What is Obstructive Sleep Apnea(OSA)?
It is a common sleep disorder, also called Obstructive Sleep Apnea or OSA, where the patient stops breathing temporarily while sleeping. This pause in breath might last for over 10 seconds and might last as much as 5 times per hour. It is usually associated with increased resistance to the airway and snoring. The brain senses that there is a problem when the oxygen levels decrease and then awakens the person so that he/she can continue breathing, like a reminder to breathe. It is usually followed by a loud gasping sound.
Patients suffering from sleep apnea do not get enough quality sleep at night leading to poor efficiency at whatever they do and can also lead to memory issues, depression and even accidents while driving.
Sleep Apnea patients have been known to suffer from heart diseases like heart arrhythmias and strokes and even diabetes.
Sleep Apnea Types
Sleep Apnea is classified into three types depending on the number of episodes of breathing pauses during sleep or apnea events and they are:
- Mild OSA: patient experiences 5-14 breathing pauses in an hour.
- Moderate OSA: patient experiences 15-30 breathing pauses in an hour.
- Severe OSA: patient experiences 30 or more breathing pauses in an hour.
Sleep Apne Treatment
The doctors usually recommend a couple of treatment options like,
- Losing weight is a good option for overweight patients for improved sleep breathing.
- CPAP or the continuous positive airway pressure, which sends a continuous stream of pressurized air to the patient’s airway as they inhale.
- Dental or Oral appliances that can help in treating mild to moderate sleep apnea.
- Doctors might recommend surgery for the enlarged tonsils and adenoids or for advancing the base of the tongue to prevent airway blockage.
Do dental devices for sleep apnea work?
These are the dental or oral appliances that are used to treat mild or moderate cases of Sleep Apnea. They are broadly classified into two main categories:
Mandibular Advancement Devices (MADs)
They look similar to mouthguards or retainers used for orthodontic treatments. They are fixed or rather fitted into the mouth by snapping two pieces, connected by metal hinges, over the upper and lower dental arches. One piece fits the upper teeth while the other is fitted over the lower teeth.This appliance work by moving the lower jaw and the tongue slightly forward, preventing the throat muscles and the pharynx from falling back into the airway. Thus, allowing for an unobstructed airflow leading to normal breathing while sleeping.
Tongue Retaining Mouthpieces
These devices are similar to the MADs but they have a smaller compartment that is fitted around the tongue, to keep it forward. This will help in preventing the tongue to fall back into the airway. Doctors recommend this device for patients whose jaws cannot be repositioned forward adequately.
How effective are oral appliances for sleep apnea?
- These devices are more comfortable to use when compared to CPAP masks.
- These devices do not create dry, itchy noses, which is found in patients using
- CPAPS. These patients find their sinuses drying out due to the air pressure.
- There are no wires or cables or tubes to entangle over while sleeping allowing the patient to turn around in bed.
- These devices are easy to carry since there is not much of equipment.
Who needs Sleep Apnea Appliances?
- Patients suffering from mild to moderate sleep apnea conditions.
- Patients suffering from primary snoring.
- Patients who used CPAPs earlier and found them ineffective.
- Patients who had unsuccessful surgeries or denied surgeries like tonsillectomy, adenoidectomy, craniofacial operations or even tracheostomy.
- Patients who are using CPAPs along with these devices to reduce their sleep apnea index to get better air pressure settings.
Authored By Dr Sanjay N - Orthodontics & Dentofacial Orthopaedics, Bangalore