Lake Forest Sleep Apnea Dental Devices | Lake Forest dental care | CA | FAQ

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west_logo2.pngScott E. West D.D.S., F.A.G.D., Inc.
Alternative Treatment of Snoring, Sleep Apnea and CPAP Intolerance,
Diplomate of the Academy of Clinical Sleep Disorders Disciplines
22672 Lambert St. Suite 603 •  Lake Forest, CA 92630

949 829-6700


FAQ

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What is Snoring?

What is Obstructive Sleep Apnea (OSA)?

I know I Snore, but I don't know if I have Sleep Apnea. Is there an easy way to screen for Sleep Apnea?

What is the relationship between snoring and sleep apnea?

What are some of the reasons why a person would have a higher tendency to have OSA?

What are the signs and symptoms of having Obstructive Sleep Apnea (OSA)?

What is the common denominator of all of these health problems?

How does someone find out if he has sleep apnea?

What is a Sleep Study?

What information do you get from a Sleep Study (PSG)?

What are my treatment options?

Is there a dental appliance that has the advantages of both the Mandibular Advance Appliance and the Full Breath Appliance?

What is the Pharyngometer?

What should I do?

 

Answers:

What is Snoring?

Sounds made during sleep caused by breathing vibrations in the pharynx (air way in the back of your throat).  In the diagnosis of obstructive sleep apnea, snoring volume and frequency of occurrence often correlate with the severity of the condition.

 

What is Obstructive Sleep Apnea (OSA)?

Repetitive cessation of breathing during sleep for 10 seconds or more due to complete closure of the throat.  Usually characterized by snoring, excessive daytime sleepiness and other symptoms of fatigue.

 

I know I Snore, but I don't know if I have Sleep Apnea. Is there an easy way to screen for Sleep Apnea?

Yes. There is a device called a Sleep Strip which you wear on your upper lip overnight and this can easily determine if you have Sleep Apnea, or not.

 

What is the relationship between snoring and sleep apnea?

The more severe the snoring, the more likely the chances are of having Sleep Apnea.

 

What are some of the reasons why a person would have a higher tendency to have Obstructive Sleep Apnea?

Overweight

Jaw Position

Tongue Position

Oversized Tonsils or Adenoids

Collapsed Pharyngeal walls (back of throat)

 

What are the signs and symptoms of having Obstructive Sleep Apnea (OSA)?

Snoring (85%)

Fatigue

Impaired Concentration

Hypertension (High Blood Pressure) twice as common with OSA

Diabetes twice as common with OSA

Impotence

Depression

GERD (Gastroesophageal Reflux Disease or Heartburn)

Associated with Cardiac Arrhythmias

Alzheimer's disease


What is the common denominator of all of these health problems?

Oxygen deprivation -- the body needs to get more oxygen to its cells!!

 

How does someone find out if he has sleep apnea?

The most definitive approach is to do a “Sleep Study”.

 

What is a Sleep Study?

A Sleep Study or Polysomnogram (PSG) is a multiple-component test, which electronically transmits and records specific physical activities while you sleep. The recordings become data, which will be "read" or analyzed by a qualified physician to determine whether or not you have a sleep disorder. This is done in a sleep center. Most centers today are made to be quite comfortable; actually often set up to look like a nice hotel room. Sleep studies can also be done in your own home.

 

What information do you get from a Sleep Study (PSG)?

1.  An Electrocardiogram - This is done to see if there is a correlation between the apneic event and arrhythmia.

2.  Oxygen saturation- This is a measure of oxygen carried by hemoglobin in the blood.  Normal values range from 90% to 100%.

3.  Length of apneic episodes- Sometimes these episodes can be as long as 90 seconds.

4.  Several other vital signs are taken but the common summary measure used to describe respiratory disturbances during sleep is the Apnea-Hypopnea Index or AHI.  This is the total number of episodes of apnea and hypopnea during sleep divided by the hours of sleep time.  Apneas are episodes where breathing stops for 10 seconds or longer.  Hypopnea is a partial blockage of airflow resulting in an arousal and oxygen drop of 4% or more.  An AHI greater than 5 is diagnostic of OSA.

 

What are my treatment options?

1.  Preventive

a.  Get to optimum weight

b.  Decrease alcohol consumption

c.  Exercise

 

2.  CPAP

The CPAP (Continuous Positive Airway Pressure) is a medical device used to treat sleep apnea.  Air pressure is delivered through a hose to a mask that fits over the nose, or both the nose and mouth.  The mask is secured on the face by a headgear that is worn over the head.  The appropriate air pressure level is determined during the sleep study.

Pros of this treatment:

  • Very high success rate (nearly 100% of the time) when used (see below).

 

Cons of this treatment:

  • After 1 year there is only about a 30% compliance rate.

 

Some reasons for the low compliance rate are:

  • Straps bother patient 
  • Can't move around 
  • Difficult, if not impossible, to sleep on side 
  • Noise of the pump
  • Air leakage
  • Pressure on nose
  • Don't want to wear it around bed partner
  • Feeling of claustrophobia
  • Creates problems when traveling

 

3.  Surgery

What is commonly recommended most is a surgical procedure called a Uvulopalatopharyngoplasty, or UPPP. Essentially it is the removal of the uvula (the thing that hangs down in the back of your throat) along with a portion of the back of your soft palate, and the widening of the back of your throat.

 

Pros of surgery: 

  • Usually prescribed for the morbidly obese

 

Cons of surgery:

The Journal of the American Academy of Oral and Maxillofactial Surgons state "Unfortunately, there is simply not sufficient evidence that these procedures are beneficial for patients with Sleep Apnea".

  • Can be painful, particularly during recovery
  • Relatively expensive
  • Down time from surgery
  • Effective for 2-6 months; efficacy declines after 1 year

 

4.  Dental Appliances

AMandibular Advance Appliance

Moves the mandible (lower jaw) forward.  Moving the jaw forward can help open the airway.  This appliance typically has some type of device to allow the dentist to adjust the lower jaw forward 2 to 3 times.

 

Pros of Mandibular Advance Appliance Therapy:

  • Easy to travel with
  • Can sleep in any position
  • Handles about 80% of cases
  • Averages 56% reduction of AHI (Dr. West averages 75%)
  • Good for patients with gag reflex
  • Recent improvements in designs

 

Cons of Mandibular Advance Appliance Therapy:

  • Some designs are bulky
  • Adjustment is to bring jaw forward and for some this may be difficult on the TMJ (jaw joint).
  • With over 40 types on the market, the dentist needs to be an expert in working with all appliance types.

 

B.  The Full Breath Appliance©.

An appliance invented by Dr. Bryan Keropian, who treats patients with TMJ (jaw joint) pain. This appliance was developed to treat patients where moving the jaw significantly forward is not an option.

 Pros of the Full Breath Appliance:        

  • Easy to travel with
  • Can sleep on side
  • One piece appliance
  • More ability to adjust
  • 75% reduction of AHI
  • Less likely to cause TMJ problems
  • More options in treatment
  • FDA approved
  • Uses Pharyngometer with treatment

 

Cons of the Full Breath Appliance:

With the Full Breath Appliance©, there are many adjustments we can make to help stop snoring and sleep apnea.  So there may be more visits with a Full Breath Appliance©, but this is also why the success rate is higher.  Not indicated for persons with a high gag reflex.

 

Is there a dental appliance that has the advantages of both the Mandibular Advance Appliance and the Full Breath Appliance?


Yes, Dr. West can make a custom appliance that can have the advantages of both types of appliances.

 

What is the Pharyngometer?

It is a computer program and device developed at Harvard that allows one to measure the Volume of Air by sending sonic waves into the mouth from the opening of the mouth to the back of the throat.  It also measures the Minimum Width of space in the mouth.  With this instrument we can actually monitor the improvement of space made with different appliances. Go to http://www.oraldilators.com/pharyngometer.htm for more information.

 

What should I do?

If you, or someone you love, snores loudly or has been diagnosed with OSA, take this seriously.  Seek treatment right away.

Conversely, every night that one does not experience these episodes, the better chance they have of living a longer healthier life.

Our recommendation is that you contact Dr. West’s office to set up an initial interview and testing.

This consultation is FREE!


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