Obstructive sleep apnea (OSA) is the medical term used when referring to a sleep disorder that is characterized by an intermittent failure to breathe during sleep due to some type of physical obstruction that repeatedly blocks the airway. The body struggles to breathe but cannot – the effort can go on for 10, 20, 30 seconds or more. When the blockage is finally cleared, gasps for air, snorts and/or choking sounds occur as the body resumes normal breathing. Until the block happens again.
For years, individuals with OSA have been treated with continuous positive airway pressure (CPAP); however, oral appliances as a first line therapy for sleep apnea may be able to address a patient’s obstructive sleep apnea without the need for expensive, bulky and uncomfortable equipment.
As an individual sleeps, the muscles throughout the body relax. This is a natural process and is meant to provide the muscles time to repair themselves; nevertheless, the muscles in the throat and mouth also relax. For approximately 22 million Americans, these muscles relax and fall back, blocking the upper airway. Furthermore, if soft fatty tissues are present, these may also create a blockage.
When an individual stops breathing during sleep, the brain responds by sending the respiratory system signals to work harder to get past the blockage. In order to send these signals, the brain must partially awaken, which is why many people who have untreated obstructive sleep apnea consistently feel tired. In addition, individuals may experience mood disturbance, pounding headaches directly after waking up, memory problems, cognitive impairment, a sore throat upon waking, loud snoring, depression and an overall decrease in their quality of life.
The severity of an individual’s OSA is determined by the number of apnea events he or she experiences during sleep:
The side effects of sleep apnea include:
There are certain factors that increase the likelihood that an individual will develop sleep apnea.
Factors that increase the likelihood of developing OSA include:
Following a mild to moderate obstructive sleep apnea diagnosis, a custom-designed oral appliance can be created to prevent the blockage from occurring. Keep in mind that OSA is a serious health condition; therefore, over-the-counter devices are not recommended for treating this disorder.
OAT has emerged as the leading alternative to continuous positive airway pressure for the treatment of sleep apnea.
Clinical guidelines recommend the use of MADs prior to implementing CPAP when an individual has mild obstructive sleep apnea as well as in cases where an individual with a more severe case of obstructive sleep apnea refuses to or cannot tolerate treatment with a continuous positive airflow pressure machine.
In the past, CPAP therapy has been the preferred treatment for OSA. Today, doctors focus on recommending the treatment the patient is more likely to use and work hard to make that choice the most effective, also. Some patients should only consider CPAP; most patients become well-informed enough to choose from several alternatives, including OAT.
The side effects frequently associated with CPAP therapy include:
Furthermore, due to their ease of use and comfort level, many patients with mild to moderate sleep apnea prefer oral appliance therapy over CPAP therapy. Oral appliance therapy devices are similar to orthodontic retainers or the mouth guards worn while participating in sports.
Numerous devices are used to treat sleep apnea and while each differs somewhat in appearance, most fall within one of the following categories:
Mandibular advancement devices (MADs) – these appliances reposition the lower jaw by moving it slightly forward and down to make sure that the airway remains open while an individual sleeps. These devices are the most commonly used oral appliances for treating sleep apnea. MADs snap over the patient’s upper and lower arches, with a connection that keeps the lower jaw forward, not allowing it to drop back. There are several variations on the type of MAD that you can discuss with your dentist.
Mandibular advancement devices work by preventing the throat muscles and pharynx from collapsing into the airway; thus, allowing the individual to breathe normal while sleeping. Most of these devices can be adjusted, which allows the sleep apnea dentist to fine-tune the device for maximum effectiveness.
Oral Appliance Therapy vs. CPAP Therapy for OSA
When compared to continuous positive airway pressure therapy, there are many benefits to choosing OAT for the treatment of sleep apnea.
OAT vs. CPAP:
Appliance costs vary; however, the use of oral appliance therapy to treat sleep apnea is usually much more economical when compared to the costs associated with continuous positive airway pressure therapy.
While the majority of insurance companies will cover OAT treatment, patients should always check with their insurance company before starting treatment for sleep apnea.
Yes, before receiving treatment for obstructive sleep apnea, a sleep study is required. Understanding the specifics of an individual’s disorder and receiving an accurate diagnosis is essential to determining which treatment will provide you or your child with optimal results.
For more questions about Oral Appliance therapy, feel free to contact Premier Sleep Associates today by calling us at (452) 698-1732. Or click the button below to request an appointment today!