Do you often feel tired during the daytime? Do you find yourself snoring or gasping for breath in your sleep? Then, you likely have Obstructive Sleep Apnea (OSA). This common sleep disorder affects millions of men, women, and children.
Dr. Mark Sowell and Dr. Sara Chen are board-certified dentists in Dallas, TX. They can evaluate you for sleep apnea, a sleep-related disorder. We provide sleep apnea treatment options that go beyond the traditional Continuous Positive Airway Pressure (CPAP) machine.
What is Sleep Apnea?
Sleep apnea occurs when breathing stops for at least ten seconds. In children, consider two and one-half missed breaths as apnea. Similar to apnea is hypopnea, in which an individual continues reduced breathing.
Obstructive sleep apnea is one of the most common sleep disorders. The airway closes completely, causing the sufferer to stop breathing. Sometimes as much as 100 times an hour!
Sleep Apnea Treatment Solutions in Plano, TX
We help with dental sleep apnea by giving the patient a sleep apnea appliance or a snore guard. This guard helps prevent the throat from closing up. The types of sleep apnea appliances we use include:
- Mandibular Advancement Device (MAD). This is the most popular dental device for sleep apnea. It brings the lower jaw forward and down, which helps prevent the throat from collapsing.
- Snoring Appliance
- Stop-snoring Mouthpiece
After we give you a sleep apnea appliance, we will check it soon after to make sure it’s working. Sometimes, adjustments or replacements are necessary.
Snoring Treatment
Sleeping on your side can fix gentle snoring. Raising the head of the bed, losing weight, and avoiding alcohol are also steps you can take. If these simple measures are not enough, then surgical procedures by an ear, nose, and throat (ENT) specialist may be appropriate.
ENT specialists concentrate their practice on airway procedures. You can also get an oral appliance from a dentist who treats snoring and sleep apnea. These appliances help your airway stay open while you sleep, reducing or stopping snoring.
Sleep Apnea Treatment
Dentists commonly treat obstructive sleep apnea (OSA) with a CPAP machine. The machine applies continuous positive airway pressure through a nasal mask. This method is the “gold standard” in treating OSA. CPAP machines will treat it 100% of the time, and for this reason, the medical profession recommends it.
The problem is that multiple research articles show that CPAP has as low as a 50% compliance level. This means only 50% of the patients use the device, mainly because of discomfort and inconvenience. OSA sufferers who do not use the machine increase their risk of other issues. Problems include heart failure, high blood pressure, stroke, drowsiness during the day, gasping for air, choking loudly, and falling asleep while driving.
If the doctor finds severe levels of OSA during your sleep study, he will only recommend a CPAP machine. However, mild and moderate OSA sufferers have alternatives if they are CPAP-intolerant. Having better-quality sleep at night leads to feeling more alert and energetic during the day.
Problems people have with CPAP machines include:
- The mask is uncomfortable, irritates the skin, or causes claustrophobia
- The mask falls off at night without the sleeper knowing it, and they forget to put it back on
- Air in the stomach or sinuses
- The mask leaks air
- The CPAP machine is too noisy to allow sleep
- The tubing gets in the way
- Your nose can be stuffy because of a cold or allergies
- The air is too hot or too cold
Surgery is another option that may help OSA patients. Oral surgery removes tissue from the upper airway to increase the size of the back of the throat. Surgery can also expand the jaw structures that restrict the space for the throat. The success rate varies greatly, as the obstructions vary between individuals.
As OSA gets worse, the treatments needed become more invasive. Some treatments also have higher chances of the problem coming back.
Oral appliances for Sleep Apnea
Oral appliance therapy can be an effective alternative to CPAP machines. Dr. Mark Sowell and Dr. Sara Chen have training in the use of these devices.
A recent parameters paper published in the journal Sleep by the American Academy of Sleep Medicine stated that oral appliances could be used as first-line therapy in some patients for treating mild to moderate OSA. The guidelines state:
“Although not as efficacious as CPAP, oral appliances are indicated for use in patients with mild-to-moderate obstructive sleep apnea who prefer oral appliances to CPAP, or who do not respond to CPAP, are not appropriate candidates for CPAP, or who fail treatment attempts with CPAP or treatment with behavioral measures such as weight loss or sleep position change.”
Oral appliances have better compliance rates than CPAP systems for many patients. Oral appliances are also a first-line treatment for primary snoring that is not because of OSA.
Dentists with oral appliance therapy training can fit you with these appliances. Dentists with experience in treating temporomandibular joint disorders and dental occlusion can also help.
Visit our Plano, TX, dental office for an evaluation. We have a Watermark take-home sleep study device for diagnosis, so you don’t have to stay at a sleep lab overnight. We will download the data the following day and medically review the report to determine a diagnosis.
Snoring vs. Sleep Apnea
About Snoring
About half of men and a quarter of women snore regularly. Both men and women are more likely to snore as they age. Snoring is also more common in people who are overweight. Snoring occurs when tissue in the back of the throat becomes loose, narrows the airway, and vibrates as you sleep.
You are more likely to snore if you cannot breathe through your nose because of nasal obstruction.
How do I stop snoring?
Often, sleeping on your side will help. When you are on your back, the weight of your jaw and tongue fall back, narrowing your airway and causing you to labor to breathe. Sleeping on your side causes your jaw and tongue to fall with gravity. You can breathe easier and reduce snoring while sleeping on your side.
Some people find that snore strips on their noses help if they have nasal blockages. Losing weight can help open the airway and reduce snoring. Drinking alcohol and taking sleep aids can actually make snoring worse.
Dental oral appliances can hold the lower jaw forward. This helps open the airway, making it easier to breathe and reducing snoring. These appliances are like a sports mouthguard or a retainer you wear at night. Snore guards also help many people stop snoring this way.
What people don’t realize is that snoring is a warning noise produced by the force of air through a narrowed upper airway. The collapse of the soft tissue in the back of the throat causes it. It is an indication that there is a problem with normal breathing. If we don’t get enough oxygen, it’s a problem.
As the problem progresses, the snoring gets louder. Eventually, pauses in breathing, and then a gasping noise for breath interrupts the snoring. As our oxygen levels fall, a feedback mechanism in our body takes us out of deep sleep to a lighter level of sleep. This wakes us up so we can gasp for air.
The snorer is never awake enough to remember or be aware of these episodes. This can happen a few times per night to several hundred times per night. The result is the snorer cannot get into a deep sleep where we feel rested and recharged in the morning. This is sleep apnea.
Do I have Central Sleep Apnea or Obstructive Sleep Apnea?
Sleep apnea is present when we do not breathe for 10 seconds or longer. This causes our blood oxygen levels to drop, which takes us out of deep sleep so we can gasp for breath. This can happen a few times per night or several hundred times per night, resulting in no deep sleep and many health problems. Two types of sleep apnea are common: central and obstructive.
Central sleep apnea is much less common and is a problem in the regulatory function of the brain or heart. This occurs most frequently in people who have chronic congestive heart failure, stroke, prolonged opioid drug use, heart disease, or kidney disease.
Obstructive sleep apnea is more common. It happens when the tissue in the back of your throat collapses and blocks your airway at night. This stops oxygen from getting to your lungs and muscles. When you sleep, your throat muscles relax, and gravity causes your tongue to fall back and block your airway.
Sleep Apnea FAQs
Are snoring and sleep apnea serious?
Snoring can be serious, both medically and socially. Snoring can disrupt marriages and cause sleepless nights for bed partners. Medically, snoring can be a precursor of obstructive sleep apnea that has links to heart failure, high blood pressure, and stroke. The risk of death is much higher for people with large necks, are overweight, and have large uvula and soft palate or nasal congestion.
Doctors associate snoring with type II diabetes and a higher rate of heart disease in its own right. People with untreated obstructive sleep apnea suffer from daytime fatigue, sleepiness, and irritability. Additionally, they have higher rates of high blood pressure, heart disease, stroke, depression, and erectile dysfunction.
People with severe untreated sleep apnea will fall asleep at a stoplight or dose off (micro-sleep) for a moment while driving. The daytime fatigue from the lack of quality sleep can affect your job performance, memory loss, and concentration. It can make you irritable, affecting your relationships as well.
How many times a night do you wake up with sleep apnea?
On average, OSA wakes patients 30 times per hour at night. OSA is extremely disruptive to sleep. If your breathing stops more than 5 times a night, then Obstructive Sleep Apnea will be your diagnosis.
Is sleep apnea a disability?
The Social Security Administration does not classify sleep apnea as a disorder. However, it once was, and it still lists some breathing disorders. If your sleep apnea meets the guidelines for any of the breathing disorders, you may qualify for disability benefits.
Can I naturally cure Sleep Apnea?
The main way to naturally prevent sleep apnea is to keep your body at a healthy weight. Obesity is one of the most common causes of sleep apnea. When you are overweight, it is more likely for your airways to be tight.
Sleep apnea symptoms & warning signs
- Snoring interrupted by a pause in breathing, followed by gasping (sudden strong intake of air)
- Daytime fatigue & falling asleep at inappropriate times
- Loud, chronic snoring
- Trouble concentrating, poor memory
- Depression, irritability, or loss of sex drive
- Headaches
- Frequent nighttime urination
- Dry mouth, sore throat, or nausea in the morning
Unfortunately, you cannot diagnose yourself. As long as you snore, you are at risk, and until you have a sleep study, you may not know, as not all people have symptoms or warning signs. Your dentists in Plano, TX, can diagnose and treat your sleep apnea.
Diagnosis: How do you know if you need apnea treatment?
Taking the simple test below is a starting point. However, be sure to visit your physician or dentist (if they offer home sleep studies) if you think you have a problem. This test is for daytime sleepiness, not specifically for snoring and apnea.
Epworth Sleepiness Scale
The Epworth Sleepiness Scale is a self-administered questionnaire that measures how sleepy you are during the day. It asks you to rate your chances of falling asleep in different situations. Doctors often use the scale to help diagnose conditions like sleep apnea and narcolepsy. Scores range from 0 to 24, with higher scores showing greater daytime sleepiness.
We use the Epworth Sleepiness Scale to determine the level of daytime sleepiness. A score of 10 or more is considered sleepy. A score of 18 or more is very sleepy.
If you score 10 or more on this test, consider whether you are obtaining adequate sleep. We recommend seeing a sleep specialist to improve your sleep hygiene. You should discuss these issues with your personal physician.
Use the following scale to choose the most appropriate number for each situation:
0 = would never doze or sleep.
1 = slight chance of dozing or sleeping
2 = moderate chance of dozing or sleeping
3 = high chance of dozing or sleeping
Print out this test, fill in your answers, and see where you stand.
| Situation |
Chance of Dozing or Sleeping |
| Sitting and reading |
____ |
| Watching TV |
____ |
| Sitting inactive in a public place |
____ |
| Being a passenger in a motor vehicle for an hour or more |
____ |
| Lying down in the afternoon |
____ |
| Sitting and talking to someone |
____ |
| Sitting quietly after lunch (no alcohol) |
____ |
| Stopped for a few minutes in traffic while driving |
____ |
| Total score (add the scores up)(This is your Epworth score) |
____ |
Sleep Apnea Risk Assessment
Assess your risk for sleep apnea. The total score for all five sections is your Apnea Risk Score. Print out this questionnaire, write in your best answer for each question and see where you stand.
A. How frequently do you experience or have been told about snoring loud enough to disturb the sleep of others?
1. Never
2. Rarely (less than once a week)
3. Occasionally (1 to 3 times a week)
4. Frequently (more than 3 times a week)
Answer_____
B. How often have you been told that you have “pauses” in breathing or stop breathing during sleep?
1. Never
2. Rarely (less than once a week)
3. Occasionally (1 to 3 times a week)
4. Frequently (more than 3 times a week)
Answer_____
C. How much are you overweight?
1. Not at all
2. Slightly (10 to 20 pounds)
3. Moderately (20 to 40 pounds)
4. Severely (more than 40 pounds)
Answer______
D. What is your Epworth Sleepiness Score?
1. Less than 8
2. 9 to 13
3. 14 to 18
4. 19 or greater
Answer ______
E. Does your medical history include:
1. High blood pressure
2. Stroke
3. Heart disease
4. More than 3 awakenings per night (on average)
5. Excessive fatigue
6. Difficulty concentrating or staying awake during the day
Answer ______
If you answered 3) or 4) for questions A-D, then you may be at risk for sleep apnea. Discuss the results with your physician, especially if you have one or more of the conditions listed in question E. You should always discuss sleep-related complaints with your physician before deciding on medical evaluation and treatment.
We invite you to call our sleep apnea specialist in Plano, TX, today at (972) 382-6855. You can also request a sleep apnea consultation using our online Request Appointment form.