Snoring and Sleep Apnea
Serving Phoenix, Scottsdale, and Glendale, Arizona
Dental Sleep Apnea Treatment Phoenix | Scottsdale Stop Snoring
At Desert Smiles we are passionate about helping patients in the Glendale, Scottsdale, and Phoenix areas with snoring and sleep apnea. Dr. Wilcox wears a dental appliance that has made a remarkable improvement in eliminating snoring, improved sleep quality, and most importantly in improved overall, long-term health. Dr. Wilcox is a member of the American Academy of Dental Sleep Medicine and the Dental Organization for Sleep Apnea.
What is snoring?
Snoring is basically defined as a sound made by vibrations of the soft palate and other tissue in the upper airway (the mouth, nose & throat). If the airways in your nose and throat are narrowed during sleep, the air you inhale and exhale has to push its way through a smaller passage. The snoring is caused by a partial blockage (see photos below) that may be located anywhere from your nose to your vocal chords. This restriction may occur only during sleep, or it may persist all day long but only become worse when we are asleep.
In many situations, this compromise is minor and the body continues to get adequate amounts of oxygen to cause little or no harm. However, this is a red flag as it could also be one of the early signs or a part of sleep apnea. Most all sleep apnea sufferers snore in between bouts of apnea, or oxygen interruption. A sleep study should be done to determine the seriousness of one's condition.
What is Obstructive Sleep Apnea?
Obstructive Sleep Apnea (OSA) is a potentially life threatening condition that is more common than generally recognized. Over 20 million Americans suffer from OSA and don't even know it!
An apnea is when breathing stops for 10 seconds or more while you are asleep. Coughing or choking sensations, which force you to wake up or "get elbowed" by your sleeping partner, are common signs of OSA. These abrupt disturbances during sleep place significant strain on your heart and cardiovascular system. Snoring is often associated with OSA, although not everyone who snores has this condition. OSA prevents air from reaching the lungs even though your body continues its effort to breathe. This condition is associated with a higher risk for heart attacks and strokes!
Obstructive sleep apnea patients have a rough night and don't even know it is happening. In a given night, these apneic events (when a patient stops breathing) can occur anywhere from 30-50 times, and in some people as many as 60-100 times per hour! Obviously, these individuals awake exhausted and spent each morning, as they've been fighting for oxygen all night. Sleep should be replenishing.
Central sleep apnea is much less common. With obstructive sleep apnea, air cannot flow into or out of the person's nose or mouth although efforts to breathe continue. With central sleep apnea, the brain fails to send the appropriate signals to the breathing muscles to initiate respirations.
FREQUENTLY ASKED QUESTIONS REGARDING SNORING AND SLEEP APNEA
- What are the symptoms of snoring and sleep apnea?
- How do you diagnose snoring and sleep apnea?
- How is snoring and sleep apnea treated?
- Who most commonly snores or has sleep apnea?
- How can these conditions impact relationships and marriages?
- Are there other websites where I can gather more information?
Symptoms of Snoring and Sleep Apnea
Many of the symptoms of snoring are related to sleep and oxygen deprivation:
- Nightmares and restlessness
- Night sweats and overheating
- Headaches and sinus problems
- Daytime exhaustion and poor concentration
- Sexual problems, decreased sex drive and even impotence
- Mental fatigue and bad judgment
- Hypertension and high blood pressure
- Frequent sadness and mood swings
- Depression and irritability
- Dry mouth or bad morning breath
- Kicking, twitching, punching during sleep
- Bloating and burping
- Heartburn and indigestion
- Reduced energy
- Hearing loss
- Weight gain
- Type II Diabetes
…and the obvious one, chronic sleepiness. A simple test can be taken that will grade this last symptom called the Epworth Sleeping Scale. Additionally, a Sleep Observers Questionnaire should be filled out by anyone who regularly observes the potential sleep apnea. Not all apneics will score high, but if you do, it is a very good sign of OSA, It can also cause learning or memory disabilities, as well as periods of nodding off while on the phone or at work. Obviously, sleepy patients are at a much greater risk of having auto accidents.
Diagnosing Snoring and Sleep Apnea
If you suspect that you snore, you should see a medical professional that specializes in sleep disorders. This doctor, be it your general practitioner, your ear nose and throat (ENT) specialist, your sleep dentist or your pulmonologist, will examine your throat, nose, mouth, palate, and neck, and check for underlying health conditions. The doctor may suggest that you undergo a sleep study. It is not suggested that you try any of the over-the counter diagnostic tests nor ones that you can purchase off the internet. There are two major sleep study tests; a PSG (Polysomnogram) which is conducted in a sleep center or hospital; or an ambulatory or "at home" sleep test, conducted in your own home. The leading take home sleep device is called a Watch-PAT200 and many doctors have them in their office. If you feel that you want to do a quick test in your home, without any inconvenience, ask your health professional for the Watch-PAT200 test.
How is it treated?
There are 3 major treatments for snoring and sleep apnea
- CPAP
- Dental Appliances
- Surgery
In our office, we treat snoring and sleep apnea with a unique approach. For example, we can provide you with a home monitor to help you (and us) assess whether or not sleep apnea should be a concern. The gold standard for treatment of sleep apnea is presently with the CPAP machine. However, only a minority of CPAP owners are still compliant after one year. If you are one of the non-compliant, we can fabricate an oral appliance that will help open your airway and reduce the severity of your sleep apnea.
These appliances reduce sleep apnea associated health risks without the need for surgery, medications, or other therapies. A custom oral appliance worn while sleeping holds the lower jaw forward and open, preventing the tongue and throat tissues from collapsing the airway. This also tightens the pharyngeal walls and the soft palate. There is a 96% success rate (snoring) for people treated with these appliances. Sleep apnea results can often be improved 50% or more.
The advantage of dental appliances in treating apnea is that they are preferred by many patients and have a higher compliance rate, as only 20-40% of patients continue the use of CPAP. Compliance with oral appliances is much higher and people like sleeping without the hose, mask and compressor. Many patients who do not object to CPAP still prefer oral appliances for travel and feel they allow the return of intimacy to their bedrooms.
One "mandibular-repositioning" appliance we use is called the Thornton Adjustable Positioner (TAP) oral appliance, which is a mandibular advancement device composed of two separate arches (maxillary and mandibular) containing an advancing mechanism which permits unlimited advancement of the lower jaw. The arches are custom fit to a patient's models. The advancing mechanism is engaged and the screw mechanism in the upper tray is then turned to advance the mandible until the patient begins to feel any discomfort in the temporomandibular joint or in the facial muscles (maximum mechanical protrusion which is an average of 2.5 mm beyond maximum protrusion). The advancing screw is then turned back until patient is comfortable.
The SomnoMed MAS™ is a Mandibular Advancement Splint (MAS) that treats snoring and mild to moderate OSA by moving the lower jaw forward slightly. This forward movement tightens the soft tissue and muscles of the upper airway, which prevents obstruction of the airway while you sleep. The tightening created by the device also prevents the tissues of the upper airway from vibrating as air passes over them – the most common cause of loud snoring. The SomnoMed MAS™ is a custom-made device, consisting of upper and lower dental plates with a unique patented fin-coupling component, which allows normal mouth opening and closing. The device is adjustable which improves the efficacy and comfort level of treatment, as the jaw is moved only as far as is required to alleviate the condition.
The SomnoMed MAS™ is a highly effective solution for the majority of patients, to the problem of loud snoring and mild to moderate OSA. Its exceptional levels of patient acceptance, compliance, and treatment efficacy are backed by a large body of clinical research.
The SUAD appliance allows more lateral movement than most of the appliances, and is specially made for our patients who enjoy grinding their teeth at night (you know who you are).
CPAP
A CPAP is a medical device that delivers continuous positive air pressure through a facemask or nasal tube attached to a pump. Typically the unit is placed next to the bed and it operates on normal house current. It functions by keeping the upper airway unobstructed during sleep. Proper adjustment of the CPAP is vital to achieve maximum clinical benefits and minimal side-effects. Wearing a CPAP is a lifetime commitment and the mask (or tubes) must be in place whenever you sleep or nap.
Surgical Procedures
Several surgical procedures are available to address snoring and sleep apnea, with the most popular today being RF (radio frequency) surgery. As with all surgeries, there is always risk of post surgical complications, but surgery maybe an alternative treatment of sleep apnea. In addition to the removal of adenoids and tonsils, other surgical options include; UPPP (uvulopalatopharyngoplasty), LAUP (laser-assisted uvulopalatoplasty), tongue reduction surgery jaw reconstruction and tracheostomy. The UPPP and LAUP will often eliminate snoring, but may not be highly effective and predictable in treating sleep apnea. Pillar implants in the soft palate may also be beneficial.
Who gets it?
Nearly everyone snores at some time of their life. Race, sex nor age seem to play a major factor in who gets it (in fact even dogs snore)! In studies it has been shown that 10%-12% of children snore. Childhood snoring is related to hyperactivity and sleep apnea. Children who snore should be evaluated by an ENT for possible problems with the tonsils and adenoids. Habitual snoring among adults has been found in about 24% of women and 40% of men. Men have become less likely to snore after the age of 70.
Likelihood of snoring:
- Overweight
- Nasal obstruction
- Lack of exercise
- Smokers
- Mouth breather
- Nasal stuffiness
- Small nostrils
- Back sleeper
- Pregnancy
- Hereditary
- Using muscle relaxants
- Using drugs
- Drinking alcohol
Snoring and Relationships
One of the most severe side effects of snoring is broken relationships and divorce. Even if your snoring does not disturb your own sleep, it may be ruining your sleep partner's chance for a good night's rest. Snoring can affect both the physical and social intimacies of a relationship. The constant sleep disruption and excessive tiredness caused by noisy snoring often creates problems. Sleep partners of heavy snorers awaken many times during the night which radically affects their quality and especially, quantity of their sleep.
Many partners of snorers decide to sleep in separate rooms resulting in a lack of intimacy and strained relationships. In many cases, it ultimately leads to separation and divorce.
Whether it's snoring that has forced you into a life on the couch or a more serious apnea problem, please call or schedule an appointment today to discuss your condition!
ADDITIONAL WEBSITES dedicated to helping you get a good night's sleep:
www.ApneaDocs.com – Dental Organization for Sleep Apnea
www.SomnoMed.com – favorite appliance manufacturer
www.QuietSleep.com – a sleep-breathing disorders resource for dentists and patients
www.DentalSleepMed.org - Academy of Dental Sleep Medicine
www.ApneaNet.org – the Apnea Patients New, Education and Awareness Network
www.ihatecpap.com – total resource for sleep apnea and CPAP diagnosed patients
If you would like additional information on treatments for snoring and sleep apnea, contact Desert Smile to set up a no fee dental consultation with Dr. Wilcox. We serve the areas of Phoenix, Scottsdale, and Glendale, Arizona.
602.978.1790
18275 N 59th Ave Bldg C, Ste 114
Glendale, AZ 85308
602.978.1790
