Today’s blog concerns new treatment for Obstructive Sleep Apnea, a growing health risk in the US, with dental appliances as an alternative to the more cumbersome CPAP, or “Continuous Positive Air Pressure” masks.
Obstructive Sleep Apnea
OSA is a debilitating sleep breathing disorder defined by a cessation of breathing for at least 10 seconds resulting in a lowering of your body’s blood oxygen (an “apnea”). When this occurs the brain reacts by disrupting deep sleep and arousing you just enough to start breathing again. OSA sufferers never get a “good night’s sleep” because the repeated apneas and arousals deprive them of REM and deep stage restorative sleep and lead to chronic daytime exhaustion, mood alteration and depression, deteriorating work performance, as well as long term cardiovascular stress. OSA is associated with high blood pressure (hypertension), irregular heart beat (arrhythmias), stroke, congestive heart failure, GERD (reflux disease) and diabetes.
If you have been diagnosed with OSA (Obstructive Sleep Apnea) by your physician, pulmonologist or sleep specialist, chances are you had an overnight sleep study (PSG or Polysomnograph) performed and have been given a “score” or AHI (Apnea-Hypopnea Index) or RDI (Respiratory Disturbance Index) which measures the number of breathing disruption episodes per hour. If your index is greater than 30 per hour, then your OSA is severe and treatment with CPAP (Continuous Positive Air Pressure mask) is indicated. If your indexes are less than 30, then your apnea is mild to moderate and your doctor will decide if an oral appliance is an appropriate alternative to CPAP. For patients with mild to moderate OSA it has been shown that adjustable dental appliances made by a dentist who has been trained in sleep dentistry are an effective treatment and thus have been approved as an alternative to CPAP. These appliances are custom made and are called Mandibular Advancement Splints or Appliances and they advance the lower jaw at night and thus keep the airway open during sleep. They need to be individually fitted and then “titrated” (adjusted) by a dentist to find the right position to be effective yet comfortable.
Recently, the American Academy of Sleep Medicine has recommended oral appliances as an optional first line of treatment for snoring and mild to moderate sleep apnea. Non-compliant CPAP wearers, even those with severe apnea, could benefit from oral appliance therapy alone or with a combined CPAP/oral appliance treatment. This method of treatment allows for CPAP pressures to be lowered, giving superior comfort to patients. We are familiar in fabricating and adjusting many types of OSA appliances, such as the SomnoDent ®, TAP, EMA, SUAD, and the OASYS.
If you suffer from chronic snoring or obstructive sleep apnea talk to your physician and let us know. We can be reached in Southfield, MI at 248-356-8790. We are well trained and equipped to help you. Let us help you get a better night’s sleep!
That’s all for today so until next time,
Mark W Langberg, DDS