s lungs. CPAP machines are quite effective and considered the best solution for everyone. Unfortunately, some people simply cannot tolerate a CPAP treatment. The mask is uncomfortable until you get used to it, it’s noisy, it’s hard to adjust to your personal sleeping style, and sometimes it’s simply impractical for any number of reasons. For people with sleep apnea who cannot tolerate the CPAP therapy, their dentist has options.
Dental devices to treat sleep apnea, called oral advancement appliances, are custom made to fit your mouth, and can be quite helpful. They are designed to keep air passages open while you sleep, so that you receive the oxygen you need. By breathing more easily and waking up less often, you can get more – and better – sleep. In fact, studies have found that such appliances, used properly, can reduce the number of apnea episodes a person has by up to 60%.
What are the pros and cons of a dental sleep apnea appliance?
An oral sleep appliance is not perfect. It must be custom-made and fitted to your mouth. It can be as uncomfortable as CPAP machine, may not be sufficient for treating severe symptoms, and can cause excess saliva as well as problems with your temporomandibular joint.
Nevertheless, there are times and situations in which a dental appliance can make a difference. While no therapy is as effective as a CPAP machine, an oral appliance can be a good choice if:
you travel or go camping often, because it is small and portable, and requires no electricity to operate
you are on CPAP therapy at very high pressure, because an oral appliance can keep the jaw from falling backwards. The CPAP machine can then be set for a lower level of pressure, which is usually more comfortable
cost is a consideration, because an oral appliance is covered by medical, not dental, insurance
As dentists, we can’t diagnose sleep apnea, but we can recognize its symptoms. Now you know why we may ask you about how you are sleeping. If your answer includes any of the symptoms we listed here, it may be time to contact our office.
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