Sleep…we need good quality sleep. 

Snoring causes a disrupted sleep and if there’s a bed partner involved, often disturbs the partner more than the snorer. It’s no secret that snoring can put a strain on the relationship. Partners are often forced to sleep in separate rooms in a desperate attempt to get a better sleep. Poor sleep quality decreases quality of life. It leads to irritability, frustration, depression, difficulty concentrating at work and impaired memory.  

Do you have trouble sleeping?  If so, you are not alone. Chronic snoring problems and interrupted sleep aren’t just an inconvenience. They may indicate a more serious problem called sleep apnea. Untreated sleep apnea can lead to severe health risks. Sleep apnea is a common but serious sleep disorder that causes interruptions in breathing during sleep.

Snoring – What is it?

Snoring is a problem that affects more than 50% of adults and often leads to more serious health problems. During sleep, the muscles in our throat, neck, and tongue relax which narrows the airway. Air passing through the narrower airway causes the tissues to vibrate against each other and creates the harsh sound that we hear as snoring.

Snoring indicates a reduction in the passage of air and oxygen and may be an indication of a bigger health problem, sleep apnea. The only way to know if your snoring is a symptom of sleep apnea is to have a sleep test.

Snoring can be treated very effectively through oral appliance therapy

Contact us today to see if we can help you treat your snoring.

 

Sleep Apnea – What is it?

Sleep apnea is a serious medical condition marked by interruptions in breathing throughout the sleep cycle. The most common form is obstructive sleep apnea (OSA), a condition in which the airway repeatedly closes off during sleep. As your airway closes off, your blood oxygen drops, your blood pressure rises and your heart rate slows in attempt to conserve what’s left of the blood oxygen levels until the blood sensors detect you are in danger and partially rouse you to take a breathe. At this point, your heart races, you over breathe, your blood pressure further increases and you drift back off to sleep. This pattern happens dozens to hundreds of times per night depending on the severity of the sleep apnea. It’s easy to see how someone with sleep apnea is at high risk of suffering a heart attack or stroke.

An estimated 1 in 5 adults suffer from mild to moderate OSA and 1 in 15 from moderate to severe OSA. As many as 80% of these cases are undiagnosed or unaware of their condition.  Awareness of OSA and access to treatment is a public health problem with potentially life threatening results.  It is crucial that anyone experiencing symptoms be screened or tested for OSA.  Intervening early can prevent progression of the disease and improve overall health, reducing other problems.

Learn more about treatment options for sleep apnea.

 

Most Common Symptoms of Obstructive Sleep Apnea (OSA):

  • Frequent, loud snoring

  • Morning headaches

  • Fatigue

  • Daytime sleepiness

  • Gasping, chocking, or snorting during sleep

  • Irritability, mood changes

  • Dry mouth or sore throat, chronic cough

  • Difficulty concentrating

  • Poor memory

  • Depression

  • Clenching or grinding of teeth

  • Gastro esophageal reflux disease (GERD)

  • Erectile dysfunction

  • Frequent trips to the bathroom to urinate

Common Risk Factors Associated with Obstructive Sleep Apnea (OSA):

  • Being overweight/obese (BMI > 30)

  • Age (higher risk as we get older)

  • Larger neck size (men > 17”; women >16”)

  • Smoking

  • Consumption of alcohol or other sedatives

  • Family history or OSA

  • Large tonsils, adenoids or uvula

  • Enlarged tongue

  • Underdeveloped upper and/or lower jaws

  • Limited nasal airway due to anatomy, injury, or allergies

Health Risks Associated with Sleep Apnea:

  • Stroke: people with sleep apnea are 3x more likely to suffer a stroke. Almost 70% of people who have had a stroke also have sleep apnea.

  • Heart attack

  • High blood pressure: 50% of people with high blood pressure may also have sleep apnea

  • Type II diabetes: 58% of people with type II diabetes may also have sleep apnea

  • Obesity: 77% of people who are obese (BMI > 30) may have sleep apnea

  • Depression: sleep apnea doubles the risk of developing depression

  • Motor vehicle accidents: people with OSA are 7x more likely to have a motor vehicle accident

  • Job impairment: people with OSA are 3x more likely to suffer work related injury

  • Cancer



 

Diagnosing Sleep Apnea

Sleep apnea can only be diagnosed by a sleep study. This can be done either in your own bed or in a hospital. A sleep physician will make the diagnosis and recommend treatment options.

Someone with obstructive sleep apnea will either:

  • Completely stop breathing for at least 10 seconds (known as apnea) or

  • Have their breathing severely restricted for at least 10 seconds (known as hypopnea)

These events are recorded on the sleep study, along with blood oxygen levels, heart rate, pulse and snoring.

AHI (Apnea-Hyponea Index) or RDI (Respiratory Disturbance Index) is the standard method of scoring and determining the level of sleep apnea.

< 5 = Normal

5–15 = Mild

15–30 = Moderate

> 30 = Severe


If you are concerned you may have sleep apnea, speak to your physician to request a home sleep study or contact us for a screening.

Treatment Options 

CPAP  (continuous positive airway pressure) is the gold standard treatment for treating severe obstructive sleep apnea. CPAP provides a steady stream of pressurized air to patients through a mask that is worn during sleep. This airflow keeps the airway open, preventing pauses in breathing and restoring normal oxygen levels. The amount of pressure is carefully determined and adjusted based on the severity of symptoms. This machine has saved many lives by keeping patients breathing at night.


Oral Appliance Therapy (OAT) is what we do!  We make an appliance called a mandibular repositioning device (MRD) that works by gently holding the lower jaw forward during sleep, keeping the airway open. This allows for better air exchange at night while you sleep. For many, it eliminates or reduces snoring. They are small, relatively comfortable and easy to wear, require no electricity and are easy to travel with. 


Surgery is effective only when there is an obvious deformity that can be corrected to alleviate the breathing problem. These include removal of nasal blockages or removal of excess tissues in the upper airway and throat such as tonsils, adenoids, uvula and soft palate. These surgeries are not typically recommended as first line treatments of OSA.


There are many lifestyle changes you can make that may reduce the severity of your symptoms and improve the effectiveness of other sleep apnea treatments:

  • Weight loss: excess weight is the most common contributing factor to OSA. The excess mass around your neck increases narrowing of the airway;

  • Limiting alcohol consumption before bed, as well as sleeping pills or other sedatives. These cause the throat muscles to relax, exacerbating your sleep apnea;

  • Quitting smoking. Smoking causes inflammation and swelling of the airway, exacerbating sleep apnea. Smoking also acts as a sedative;

  • Nasal sprays or nasal dilators;

  • Positional therapy to discourage sleeping on your back

Upper Airway Resistance Syndrome (UARS)

Upper Airway Resistance Syndrome (UARS) is caused when soft tissues in the throat relax, reducing the size of the airway and increasing the effort required for breathing. UARS restricts the airflow like OSA but the level of resistance is lower than what is required for a diagnosis of OSA. These repetitive increases in resistance to airflow in the upper airway lead to brief arousals (called RERAs: respiratory effort related arousals) and interrupt the sleep cycle. This leads to many of the same symptoms of OSA such as daytime fatigue. It does not usually lead to significant reduction in oxygen saturation. Although blood oxygen levels may be in the normal range, the patient can still have symptoms of OSA and left untreated can progress to OSA.

UARS can be treated effectively with Oral Appliance Therapy.