Dentists can treat sleep apnoea that is not severe. In fact, studies have shown that oral dental appliances are effective, safe and simple treatment options for suffers of mild to moderate obstructive sleep apnoea. It’s important that your dentist has the expertise, training and accreditation in dental sleep medicine. This will ensure you receive the right advice, best guidance and suitable treatment options.
What is your sleeping problem?
Before deciding how to treat your sleeping problems, it’s important you and your sleep specialist understand the cause. Not all sleeping problems are the same. Sleep apnoea affects approximately 25% of the population and is categorized as either Central Sleep Apnoea (CSA) or Obstructive Sleep Apnoea (OSA).
Central Sleep Apnoea occurs when the patient’s brain fails to signal the muscles to breathe. This usually results in more frequent and longer lasting apnoeas (breathing pauses) as compared to OSA. There can be different reasons for CSA: neuromuscular disorders, stiffened lungs or weak lung muscles etc. CSA is not due to blocked or narrow airways. CSA is a less common cause of sleep disturbance than OSA, affecting only about 10% of sleep apnoea sufferers.
Obstructive Sleep Apnoea is caused by narrowing or blockage of the air passage during sleep. When the wind pipe is blocked or obstructed, it causes apnoea (pauses in breathing) and often awakens the sufferer. A typical tell-tale sign of an OSA sufferer is someone who snores loudly, gasps and repeatedly chokes, often disturbing loved ones as well. OSA causes a person to sleep less soundly and awaken tired. The ailment is one of the most prominent causes of snoring and affects approximately 25% of middle-aged males and 10% of middle-aged females.
Factors associated with OSA
- excess weight
- high alcohol consumption
- a large tongue
- obstruction of the nasal passages
- an enlarged uvula
- large tonsils
- excessive tissue in the throat
A person that suffers from OSA stops breathing more often and for longer periods of time than normal people. The human brain has a group of cells that act like an oxygen sensor. If you don’t breathe for a longer period of time than normal, the oxygen content of your blood drops. The sensor releases a protein that makes you wake up and tells you to breathe so you can keep living. This is why people that have OSA wake up during the night. In addition to disrupted sleep, the lack of oxygen triggers other responses in the body that have been associated with significant health risks like, high blood pressure, heart disease and stroke. Click here to read more articles about health consequences relating to Obstructive Sleep Apnoea.
Why are dentists involved in sleep apnoea treatment?
Dentists became involved in sleep apnea treatment as a result of the lack of success of other OSA devices. CPAP is a widely used OSA device that can be effective, however some 40% of sufferers didn’t find relief for their sleep problems. A CPAP device requires an air-tight mask to be worn during the night and the mask is attached to a machine near the bed. During the night the machine pumps a constant flow of oxygen into the mask. The positive air pressure caused in the mask helps the airways to stay open, allowing the sufferer to breathe freely. While CPAP treatment is effective, some people cannot find an air-tight fit for the mask. Lack of an air tight fit can make the problems caused by OSA worse. The hum of the machine can also interfere with sleep in individuals that require silence in order to doze off. The mask and machine is bulky and can be quite intrusive and impractical.
Dentists with a keen interest in obstructive sleep apnoea have devised oral devices to help patients. These oral devices are small and fit snugly into your mouth, they don’t require a mask, nor a machine and have been proven effective treatment options for mild to moderate OSA sufferers.
How do oral devices work?
OSA is when the airways become obstructed and breathing is limited or paused due to blockages. The oral devices work to increase the opening of your airways. The specially designed oral appliances act to push the lower jaw forward. Moving the lower jaw slightly forward moves the tongue forward and works to open the air passage. A correctly designed and fitted oral appliance can move the lower jaw forward approximately 8-10mm. This small movement of the jaw is sufficient to keep the airways open, preventing snoring and allowing you to sleep soundly all night!
Why should you see a dentist?
A custom fitted oral appliance has a higher rate of success in treating OSA than similar devices that can be acquired from a pharmacy. An incorrectly designed of poorly fitted oral device will do little to improve your sleep and could make it worse. A dentist with training and qualifications in dental sleep medicine understands how your oral device should be designed and fitted to your specific needs. The oral device that is tailor made to your mouth, is an advance in personalised medicine for sleep apnoea treatment. The idea is that one size does not fit everyone! A custom fitted appliance allows the device to conform to the particular shape of your mouth. Your device will be more effective and more comfortable, helping you to comply with your sleep treatment.
What you should do first.
While dental oral medicine is effective in treating mild to moderate sleep apnea, it is less effective in severe cases. Your first step in determining if a dental appliance is a good fit for your obstructive sleep apnea treatment is to have a sleep specialist determine the severity of your sleep apnea. The Apnoea Hypopnoea Index (AHI) is the most widely acknowledged measurement of OSA. Derived from an overnight sleep study, the AHI measures the extent of OSA; scores of > 5 indicates the presence of OSA and > 30 signaling a severe case.
Your next step is to find a dentist that is qualified in oral sleep medicine to fit you with an oral device. The qualification to provide this service requires extensive training by the dentist and any technicians involved in making your breathing appliance. This training allows your dentist to collaboratively work with other sleep professionals involved in your care.
How can you pay for this?
The cost of an oral device that is an obstructive sleep apnea treatment depends in part on the shape of your mouth, the material used in the device, and the amount of the costs that are covered by your insurance.
Generally speaking the total cost is comparable and slightly less than a CPAP machine. The majority of insurance providers have accepted the huge body of clinical evidence that proves that oral devices are an effective and safe to use as a treatment for sleep apnoea and the sleeping problems caused by obstructive sleep apnoea.