Obstructive Sleep Apnea
and Snoring
Do you feel tir
ed and sleepy during the day, even though you get lots of sleep every night?
Do you have frequent short term memory loss?
Do you feel extra moody, fatigued, and/or irritable, but don't know why?
You might have Sleep Apnea!
What is Sleep Apnea? It is a dangerous medical condition, in which the patient stops breathing during sleep. Without breathing, the oxygen level in the blood starts to fall until the brain triggers a "gasping reflex", which delivers a lung full of oxygen to the bloodstream. A Few minutes later, the cycle repeats itself.
Fall asleep --> Stop breathing --> Oxygen level drops --> Gasp for air --> Get oxygen --> Fall asleep
This cycle repeats itself over and over, all night long. Because of this, the patient never gets to the deeper, more restful, stage 4 sleep, but stays in a light sleep state all night. Without getting the more restful stage 4 sleep, it is common to experience:
* Excessive daytime drowsness
* Short term memory loss
* Mood changes
What is the cause of sleep apnea? As you fall asleep, and you relax, your tongue falls backwards towards your throat, and partially blocks your airway. (When there is a partial blockage, the tongue flaps against the back of your throat when you breathe, and it creates a "snoring" sound.) This happens most frequently when you are lying on your back. If the airway is completely blocked, breathing momentarily stops, and the cycle of sleep apnea and gasping starts.
In an extreme case, is is possible that the gasping reflex might not be triggered, and the oxygen level just keeps dropping until the patient just quietly dies in his or her sleeep. That's why medical professionals treat sleep apnea as a serious life-threatening condition!
How would you know if you have sleep apnea? Usually, the patient is unaware of his or her restlessness during the night, but his or her spouse usually knows. Your partner hears you stop breathing, 
then hears you gasping for air, then the breathing stops again. Sometimes, they will poke you to get you to start breathing. Then they will insist that you see a doctor.
How is sleep apnea treated? There are several approved treatments, but they all focus on unblocking your airway, or just forcing air past a partial airway blockage. But the first step in treatment is to determine if you really have sleep apnea. (All people with sleep apnea snore, but not all snorers have sleep apnea!)
A diagnosis of sleep apnea is only possible after having a sleep test, called a "polysomnogram", where you are tested all night long in a sleep center. You have various sensors and electrodes attached, and your vital signs are monitored all night. The doctors check your blood oxygen levels, your rate of breathing, the depth of your breaths, the frequency and duration of your apnea episodes, and the effect of your stage of sleep.
If you are diagnosed with sleep apnea, there are only three medically accepted treatments.
1. Throat surgery: Excess tissue is cut away from the back of your throat, which keeps your relaxed tongue from blocking the flow of air. In my opinion, this surgery is drastic, forever changing the way that you breathe and swallow. Though it is an effective treatment, it is irreversible, and it should only be a last resort.
2. A C-PAP Machine: This motorized ("continuous positive airway pressure") unit has a mask that is strapped to your face, and when you start to inhale, it forces air under pressure past your partially blocked airway. This is an effective, conservative, reversible treatment. But the C-PAP is cumbersome, awkward, noisy, and some patients find it uncomfortable. The noise may keep your partner awake. On the positive side, it is usually covered by medical insurance, and you get the stage 4 sleep that you need.
3. Oral Appliance Therapy (OAT): There have been numerous dental appliances invented over the years that treat snoring, by finding a way to pull the patient's tongue forward from the back of the throat. The most notable ones are the "TRD" (Tongue Retaining Device), and the "AERO" device . They do help with snoring, but they are not approved for the treatment of sleep apnea.
Approved sleep apnea appliances work by pulling the lower jaw forward. (Because your tongue is attached to your lower jaw, it is then pulled away from the back of your throat and unblocks your airway). The FDA has approved only two custom-fitted dental devivces as being effective for the treatment of sleep apnea. Both devices can adjust the amount of jaw repositioning. If your lower jaw is pulled too far forward, you will feel jaw pain. If it is not pulled forward far enough, you will still experience sleep apnea symptoms. There are NO over-the-counter devices that claim to treat sleep apnea.
There are only two "FDA Approved" devices for treating Sleep Apnea
"T.A.P" - (Thornton Adjustable Positioner): The TAP Device consists of upper and lower pieces that are locked together and adjusted for comfort and effectiveness by turning a little screw. This device is backed by the most clinical research, is considered the most effective, but is also the most expensive. The regular fee for this T.A.P. appliance is $2,200 to $2500, but we have a current "special" for only $1,949.
"E.M.A." : This device also pulls your lower jaw forward, and it is adjustable by replacing elastic "straps", which come in various lengths and strengths. This device is newer, simpler, and cheaper, than the T.A.P., but doesn't have as much clinical research. We are currently offering this custom-made strap device for a "special" reduced fee of only $1,395.
Whichever one you choose, we still recommend that you see your physician and have a "polysomnogram" (sleep test) done before treatment (to establish your personal baseline), and after treatment (to measure its effectiveness). Dentists are not trained to diagnose sleep apnea, or the effetiveness of our dental apppliances. Only a physician in a sleep center can do that.
How do I get a custom-made Sleep Apnea appliance? It only takes two visits. The first visit is about 1/2 hour for impressions of your upper and lower teeth and a bite registration record. Easy and painless! The second visit is for another 1/2 hour, 2-3 weeks later, for delivery and any necessary device adjustments.
What about payment and insurance? We don't know of any dental insurance plans that cover appliances for snoring or sleep apnea. It is possible that your medical insurance may reimburse you for a sleep apnea appliance, but only if diagnosed by a physician after a polysomnogram. We'll be glad to fill out an insurance claim form for you, but we have to proceed on the assumption that they will pay nothing at all. Because high laboratory expenses are involved, we need 1/2 of the total fee at the first appointment, and the other 1/2 at your second appointment.
SPECIAL NOTE: Find the three secret words in our website, and you can apply your $75 credit towards your sleep apnea appliance. (Pssst: The first word is 6 letters long and starts with "H-A-R-L- - ". You might want to take a photo of it!)
If you have questions, send an e-mail to one of our dentists.
If you want to schedule an appointment for a FREE Sleep Apnea and Snoring Consultation,
send an e-mail to our Office Staff.
