In the most basic of definitions apnea means suffocation. The airway in the orpharynx (the back of the throat) must be thought of as a collapsible tube that extends the length of the neck. If this tube becomes blocked or narrowed in any way, an obstruction has been created. Commonly, obstructions occur when an individual has larger neck sizes. The neck size and Body Mass Index (BMI) have a direct relationship. Individuals with high BMI's have an increased chance of sleep apnea. Some individuals may not have large neck sizes or be overweight, but may still suffer from the condition due to airway physiology. When these individuals lie supine, (flat on the back) the weight of the tongue and the tissues of the orpharynx will cause the airway to narrow and in some cases completely close; a very common cause of snoring and apnea episodes. Snoring can be a mild to moderate form of Obstructive Sleep Apnea (OSA), because it lowers the amount of oxygen available for the body.
Dental management for sleep apnea involves the use of a dental device that moves the lower jaw forward. This movement of the lower jaw allows the tongue to be raised off of the airway and helps the individual get the needed oxygen while asleep.
Sleep disordered breathing (SDB) includes an array of breathing problems during sleep. Snoring, difficulty with breathing, and interrupted breathing are included.
Sleep disordered breathing is a spectrum of severity based on the collapsibility of the airway. Symptoms increase due to the increase in the disruption of airflow.
When the jaw opens and the tongue falls into the back of the throat, the airway narrows forcing air through the smaller opening. This creates vibrations in the throat known as snoring. Although snoring seems physically harmless, it can be a "red flag" for a much more serious and sometimes fatal condition called obstructive sleep apnea (OSA).
Good sleep hygiene, weight loss, and exercise, are some helpful treatments a patient can practice on their own. Medical and dental treatments include Continuous Positive Airway Pressure (CPAP), Oral Appliance Therapy, and Surgery.
Oral appliances are worn in the mouth to treat snoring and obstructive sleep apnea (OSA). These devices are similar to orthodontic retainers or sports mouth guards. Oral Appliance Therapy involves the selection, design, fitting and use of a custom-designed oral appliance that is worn during sleep. With an oral appliance, throat structures move out of your air passage, allowing air to flow freely through your throat. Oral appliances may be used alone or in combination with other means of treating OSA. These means include general health, weight management, surgery, or CPAP.
Oral appliances work in several ways:
Continuous Positive Airway Pressure (CPAP) is pressurized air generated from a bedside machine. The air is delivered through a tube, connected to a mask, covering the nose. The force of the pressurized air splints the airway open. The CPAP opens the airway like air into a balloon; when air is blown into the balloon, it opens and gets wider. This is exactly how CPAP clears the airway.
In addition to Oral Appliance Therapy, dentists who are oral and maxillofacial surgeons may consider a variety of methods to evaluate, diagnose and treat upper airway obstruction. These dental specialists treat upper airway obstructive disorders by utilizing both minimally invasive procedures as well as more complex surgery, including jaw advancement. Additionally, an ENT specialist may evaluate you for other types of surgery, mainly the removal of the excess tissues in the throat. It may be necessary to remove tonsils and adenoids (especially in children), the uvula, or even parts of the soft palate and the throat.
If you or someone you know suffers from sleep apnea contact our office for more information on how we can help.