Snoring: Cause and Effect
You may think of snoring as a mild nuisance, but it can actually be indicative of a sleep-breathing disorder known as sleep apnea. Snoring occurs when soft tissues block air passages. Air forces entry, causing the muffled vibrations we know simply as snoring. A variety of factors can contribute to airway blockage, including tongue and jaw position, throat size, and tonsil or adenoid size. Snoring does not necessarily indicate sleep apnea, but the only way to be certain that you don’t have obstructive sleep apnea is to complete a sleep study. Even if you don’t have sleep apnea, an oral appliance can eliminate snoring. And your bed partner would like to get a good night's sleep, too!
CPAP Alternative - Free Consultation and Exam for Sleep Apnea
Sleep apnea occurs when the airways are blocked to the extent that the person stops breathing at intervals of ten seconds or longer. The continual oxygen deprivation prevents the person from receiving a restful night’s sleep, because he or she must awaken enough to breathe. If left untreated, sleep apnea can lead to:
Symptoms of Sleep Apnea
If you snore, gasp for breath at night, or sleep restlessly, you may have sleep apnea. Other signs include dry mouth, dizziness, inability to concentrate, morning headaches, irritability, and falling asleep when driving, reading, or sitting quietly. Other factors can contribute to fatigue. It is best to also consult with your primary care doctor to rule out other causes of these symptoms.
Rev. Reggie White, Super Bowl Champion, had sleep apnea.
He died in his sleep before he had his 44th birthday. Men and women who struggle with sleep apnea are at a 46 percent increased risk of dying an early death as opposed to those who do not have the nighttime breathing problem. Although more than 12 million people have sleep apnea, most do not know it and therefore do not realize they are at risk for a possible early death. Risk factors include obesity, high blood pressure, heart failure, and strokes.
Take our online quiz to see if you are at risk for sleep apnea. Just fill out this short survey and we will let you know what your risk would be.
If it is determined that you have a high risk for sleep apnea, Dr. Hornstein may recommend that you complete a sleep study. This sleep test will help determine the best choice of treatment for you. In most cases, you can have a sleep study completed in your own home. A home sleep study is more convenient and measures most of the same criteria that an in-hospital sleep study does. It records in what position you sleep, your oxygen levels, the loudness of your snoring, how many times you may stop breathing and for how long, the length of time you spend sleeping, the levels of sleep and how long you spend in each stage (can help determine the quality of sleep), and your heart rate. The device is simple to use.
A medical doctor who specializes in sleep medicine will interpret the information and we can have the results within a few days. We will contact you as soon as we receive the results of your test and then discuss the results. As a courtesy, we will also forward the results of your sleep test to your primary care doctor and any specialists who also monitor your health.
Three methods of treatment include surgery, using a CPAP (Continuous Positive Airway Pressure), and wearing a custom fit oral appliance at night.
One option is surgery for those patients who have a blocked airway. With obstructive sleep apnea (OSA), blockages somewhere in the airway occur repeatedly and cause breathing to stop for at least ten seconds and maybe for a minute or longer. The intention of surgery is to open the airway sufficiently to eliminate or to reduce obstructions to a clinically insignificant level. In order to do so, surgical therapy in adults often must reconstruct the soft tissues (such as the uvula and the palate) or the bony tissues (the jaw) of the throat. This method has about a 50% success rate. There are other surgical options that can assist in opening the airway.
The most common method of treatment for sleep apnea involves a CPAP machine, which delivers a continuous stream of oxygen via nose and/or facial mask. While effective, the CPAP often proves cumbersome, and many patients find CPAP therapy intolerable and discontinue use.
In many cases, Dr. Hornstein can provide CPAP intolerant patients with an alternative. Oral appliance therapy involves a custom-made orthotic worn at night. Depending on your needs, the orthotic can reposition the tongue, hold the jaw forward, and prevent the soft palate from blocking the airways. An oral appliance also alleviates snoring. Dr. Hornstein will discuss with you which oral appliance is appropriate for you.
Whether your main concern is snoring, you hate your CPAP, or you just feel tired after a full night’s sleep, a home sleep test can help determine if you are have sleep apnea.
We offer a complimentary consultation for our patients who snore and/or those who do not like to use a CPAP machine. At the initial visit, we will:
If it is determined that a home sleep study is warranted, then documentation is completed to initiate this process. This includes an airway evaluation, digital photographs, a letter of medical necessity, and gathering other pertinent information.
If you have already completed a sleep study in the past 5 years, Dr Hornstein will review those results with you and refer you to a physician who specializes in sleep medicine to review your options. A dentist must have a medical doctor’s recommendation for an oral appliance before he can proceed with that process.
If the sleep physician recommends an appliance, then we will fabricate an oral appliance. The appliance will help pull the tongue forward. This opens the airway to diminish or relieve any obstruction caused by the collapse of the soft tissues of the throat.
Before fabricating the appliance, we will complete these steps:
1. A thorough dental exam to make sure that the teeth are healthy enough to support the oral appliance.
2. Impressions are taken of the upper and lower teeth to make the custom fitted appliance.
3. Electrical stimulation (TENS) is used to relax the chewing muscles. This allows the jaw to move as freely as possible. Once the muscles are fully relaxed, Dr Hornstein will determine the optimum starting position of the jaw for the oral appliance. An impression will be obtained of that position. This appointment takes about 1.5-2 hours. The models and jaw position impression are sent to the lab to have the appliance fabricated.
The next visit will be in 2-3 weeks to deliver the appliance. At this visit, the appliance is fitted and adjusted to make it comfortable. You will receive full instructions on the care and usage of the oral appliance. We will see you again within a month and have phone contact to monitor your progress. Another sleep study is repeated in 3-6 months to determine the effectiveness of the oral appliance treatment, although the improvement of your symptoms is just as indicative of its success.
Because sleep apnea is considered a medical condition, we will submit a claim to your medical insurance. We are committed to maximize your medical insurance benefits.
Dr Hornstein takes the time to answer all your questions. We look forward to helping you find an effective solution to the serious condition of sleep apnea.
The Center for Advanced Dentistry…Where Holistic Health and Aesthetic Dentistry Come Together.
Call our Beachwood dental office to make an appointment with Dr. Hornstein. We serve residents from Cleveland, Solon, Shaker Heights, Pepper Pike, and the surrounding areas.