Sleep Apnea / Snoring

It has been estimated that 60% of men and 40% of women between the ages of 40 and 60 years old snore.

When a partial obstruction of the upper airway occurs, the roof of the mouth and the adjacent soft tissues will start to vibrate to the air passage — resulting in what is known as snoring.

Everybody has heard somebody else snore at least once in their life. Besides being a nuisance for the bed partner, it usually does not create any life threatening conditions. However, snoring can be the first sign of a more serious health condition called sleep apnea.

Sleep apnea occurs when the airway is completely blocked for a short period of time while sleeping. Sleep apnea poses a significant health risk in that it can lead to increase blood pressure, irregular heartbeats, and ultimately a heart attack or stroke.

What is sleep apnea?

Sleep apnea is a condition in which a patient will periodically stop breathing for short intervals while sleeping. Most pauses will last 10-30 seconds, but some may persist for up to one minute or longer.

In some severe cases of sleep apnea, the patient will stop breathing up to 30 times per minute. The frequency and duration of breathing pauses significantly affects the concentration (saturation) of oxygen in the blood. The lack of oxygen in your body triggers a cascade of reactions that ultimately result in waking you up to catch your breath.

Because the time when they’re awakened is so short, most people will not be aware that they have sleep apnea until more significant symptoms manifest.

Symptoms of sleep apnea:

  • Difficulty sleeping
  • Snoring, usually loud and irregular
  • Walking up at night short of breath
  • Choking sounds during the night
  • Headaches upon walking up in the morning
  • Excessive daytime sleepiness
  • Restless sleep
  • Confusion, irritability, lack of concentration

Factors that can affect obstructive sleep apnea:

  • Age
  • Obesity
  • Alcohol consumption and smoking
  • Medication/Sleeping pills
  • Family history

Sleep apnea is more common in males than females, and more common in older adults than young adults or children. However, anyone can suffer from sleep apnea. Sleeping on your back can also worsen the frequency of breathing cessation. Sleep will relax your muscles and jaws, this combined with the effect of gravity, will pull your lower jaw and tongue toward the back of your mouth, obstructing the airways.

An upper/lower jaw that are too small or positioned backward will also impede the breathing capacity, resulting in an obstructive sleep apnea.

Diagnosis

Dr. Martin, as an orthodontist, can help provide some guidelines in managing sleep apnea. However, sleep apnea is a medical problem and the diagnosis must be made by a physician such as an Ear-Nose-Throat (ENT) specialist or a pneumologist (specialist of the lungs).

How is sleep apnea treated?

Treatment options vary widely depending on the severity of the problem and the causes of the obstruction. In mild cases of sleep apnea, your ENT specialist may suggest a diet to lower your body weight, reduce alcohol consumption (especially before bedtime), and limit medication intake.

In some instances, oral appliances can be used to position your mouth/jaws/tongue in such a way that the air passage will be enlarge, clearing the way for air passage. If the reason for your sleep apnea is excessive soft tissue, removal of the tissue from the roof of the mouth can be suggested in order to facilitate air exchanges.

The current gold standard of care in treating sleep apnea is the CPAP (Continuous Positive Air Pressure). The CPAP consist of wearing a tight fitting nose/mouth mask that is connected to an air compressor. The compressor forces the air in the narrow/obstructed airways, clearing the passage for adequate air exchange.

Despite the fact that the CPAP is highly efficient in eliminating and reducing sleep apnea, there are a number of patients who cannot or choose not to wear the CPAP. These patients can be candidate for jaw surgery in conjunction with orthodontic treatment.

Jaw surgery in conjunction with orthodontic treatment will be suggested for patients who cannot or choose not to wear the CPAP, do not get improvement with the CPAP or for patients with severe sleep apnea. The jaw surgery consists of advancing the upper and lower jaw forward bringing with it the soft tissues of the roof of the mouth and the tongue. This will clear/improve the air passage facilitating the air exchange.

At Dr. Martin Braces, we have had the pleasure of helping many patients suffering from sleep apnea, and we have drastically improved their quality of life. We regularly have our sleep apnea patients tell us:

“I am finally the same as what I was 20 years ago: cheerful, energetic, and most importantly – healthy!”