Dental Treatment Solutions for Sleep Apnea

If you have sleep apnea, it means that you periodically stop breathing while asleep. Your brain then sends a signal to rouse you in order to restart your breathing. This can happen dozens or even hundreds of times each night. 

Many people with sleep apnea aren’t aware that their night-time breathing is being disrupted so often; they only know that they feel exhausted on a daily basis. Usually, a sleep partner is the one to alert them to their loud snoring and cessation of breath. Sleep apnea affects an estimated 22 million people in the United States, and it’s believed that the majority of moderate to severe cases go undiagnosed.

Complications from sleep apnea include fatigue, irritability, high blood pressure, abnormal cholesterol levels, high blood sugar levels, issues with medications and surgeries, liver complications, type 2 diabetes, heart attacks, and strokes.

There are three types of sleep apnea:

• Obstructive sleep apnea. This is the most common type. It occurs when your upper airway repeatedly becomes completely or partially blocked during sleep, usually because the soft palate or other soft tissues in the back of your throat collapse. During these episodes, your diaphragm and chest muscles work harder than normal to open your airways. You may gasp loudly or jerk your body. This can lower your oxygen level to your vital organs, leading to abnormal heart rhythms and problems sleeping.
• Central sleep apnea. With this type, your airway doesn’t become blocked. Instead, your brain fails to tell your muscles to breathe because of respiratory control issues in your central nervous system. Central sleep apnea happens most often in people with neuromuscular diseases such as ALS, those who’ve had a stroke, or people with heart failure or other forms of heart, kidney, or lung disease.

• Complex sleep apnea syndrome. This condition is when you have both of the other types of sleep apnea.

You may not notice your first symptoms of sleep apnea. Instead, your sleep partner may make you aware of them. The most common symptoms are:

• Loud, persistent snoring
• Fatigue or sleepiness during the day
• Restlessness while sleeping, or regular night-time awakenings
• Dry mouth or sore throat when you wake up
• Breathing problems while sleeping, including gasping or choking
• Trouble concentrating, forgetfulness, or crankiness
• Mental health conditions, such as depression or anxiety
• Constant need to urinate at night
• Night sweats
• Sexual dysfunction
• Headaches

Factors that increase the risk of obstructive sleep apnea include:

• Excess weight. Obesity greatly increases the risk of sleep apnea. Fat deposits around your upper airway can obstruct your breathing.
• Neck circumference. People with thicker necks might have narrower airways.
• A narrowed airway. You might have inherited a narrow throat. Tonsils or adenoids also can enlarge and block the airway, particularly in children.
• Being male. Men are two to three times more likely to have sleep apnea than women. However, women increase their risk if they’re overweight, and their risk also appears to rise after menopause.
• Being older. Sleep apnea occurs significantly more often in older adults.
• Family history. Having family members with sleep apnea might make you at higher risk of developing it. 
• Use of alcohol, sedatives, or tranquilizers. These substances relax the muscles in your throat, which can worsen obstructive sleep apnea.
• Smoking. Smokers are three times more likely to have obstructive sleep apnea than people who’ve never smoked. Smoking can increase the amount of inflammation and fluid retention in the upper airway.
• Nasal congestion. If you have difficulty breathing through your nose — whether from an anatomical problem or allergies — you have a higher risk.
• Medical conditions. People with type 2 diabetes, congestive heart failure, high blood pressure, and Parkinson’s disease may have an increased risk of obstructive sleep apnea. Polycystic ovary syndrome, hormonal disorders, prior stroke, and chronic lung diseases such as asthma also can increase the risk.

Factors that increase the risk of central sleep apnea include:

• Being older. Middle-aged and older people have a higher risk.
• Being male. Central sleep apnea is more common in men than it is in women.
• Heart disorders. Having congestive heart failure increases the risk.
• Using narcotic pain medications. Opioid medications, especially long-acting ones such as methadone, increase the risk.
• Stroke. Having a stroke increases your risk of central sleep apnea.

If you’re diagnosed with sleep apnea, you’ll likely be prescribed a continuous positive airway pressure (CPAP) machine. This breathing machine consists of a face mask with an attached hose that leads to a power device placed near your bedside. The CPAP uses humidified air to maintain positive pressure in your airway to prevent it from becoming blocked by your soft tissues.

Many patients find CPAP masks to be uncomfortable and the machines to be cumbersome. The machines are also noisy, which can make sleep difficult for both partners. Some patients also suffer from side effects of CPAP usage, such as stomach bloating and distension, nasal passage dryness, bleeding, and congestion. The difficulty of using a CPAP may lead some patients to stop using the machine. 

As an alternative, your dentist can custom fit you for an oral appliance — very similar to a mouthguard — which gently repositions your oral structures as you sleep to keep your airway open. This unobtrusive, cost-effective alternative prevents sleep apnea, allowing you — and your sleep partner — to get a good night’s sleep every night.