Sleep Apnea and Snoring in Redmond

For some people with snoring or obstructive sleep apnea, a custom oral appliance worn during sleep can be a treatment option. Sleep apnea is a medical condition that is diagnosed by a physician, and oral appliance therapy is done in coordination with your physician. Here is how snoring and sleep apnea differ, how an oral appliance works, and what the process looks like.

Snoring and Obstructive Sleep Apnea

Snoring is the sound made when air moving through a narrowed airway makes the relaxed tissues in the throat vibrate. It can disturb a bed partner’s sleep, and on its own it may not be a sign of a medical problem.

Obstructive sleep apnea (OSA) happens when the airway repeatedly narrows or closes during sleep, so breathing becomes shallow or stops for short periods. These pauses can lower oxygen levels and interrupt sleep many times a night, often without the person knowing. Untreated sleep apnea has been linked with daytime sleepiness, high blood pressure and heart problems.

Loud snoring is a common sign of sleep apnea, but not everyone who snores has it, and not everyone with sleep apnea snores loudly. That’s why it’s important to be evaluated by a physician.

Signs to Talk With Your Physician About

• Loud, frequent snoring
• Pauses in breathing, gasping or choking during sleep, often noticed by a bed partner
• Waking up with a dry mouth or a headache
• Feeling very sleepy or tired during the day, even after a full night in bed
• Trouble concentrating, or waking up often during the night

Diagnosis Comes From a Physician

A dentist does not diagnose sleep apnea. Your dentist may notice signs during an exam, such as worn teeth from grinding or a narrow airway, and suggest that you talk with your physician. Sleep apnea is diagnosed by a physician, usually with a sleep study done in a sleep center or with a home sleep test that your physician orders. The results show whether you have sleep apnea and, if so, how severe it is. Even if snoring is your only concern, a physician’s evaluation is recommended before an oral appliance is made, to make sure sleep apnea isn’t being missed.

How an Oral Appliance Works

The most common oral appliance for snoring and sleep apnea is a mandibular advancement device. It looks a bit like two mouthguards, one for the upper teeth and one for the lower teeth, connected so they work together. It holds your lower jaw slightly forward while you sleep. This helps keep the tongue and soft tissues from falling back into the throat, which helps keep the airway open. Most of these appliances can be adjusted in small steps to find the position that works best for you.

Who May Be a Candidate

Whether an oral appliance is right for you is a decision made with your physician. Oral appliances may be considered for:

• People who snore and do not have sleep apnea, after a physician’s evaluation
• People with mild to moderate obstructive sleep apnea, when their physician recommends it
• People with sleep apnea who can’t use or tolerate a CPAP machine, as recommended by their physician

CPAP (continuous positive airway pressure) remains a common treatment for sleep apnea, especially when it is severe. Your teeth and gums also need to be healthy enough to hold an appliance, and your dentist will check your jaw joints and bite.

The Process

1. Physician evaluation. Your physician evaluates your sleep, orders a sleep study if needed, and recommends a treatment plan.
2. Dental exam. Your dentist examines your teeth, gums, jaw joints and bite, and takes X-rays if needed, to make sure an appliance is a good option.
3. Digital scan. A digital scan of your teeth and bite is sent to a dental laboratory, where your appliance is custom-made.
4. Fitting. Your dentist checks the fit, shows you how to put the appliance in and take it out, and explains how to clean it.
5. Adjustments. Over the following weeks, the appliance is adjusted in small steps, a process called titration, to find a position that is both comfortable and helpful for your symptoms.
6. Follow-up with your physician. Your physician may order another sleep test with the appliance in place to see how well it is working.
7. Ongoing checkups. Regular dental visits let your dentist check the appliance, your teeth, your bite and your jaw joints over time.

Throughout treatment, our office coordinates with your physician, so both know how you are doing. Results vary from person to person, and an oral appliance doesn’t work for everyone. It does not replace your physician’s care. If you have questions about snoring or a sleep apnea diagnosis, we’re glad to talk with you at our Redmond office.