#155. 100 Anderson Road SE Calgary, Alberta T2J3V1 Monday –Thursday 7:00 am to 4:30 pm 403-278-1415

Sleep Apnea

If you are a chronic snorer, it is possible that you have sleep apnea. Snoring occurs when the airway is partially blocked by the relaxed throat or tongue tissue and the sound comes from this tissue vibrating.

Sleep apnea is a condition where the airway repeatedly becomes entirely blocked, preventing breathing – the word “apnea” means “no breathing”. You might wake up enough to gasp for air and then fall back to sleep. In the morning you often have no memory of these incidents.

The official definition of sleep apnea is blocked breathing five or more times per hour for at least ten seconds each time. The average time is 22 seconds. Try holding your breath for 22 seconds -- good luck! The lack of breathing causes a significant drop in blood oxygen levels. Although there are three types of sleep apnea, the most common one is called Obstructive Sleep Apnea (OSA).

Sleep Apnea Symptoms

Although OSA sufferers are not typically aware of the non-breathing episodes each night, they do notice daytime sleep apnea symptoms:

  • Fatigue and drowsiness
  • Headaches
  • Memory problems
  • Difficulty in concentrating
  • Night time sweating
  • Chest pain at night
  • Depression
  • Irritability
  • Menstrual irregularities
  • Grinding teeth
  • Excessive daytime sleepiness
  • Episodes of breathing stoppages while you sleep
  • Abrupt awakenings accompanied by shortness of breath
  • Dry mouth
  • Sore throat
  • Morning headaches
  • Short term memory issues
  • Problems concentrating
  • Weight gain
  • Gastric reflux
  • High blood pressure
  • Diabetes
  • Mood swings
  • Poor performance at your job
  • Restless sleeping
  • Impotence
  • Decreased sex drive
  • Insomnia

Sleep Apnea Symptoms in Children:

Children under the age of five exhibit the following symptoms:

  • Snoring
  • Mouth breathing
  • Sweating
  • Restlessness
  • Waking up repeatedly during the night

Children over the age of five may experience the following symptoms:

  • Snoring
  • Bed wetting
  • Poor performance in school
  • Stunted growth
  • Behavior problems
  • Short attention span

As with adults, snoring is the most common symptom among children with sleep apnea.

Find out if you are sleep deprived — take the Epworth Test.

Who is at Risk for Sleep Apnea?

Certain groups are more likely to suffer from sleep apnea than others:

  • Anyone who is obese
  • People over the age of 50
  • Members of a family where someone has sleep apnea
  • Hispanics and First Nations
  • Males (males have OSA twice as often as females )
  • Anyone with airway constriction
  • Children with enlarged tonsils

Diagnosing Sleep Apnea

First, we have to determine if you snore or have sleep apnea (or both). We can provide you with a take-home test called ARES to evaluate the potential levels of sleep apnea and snoring you may be suffering from. This test is an initial screening tool. It is not used by us to diagnose if you have sleep apnea. The diagnosis of whether you have sleep apnea must be completed by a doctor. We will refer you to appropriate professional for further diagnosis

Sleep Apnea Treatments

Following your diagnosis and the severity of your symptoms, Dr. Cload may recommend snoring treatment with a Mandibular Advancement Device. This device keeps your airway open by moving your lower jaw forward. We use a device called the SOMNOMED, which is custom designed to fit over your upper and lower teeth.

Benefits of SOMNOMED:

  • Comfortable to wear
  • Comes with a three-year manufacturer warranty
  • Is easy to use
  • You are able to open your mouth
  • Will be custom fit
  • Has been FDA-approved for treating OSA

If, in addition to OSA, you have other symptoms such as headaches, facial pain, or discomfort when you open your mouth too widely, you may be suffering from Temporomandibular Joint Disorder.

CPAP

For years, CPAP (Continuous Positive Airway Pressure) has been one of the most common treatments for sleep apnea. CPAP treatment uses a special mask and hose to deliver air to your nasal passages. This air helps prevent your throat from collapsing while you sleep so that you can breathe freely through the night.

CPAP can be a very effective treatment for sleep apnea. It also helps minimize snoring so that your bed partner can enjoy a restful night’s sleep as well. CPAP can also reduce other issues associated with sleep apnea, such as headaches.

Unfortunately, there are also many problems associated with CPAP that make it a less than ideal solution for many sleep apnea patients. You must wear the CPAP appliance every night in order to reap the benefits of this treatment. However, many patients have trouble complying with this treatment.

In many cases, patients do not use the CPAP device for more than 4 hours a night, and some patients fail to use it at all. This poor compliance rate becomes very problematic for a treatment that must be worn all night to be effective.

Other problems with CPAP include:

  • Facial breakouts from the straps
  • Eye irritation
  • Nasal irritation
  • Mouth dryness
  • Runny nose
  • Sore throat


People who breathe through their mouths or sleep on their stomachs also frequently have difficulty complying with CPAP treatment.


Epworth Test

Please take a minute to take the test below:

0 = no chance of dozing
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing

Rate your chance of Dozing (0-3):

  1. Sitting and reading? ___
  2. Watching TV? ___
  3. Sitting inactive in a public place (e.g., a theater or a meeting)? ___
  4. As a passenger in a car for an hour without a break? ___
  5. Lying down to rest in the afternoon when circumstances permit? ___
  6. Sitting and talking to someone? ___
  7. Sitting quietly after a lunch without alcohol? ___
  8. In a car, while stopped for a few minutes in traffic? ___

Now, add up all 8 answers.

Results:

Less than 10:You have a normal amount of sleepiness.
10+You may be excessively sleepy depending and may have a sleep disorder. You may want to seek medical attention.
15+ You have excessive daytime sleepiness and should seek medical attention.

 

Types of Sleep Apnea:

There are two main types of sleep apnea – obstructive sleep apnea and central sleep apnea. Each has a slightly different cause.

Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is the most common form of the condition, It occurs when the soft tissue in the back of your throat collapses and blocks your airway. This blockage prevents you from breathing and deprives your brain and heart of needed oxygen. This can result in an increase in blood pressure and heart rate, which can place you at a greater risk of heart attack and stroke.

Treatment for obstructive sleep apnea works to open your airway so that you can breathe continuously while you sleep. Oral appliance therapy and CPAP (continuous positive airway pressure) are two of the most common treatments used.

Central Sleep Apnea

While less common, central sleep apnea is equally dangerous. It occurs when your brain fails to send the proper signals to the muscles that regulate your breathing. There is no blockage of your airway, just a breakdown in the function of your respiratory center. Patients with central sleep apnea may experience pauses in breathing for as long as two minutes at a time. As a result, your brain and heart become severely oxygen deprived, placing you at greater risk for serious health complications.

Other Types Of Sleep Disorders:

  • Bruxism
  • Hypopnea
  • Snoring

Many sleep disorders are related to sleep apnea and may be an indication of a larger problem. During your sleep disorder diagnosis, Dr. Cload can help you determine if your disorder is treatable with dental services, or if you will require additional medical assistance.

Living with a sleep disorder can wreak havoc on every aspect of your life.


 

Long-Term Effects of Sleep Apnea

Sleep apnea, or obstructive sleep apnea (OSA), is a serious medical condition that affects one in five adults, though children are also susceptible to this sleep disorder.

Failure to treat sleep apnea can lead to severe mental stress and other health problems including:

  • Heart attack
  • Heart disease
  • Stroke
  • High blood pressure
  • Obesity
  • Memory loss
  • Depression and other mood disorders
  • Attention deficit disorder (ADD)

Constantly being deprived of sleep and oxygen will wear heavily on your heart, lungs and overall mental state. Certain hormone levels may become imbalanced and sometimes stop functioning, disrupting your daily life.

Sleep apnea not only affects you and your body but also your loved ones. Erratic behavior and/or mood swings can cause friction in relationships. Constant loud snoring may disrupt sleep cycles and annoy those closest to you, causing them to sleep in separate rooms. Sleep apnea has also been connected to job-related accidents and traffic accidents.

Fortunately, there are treatments available for OSA and other types of sleep apnea. One popular and effective option is a sleep apnea/snoring appliance.


 

Frequently Asked Sleep Apnea Questions:

Are snoring appliances painful or uncomfortable?

No. The appliance is custom-made for your mouth and is very comfortable to wear.

Is it difficult to sleep with an appliance in your mouth?

No. Most patients find the appliances very comfortable and sleep through the night within one week. Less than 10 percent have reported a period of adjustment of up to two weeks, but after that most report they aren’t aware they’re even wearing a dental appliance.

Will the appliance affect my dental health?

No. Prior to constructing the appliance, we will check the health of both your teeth and gums. We will advise you of any dental treatment required before construction of the snoring appliance. There is the potential for tooth movement and a change in your bite position. However, as we say to our patients, a little tooth movement is nothing compared to not waking up after having a heart attack due to sleep apnea.

Will it adversely affect existing TMJ or cause TMJ problems?

Many patients who suffer from sleep apnea and snoring also present with temporomandibular joint disorder (TMJ or TMD) symptoms. Some patients actually see some improvement in their TMJ symptoms, others do not. We will work to adjust the snoring appliance to obtain an optimum position to manage your sleep apnea and any TMJ symptoms.

Is the plastic in the snoring appliance dangerous to my health?

The plastic used in the construction of our custom-fit snoring appliances is medical grade and has been carefully tested for safe human use.

Do I have to go to a sleep centre before getting a snoring appliance?

No. After your consultation, we can arrange for you to take home a sleep testing unit called the Apnea Risk Evaluation System (ARES). After you wear the appliance for two nights, we will be able to obtain detailed information about your sleep and the level of both your snoring and sleep apnea. If your sleep apnea is severe enough for a referral to a sleep centre, we will refer you for further evaluation.

Do I need a doctor referral for a sleep apnea and snoring appliance consultation?

No referral is needed. We will provide your family doctor with all our findings from the ARES sleep test and discuss with them any benefits to your overall health, such as reduced blood pressure and weight loss.

How long before I can start using my snoring appliance?

Following your impressions and the recording of your bite, it takes approximately two weeks to have the appliance constructed by our laboratory.

How soon does the snoring appliance start to work?

Immediately. The appliance is designed to bring the lower jaw forward into proper alignment. Therefore, a decrease in the obstruction that is the cause of your sleep apnea will begin as soon as you start to wear the appliance. The snoring appliance does need to be adjusted over a few weeks to achieve optimum results. Follow-up visits and sleep studies will ensure that the snoring appliance is having the desired effect.

How long do the snoring appliances last?

With proper care, most snoring appliances last three to five years.

What if it gets lost or damaged?

Sometimes the snoring appliance can be repaired if it is damaged. In the first year, the appliance is guaranteed and there is no charge for any repair or replacement due to damage or breakage while wearing the snoring appliance. If you lose the appliance, we have to charge you the full cost of replacement.

What if I have problems with the appliance?

After fitting you with your snoring appliance, we will see you for follow-up visits at set intervals. You can call us at any time with any questions or concerns.

Is there a payment plan?

We know the importance of wearing a snoring and sleep apnea appliance. For this reason we work with Dental Card to allow you to pay for your appliance over time. Please refer to our Financing page to find out how you can pay installments with Dental Card.

Should I try CPAP first?

We do not start any treatment until we have completed an initial sleep study with the ARES device and your doctor has reviewed its findings. Depending on your discussion with your doctor they may refer you for a CPAP evaluation.

If you have further questions about sleep apnea or snoring appliances, please contact us at the Southcentre Dental Clinic to schedule a free consultation.

 

Services are provided by General Dentists

Book an Appointment with Your Calgary Dentist

Book Appointment