What is sleep apnea?
Sleep Apnea is a type of sleep disorder that causes breathing to stop momentarily due to repeated airway blockage. The blockage causes snorting or choking sounds as you try to breathe. Oxygen deprivation triggers such arousal episodes. Such interruptions can last from a few seconds to a few minutes. In a single hour, you may have interrupted breathing 20-30 times or more.
In some people, nocturnal tooth grinding (sleep bruxism) can occur together with sleep apnea. In mild apnea, sleep bruxism may be the earliest sign of airway restriction.
How can I treat sleep apnea?
The most widely used devices for treating sleep apnea are the continuous positive airway pressure (CPAP) machine and the use of jaw repositioning dental appliances.
If you have mild to moderate sleep apnea and you cannot tolerate the CPAP, there are customized oral devices that maintain your airway during sleep.
1. Mandibular Advancement Devices (MAD)
Continuous Open Airway Therapy
- An affective option for treatment of sleep apnea (Phillips et al, 2013)
- Is very comfortable for patients (Vanderveekan et al, 2013)
- Is used for longer than CPAP throughout the night (Ngiam, 2015)
An oral appliance (OA) is a device worn in the mouth only during sleep. It fits like a sports mouth guard or orthodontic retainer.
A custom-fit SomnoDent oral device is an effective treatment that prevents the airway from collapsing by supporting the jaw in a forward position – resulting in COAT.
The OA’s are the most commonly used appliances. These are fitted to both upper and lower dental arches. Most consist of 2 separate pieces for more freedom of movement in the lateral direction. The appliance repositions the lower jaw forward to open up the airway.
Prescription and close monitoring of an OA is mandatory as long term wear can cause tooth migration and changes in your bite.
2. Tongue Retaining Devices
Tongue retainers can also be used. It is a splint that holds the tongue forward to prevent it from falling backwards into the throat when the muscles relax during sleep.
The CPAP Machine
The CPAP keeps your air passages open using pressurized humidified air. It consists of three parts – a mask that fits over your nose (or both nose and mouth) and secured with straps, a motor for the air pump, and a large tube (cannula) which connects the motor to the mask.
This device is considered the gold standard treatment for all types of apnea.
The CPAP is portable enough for travel. It reduces snoring, thereby improving sleep quality for you and your bed partner. Improved sleep quality can also reduce sleep bruxism, improve blood pressure and reduce diabetes markers.
The CPAP can cause:
- Constricted or confined feeling in the face from the mask
- A dry mouth
- Rashes around the mouth
- Nasal congestion
- Irritation over the bridge of the nose especially for first-time users
- Stomach bloating
- Chest compression
Should these problems arise, inform us immediately so that we can help you with the necessary adjustments.
SLEEP APNEA MANAGEMENT AT ELITE DENTAL
Step 1: Assessment
Your breathing patterns and tooth wear rate is assessed as part of the new patient examination and active maintenance. Nasal congestion/obstruction, narrow airways, nasal septal defects, sinus abnormalities and lower jaw disproportion can be assessed on panoramic and lateral ceph xrays.
If we suspect that you may have undiagnosed sleep apnea, we will arrange for our in-house ENT surgeon , Dr Kenny Pang, to have a consultation with you.
Further testing will then be done to assess the severity of your condition.
Step 2: Making and fitting of your oral appliance
If you have been advised that you only require an oral appliance or if you have tried to use the CPAP unsuccessfully, custom moulds and bite records will then be taken in order to start the custom manufacturing process.
Once made, the new oral appliance will then be fitted and adjusted by us, to ensure your maximum comfort. Expect a period of adjustment when you first start using the appliance. It is common to experience difficulties falling asleep, increased salivation and mouth dryness. Several adjustment visits may be needed to fine tune the appliance so that it can be worn comfortably.
A repeat sleep test maybe taken at a later stage to determine the effectiveness of the appliance.