With the number of people who suffer from it and it’s negative effect on overall health and quality of life, obstructive sleep apnea (OSA) has become a significant public health issue that demands greater attention. Millions of people suffer from sleep disordered breathing of various degrees – from snoring to severe obstructive sleep apnea.
Unfortunately, sleep apnea is not widely recognized as a chronic disease that is a major cause of morbidity and mortality in the United States. Sleep disordered breathing affects as many as nine percent of middle aged women and one quarter of middle aged men. According to The National Sleep Foundation, approximately 18 million people suffer from obstructive sleep apnea. Recent studies indicate that up to 90% of people who suffer from sleep apnea have never been diagnosed.
Sleep Apnea is a sleep-related breathing disorder that results in a reduction or full restriction of airflow. The cause is muscles relaxing during sleep, resulting in a collapse of soft tissue in the back of the throat which blocks the upper airway.
The result is a 10 second or greater reduction or complete pause in breathing. The pauses generally last between 10 and 30 seconds, but in some people, may continue for 60 seconds or longer. This can lead to sudden reductions in blood oxygen saturation and in severe cases oxygen levels can fall 35 percent or more. The body’s survival instinct causes the brain to respond to this lack of oxygen by alerting the body, which causes a brief awakening that restores normal breathing. This process can occur hundreds of times in one night, resulting in poor quality of sleep and corresponding sleepiness the following day.
The majority of people with sleep apnea snore loudly with silence when airflow is reduced. They will often then make gasping or choking sounds once airflow resumes.
• Can occur in any ager group, but is most common among those middle age and over.
• Daytime sleepiness due to sleep apnea occurs in at least four percent of men and two percent of women
• Approximately 24 percent of men and nine percent of women have the breathing symptoms of sleep apena with or without daytime sleepiness.
• While generally associated with middle aged adults, sleep apnea occurs in about two percent of children and is most common at preschool ages.
• Sleep apnea goes undiagnosed in almost 90% of sufferers
There are two primary treatment methods for sleep apnea:
CPAP is a common treatment option for moderate to severe cases of sleep apnea and a good option for mild sleep apnea. First introduced in 1981, CPAP provides a steady stream of pressurized air through a mask worn during sleep. The airway is kept open by the continual airflow which prevents pauses in breathing and the resulting reduction in oxygen levels. Today’s CPAP systems are small, lightweight and quiet.
An oral appliance is an effective treatment option for people with mild to moderate sleep apnea who either prefer it to CPAP or are unable to successfully comply with CPAP therapy. Oral appliances look similar to mouth guards worn for sports. The appliance repositions the lower jaw, tongue and soft palate to help maintain an open and unobstructed airway. Some appliances are specifically are designed specifically for snoring, while others are intended to treat both snoring and sleep apnea. They should always be fitted by dentists who are properly trained in sleep medicine.
The practice parameters laid forth by the American Academy of Sleep Medicine in 2006 call for oral appliances as a first line of therapy in the standard care for the treatment of obstructive sleep apnea.
According to the parameters, oral appliances (OAs) are indicated:
“For patients with mild to moderate OSA who prefer OAs to Continuous Positive Airway Pressure (CPAP), and in all cases for those who do not respond to CPAP, are not appropriate candidates for CPAP, or who fail treatment attempts with CPAP or treatment with behavioral measures such as weight loss or sleep position change.”
One of the oral appliances our office fits patients with is the TAP® Oral Appliance. It is a custom, adjustable device. It consists of upper and lower trays that are molded for a custom fit and looks very similar to a sports mouth guard. The treatment includes slight movement of the lower jaw into an optimal position over time. The design of the appliance allows you to make adjustments at home, saving you unnecessary trips to our office.
The TAP® oral appliance is supported by more than 20 independent clinical research papers. Several of the studies demonstrate that the TAP alone is clinically effective in treating severe sleep apnea.
If you suffer from the symptoms of snoring and sleep apnea mentioned above, contact our office to schedule a consultation so we can help you determine the best method of treatment to give you the uninterrupted sleep you deserve.
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