Sleep Apnea (Snoring)

Snoring is a sound that is produced when the air passes through relaxed tissue in the back of the throat. Mild snoring can be treated easily with a sleep orthotic. However, when snoring becomes sleep apnea, the tissue collapses causing an obstruction - although other reasons can also cause obstruction like tonsils or adenoids that need to be removed to allow more airway space.

In the case of obstructive sleep apnea (OSA), it becomes difficult to breathe through the confined space that remains. For some people, the tissue collapses so severely that it totally blocks the airway and breathing is nearly impossible. The result is an apneic event.

Sleep apnea is a disorder affecting more than 12 million Americans, according to the National Institutes of Health. It affects men and women of all ages, even children. Apnea is a Greek word, meaning "without breath." People affected by sleep apnea literally stop breathing repeatedly during their sleep, often for a minute or longer, possibly occurring hundreds of times per night. The heart and lungs panic, sending a distress signal to the brain. The brain, in turn, floods the body with adrenalin and quickens the heartbeat. The chest heaves as its muscles try to force the body awake in order to restore airway muscle tone and allows air to pass to the lungs again. The body succeeds and for a moment the airway opens, the individual gasps to breathe, then promptly falls back asleep and repeats this scenario over and over again.

Can you imagine this action taking place hundreds of times each night? This is why it affects the cardiovascular system, causes sexual dysfunction, depression and even death. The bad news is that most people don’t remember upon awakening that they had the episodes. Instead they notice symptoms like:

• Headaches upon awakening
• Daytime sleepiness
• Being sleepy during daily activities (driving, reading, watching TV)
• Awakening with a jolt, gasp or cough
• Trouble staying asleep
• High blood pressure or hypertension
• Feeling tired despite a full night of sleep

If left untreated, obstructive sleep apnea (OSA) can lead to several serious systemic problems. For instance, these patients are at a higher risk of having a heart attack or stroke. OSA can contribute to hypertension, diabetes, liver/kidney dysfunction and congestive heart failure (CHF). Patients may also experience gastroesophageal reflux disease (acid reflux), depression, memory loss, and erectile dysfunction. Even children can have OSA. Due to their lack of a full night’s sleep, some children are misdiagnosed as having attention deficit/hyperactivity disorder (ADHD) because they cannot focus in school.

Snoring may be caused by obesity, a small retruded jaw, sedatives, allergies or airway obstruction. For the majority of adults, snoring is not a serious medical disorder. However, when a person stops breathing for at least 10 seconds up to thirty or more times a night, this cessation of breathing is sleep apnea. Apnea puts a great strain on the cardiovascular system and may be the first sign of obstructive sleep apnea.

Dr. Lau has advanced training necessary to diagnose and treat snoring and mild to moderate sleep apnea. Along with a complete medical and dental history, the in-office exam by our office may also include a simple screening using:

• Computerized Pharyngometer to measure the throat airway space
• Computerized Rhinometer to measure the nasal airway
• An intra-oral habit assessment
• Checking of gag reflex
• Evaluating periodontal health, diagnostic models
• TMJ disorder and occlusal exam with specialized x-rays to assess whether you are a sleep appliance candidate.

We may refer you to go to a sleep clinic for an overnight sleep study (called a polysomnogram). Dr. Lau consults with your physician to determine whether an airway oral appliance will be an effective treatment for you! He has the special training necessary to treat sleep disorders and he works together with sleep centers and physicians to achieve the best possible results. Many times, a sleep orthotic is the only treatment needed. Other times, a sleep orthotic can be used in combination with CPAP (continuous positive air pressure) and/or UPPP surgery.

It is good to know that oral airway appliances are economical, non-invasive, completely reversible, totally painless and many are FDA approved to be worn at night. There are several kinds of oral appliances we can provide (shown here). Dr. Lau will determine which one is best for your specific problem.

If you snore or your spouse snores or stops breathing periodically during the night, the answer may be closer than you think! With dentistry’s new knowledge and diagnostic skills our office may provide assistance for the snoring or sleep apnea patient.

Full Breath	TAP	SomnoDent
Herbst	Silencer	EMA