It is estimated that almost 100 million people, just in the United States, snore. It’s a staggering number. And, as any bed partner of a snorer can attest to – it’s annoying! Maybe not overtly to the person who snores, but to the person listening to an unwelcome nightly concert. Drs. Hochberg and Diora are frequently asked if there is anything they can do help. Before delving into possible solutions, it’s important to understand that while there are some crossover treatment options for those suffering from sleep apnea and for those who snore, they are not the same conditions.
If I snore, do I have sleep apnea?
The terms sleep apnea and snoring are not interchangeable. One can snore and not have sleep apnea; and even though most with sleep apnea do snore, one can have sleep apnea without snoring. It is important to understand that there are differences and, while snoring is bothersome and can leave the snorer tired during the day, sleep apnea can be life threatening. Snoring occurs when there is a relaxation of the intra-oral tissue(s) causing a partial blockage or a partial obstruction. Whether it’s the uvula, a nasal obstruction, a tongue that is large in relation to the oral cavity or an elongated soft palate, there is a constriction as air moves, causing a vibration – the sound of snoring. For some, lifestyle changes such as loosing weight or reducing alcohol consumptions helps.
While loud and frequent snoring oftentimes is a symptom of sleep apnea, termed Obstructive Sleep Apnea (OSA), those with OSA have periods of time during sleep when breathing actually stops or is greatly slowed. Be it an apnea, an abnormal pause in breathing, and/or a hypopnea, a reduction in the amount of breathing, oxygen flow, the sleeper may wake gasping for air or they may be completely unaware that this is occurring. It can occur infrequently each evening or repeatedly. There may be a physical blockage or, less common, central sleep apnea – a reduction in the body’s ability to maintain adequate respiratory effort during sleep – the brain is failing to send adequate signals to breathe.
So, while snoring is annoying to sleep partners, both conditions can impact the quality of the patient’s life and overall health. Patients may go to bed at a reasonable hour and arise after an 8-hour sleep cycle, but the quality of their body’s ability to fully rest is diminished. A general feeling of fatigue may persist. And evidence-based research findings have found that those with OSA are not only feel sleep, they may actually fall asleep during the day and often report difficulty in cognitive processes. This illness is linked to an increased risk of heart diseases, diabetes, certain types of cancer and dementia. Some deaths have even been attributed to OSA.
How do I know if I have sleep apnea?
You may know you snore … because you were told. Or you may have been told that you seem to stop breathing or gasp for air. Or you may find that after a full night ‘sleeping’, you are still tired. However, to determine if you have OSA, and its severity, a visit to a physician with specialized training in sleep medicine is recommended. Testing may be indicated, which takes place in a medical ‘sleep center’ for a sleep study or at home with equipment provided by the specialist. These studies are designed to measure patterns that occur while sleeping, to see if there are disruptions, how many and how often, oxygen levels and brain activity.
How do I get a better night’s sleep if I snore or have sleep apnea?
While snoring and sleep apnea are different, the goal – an even and adequate supply of oxygen, is the same. As long as the problem is not related to missed signals from the brain, an airway that stays open and clear throughout the night helps both those who snore or have sleep apnea.
A CPAP – Continuous Positive Airway Pressure – has been considered the gold standard, especially for those with OSA. There are many types of CPACs, but in general a machine is used at nighttime and continuously pushes air, keeping the airway from closing when sleeping and providing sufficient oxygen to oxygenate the blood. If the results of testing by your physician indicate that this is needed, you will be given a prescription. And new technologies, such as Provent® Sleep Apnea Therapy (also available by prescription for mild cases of OSA – an Expiratory Positive Airway Pressure (EPAPs) product), come onto the market, your physician will discuss your options.
How does a dentist assist in treating snoring or OSA?
One alternative frequently recommended, especially for those who do not have sleep apnea or cannot adapt to the CPAP (termed ‘CPAP intolerant)’ and fall into the mild or moderate category, are oral appliances provided by a dentist. Just ask Drs. Hochberg and Diora; they are available to discuss Oral Appliance Therapy (OAT). These Mandibular Advancement Devices (MADs) are custom fabricated mouth-guards. They look similar to guards worn to protect teeth while playing sports. However, they actually reposition the lower jaw by easing it forward slightly to help keep the airway open. There is an upper guard that snaps over the top teeth and a lower guard that snaps over the bottom teeth. These guards are joined together by connectors that adjust. This allows the dentist to adjust as necessary to optimize your care and help ease discomfort that may arise in your TMJ as you adapt to the appliance.
From parents insisting that their children go to bed on time to medical professionals advising us that a good night’s sleep is the foundation for health, we know that waking up refreshed helps start our day reinvigorated. When sleep is disrupted, deep sleep cycles are shortened, tossing and turning occurs, or the body undergoes the stressors when breathing is impaired, if only for seconds, our day and our health is negatively impacted. When you are told that you snore frequently, when you are not rested, if you wake gasping for air, don’t ignore the symptoms. Seek care! We, at Colony Square Dental Associates are available to discuss your concerns.