SLEEP APNEA TREATMENT

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Oral appliance therapy offers an, non-invasive treatment option for snoring and obstructive sleep apnea that can fit easily into your lifestyle

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Making Better Smiles & Improving Life

Making Better Smiles & Improving Life

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).

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Sleep Care

Suffering from snoring/sleep apnea?

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SLEEP APNEA SYMPTOMS

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

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Fatigue and drowsiness

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Headaches

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Memory problems

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Grinding teeth

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Abrupt awakenings accompanied by shortness of breath

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Morning headaches

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Impotence

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Difficulty in concentrating

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Night time sweating

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Chest pain at night

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Excessive daytime sleepiness

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Dry mouth

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Short term memory issue

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Decreased sex drive

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Depression

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Irritability

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Menstrual irregularities

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Episodes of breathing stoppages while you sleep

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Sore throat

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Problems concentrating

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Insomnia

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Weight gain

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Gastric reflux

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High blood pressure

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Diabetes

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Mood swings

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Poor performance at your job

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Restless sleeping

Sleep Apnea Symptoms in Children:

Children under the age of five exhibit the following symptoms:

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Snoring
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Restlessness

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Mouth breathing

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Waking up repeatedly during the night

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Sweating

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Restlessness

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

 

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Snoring
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Bed wetting

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Poor performance in school

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Stunted growth

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Behavior problems

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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.

 

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.

If you suspect that you have sleep disruptions, then it is essential to talk to a specialist who can help with sleep apnea in Calgary.

Types of Sleep Apnea

Sleep apnea is a dangerous condition that occurs when your breathing is interrupted while you sleep. These stoppages in breathing can occur hundreds of times a night without you even realizing. However, due to the loud snoring that often accompanies this condition, your bed partner will most likely be aware of your breathing stoppages. In order to resume normal breathing, your brain must temporarily rouse you from sleep. As a result, you may often feel tired throughout the day.
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.

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.

Everyone recognizes the importance of a good night’s sleep. Our body depends on uninterrupted rest in order to restore itself, maintain a healthy immune system, and function properly throughout the day.

Sleep apnea not only deprives our bodies of this all-important rest, it also deprives it of oxygen multiple times during the night. In fact, a sleep apnea patient’s oxygen saturation levels can drop to as low as 80% while they are sleeping.

Health Risks of Sleep Apnea

Untreated sleep apnea poses serious health risks for patients.

Health Risks of Sleep Apnea include:

  • Heart attack
  • Stroke
  • High blood pressure
  • Cardiac arrhythmia
  • Diabetes
  • Weight gain
  • Short-term memory loss

Researchers are currently studying the specific effects of sleep apnea on the pituitary and hypothalamus systems.

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. 

Visit our local sleep apnea clinic for information about these available treatment options.

In addition to sleep apnea and snoring, there are a number of sleep disorders that can rob you of a restful night’s sleep and leave you feeling groggy and tired in the morning. If you are suffering from a sleep disorder, Dr. Cload may be able to assist you in treating the problem, and help restore a good night’s sleep.

Common Sleep DisordersSome of the sleep disorders Dr. Silver is able to treat include:

  • Bruxism
  • Hypopnea
  • Snoring

Many sleep disorders are related to sleep apnea, a common condition in which air flow is obstructed during sleep resulting in restlessness and a lack of oxygen. This can lead to morning headaches as well as other symptoms of sleeplessness. Other sleep disorders may be related to TMJ. Bruxism, or teeth grinding, in particular can be a symptom of a larger problem with your temporomandibular joint, and can be treated using dental appliances such as mouthguards and oral splints.

Some sleep disorders may be an indication of a larger problem. During your sleep disorder diagnosis, Dr. Silver 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.

FREQUENTLY ASKED SLEEP APNEA QUESTIONS

What is the main cause of sleep apnea?

There are many different types of sleeping disorders. One that we frequently see in our Calgary dentist office is obstructive sleep apnea, or “OSA” for short. This particular breathing disorder is caused by a physical obstruction of the airway while you’re sleeping. Specifically, the soft tissues at the back of your throat and upper airway seal and collapse against one another, preventing oxygen flow.

OSA can happen when your tongue slips back too far, is enlarged, or you have large tonsils and a physically small opening at the back of your mouth. The soft palate (the portion furthest back at the roof of your mouth) might also have excess tissue that sags down too low. All of these factors play together when it’s time for you to sleep. As you relax, those anatomical features then block off the back of your throat. So, it’s not just your mouth that you can’t breathe through; it’s your nose, too!

Snoring in particular isn’t a cause of sleep apnea or OSA, but it could be a warning sign that there’s something wrong.

How serious is sleep apnea?

Sleep apnea can range from mild to severe. Depending on the severity of your sleeping disorder or obstructed breathing, there can be serious physical side effects that increase your chances of things like a heart attack or stroke. Sleep experts know that when your body is deprived of oxygen (which is what happens when you have sleep apnea) it can raise your blood pressure and lead to muscle tension throughout your body. That’s why it’s common to feel fatigued and tired, even if it felt like you actually slept through the night.

If you have a condition like depression or diabetes, the sleep apnea can make it more difficult to get those situations under control. Your body is essentially worn out and working overtime. Having a sleeping disorder can also increase your frequency of headaches or possibly falling asleep during the day while you’re driving or at work (which of course is quite dangerous.)

Although sleep apnea itself doesn’t kill people, the effects of sleep apnea like cardiovascular disease can. So, don’t ignore the warning signs and symptoms. If you suspect that you have obstructive sleep apnea, be sure to consult with our Calgary dentist.

Can sleep apnea be cured completely?

Sleep apnea treatments vary depending on the particular type of apnea that you have. If you’re seeing a Calgary dentist for help with obstructive sleep apnea (OSA) the most appropriate type of treatment we would offer is a custom oral sleep appliance, which is also known as a mandibular advancement device. In rare situations, surgery or laser treatment (including tonsillectomies) might also be recommended to manage excess soft tissues at the back of your throat and create more room for air flow.

With sleep apnea treatment, it’s important to carefully monitor your symptoms to ensure that you’re responding appropriately. Most people find that once they get into a routine of using an oral sleep appliance for mild to moderate sleep apnea, they don’t usually need anything else. However, if symptoms worsen or there are other conditions at play, additional treatment might be needed.

Your physician may recommend follow up testing depending on your physical health and frequency of symptoms. There’s not usually a permanent “fix” to treat sleep apnea and prevent it from coming back.

What is the best treatment for sleep apnea?

The best type of treatment for sleep apnea will vary from person to person. For some individuals it’s a CPAP combined with weight loss. For others, it might be surgery. And in certain situations, the best type of apnea appliance is a special type of mouthpiece (called a mandibular advancement device) that’s made by our Calgary dentist.

To ensure the best possible outcome from your sleep apnea treatment, our dentist will need to closely communicate with your physician or sleep specialist. Depending on the diagnosis and extent of your sleeping disorder, we’ll then determine if an oral appliance is the best treatment.

In order for any type of sleep apnea treatment to be effective, you’ll need to use it as directed and under the supervision of your medical/dental provider. For example, oral sleep appliances may need to be adjusted in order to calibrate them to find the best position. If you find that you’re CPAP intolerant or looking for a CPAP alternative, be sure to ask our Calgary dentist about oral appliances!

Can sleep apnea cause dental problems?

Yes. One of the most common side effects and symptoms of sleep apnea is teeth grinding and clenching (a condition called “bruxism”). When your brain is deprived of oxygen, your jaws clench tightly together. Even though your teeth are extremely strong and durable, they can’t stand up to this excessive force night after night. Over time, your teeth will start to wear down, look flat, chip, or break. Consequently, your dental work will start to break apart too. In a few cases, our Calgary dentist might also see things like root exposure because of receding gums.

All of that pressure on your teeth also radiates into your jaw muscles, TMJ, and the sides of your face. As a result, you’ll tend to experience issues like TMJ disorder and headaches. If you notice popping and clicking when you move your mouth or you’re not able to open as wide as you used to, it could be because of your sleep apnea. Be sure to make us aware of these symptoms when you’re here for a checkup.

What is the best dental service for sleep apnea?

When it comes to dental treatments for sleep apnea, an oral sleep appliance is the go-to solution. These mandibular advancement devices fit over your upper and lower jaws like a custom mouthguard. But what they do is guide your lower jaw slightly forward, so that your tongue and palate don’t seal off the airway near the back of your throat.

Some people find that a dental sleep appliance is all they need to manage sleep disordered breathing. Others combine it with their CPAP machine. And if you’re someone who is CPAP intolerant, a sleep mouthguard may be your best alternative.

Not everyone qualifies for a dental appliance to treat sleep apnea. Only certain types of apnea (specifically obstructive sleep apnea) can be managed with an oral appliance. Be sure to talk to our Calgary dentist at Southcentre Mall to determine which dental sleep aid is best for your situation. If you haven’t had a sleep study or seen a sleep doctor about your concerns, we can direct you along the next steps for a formal diagnosis and screening.

How can a dentist help with sleep apnea?

A dentist is the only provider who can fit you with a custom oral sleep appliance. Although sleep physicians can prescribe a dental mouthpiece for snoring or apnea, they aren’t able to fit you for one or deliver it in their office. Instead, they write a prescription and have you take it to a dentist who is trained in sleep apnea treatments.

This special mouthguard (known as a mandibular advancement device) positions your lower jaw in a special way that helps prevent airway blockage at the back of your mouth. Your dentist will take an impression of your teeth then send the specifications to the oral appliance manufacturer. Once it’s ready, they’ll try it in and adjusted to your mouth. You might need to come back a few times to have it fine tuned to find the perfect fit. However, it’s common for people to say that they see positive benefits from their oral appliance as soon as the first night they wear it! If you’re CPAP intolerant, be sure to ask your physician about seeing a sleep dentist about a mouthguard.

Does sleep apnea cause bleeding gums?

Not necessarily, but having sleep apnea can raise your risk of conditions that might contribute to bleeding gums. For example, people with apnea tend to have a harder time controlling underlying medical issues like diabetes. And science shows us that diabetics tend to have a more challenging time managing gum disease, because of how closely the two conditions are intertwined.

Perhaps you have some type of airway blockage or breath through your mouth while you’re sleeping. Mouth breathing can contribute to dry mouth and red gums, increasing your chance of issues like bleeding when you floss or a higher rate of tooth decay.

If you have sleep apnea, it’s important to pay extra attention to the health of your teeth and gums. Practice daily flossing, brushing along the gumlines, and be sure to visit our dentist in Calgary at least every six months for a professional cleaning and exam. Bleeding gums tend to be closely attributed to periodontitis, so don’t ignore the symptoms or accidentally assume that they’re because of your sleep apnea.

Does a mouth guard help sleep apnea?

Depending on the type of sleep apnea you have, a special type of dental mouthguard called a “mandibular advancement device” may be able to help you with your medical condition. These sleep mouthpieces position your jaw in a certain way that helps maximize oxygen flow while you’re sleeping.

However, not all oral appliances are the same. Only a specific type of sleep mouthguard made and delivered by a trained dentist is appropriate to wear. But even then, oral sleep appliances are best reserved for cases of obstructive sleep apnea, which is a specific category of sleeping disorders.

Dental sleep appliances can also help with chronic snoring. So, if you make it difficult for your loved one to get a good night’s rest, you may want to look into having a dental appliance made. All you’ll need is an impression of your teeth!

It’s also effective to wear your sleep mouthguard with a CPAP as needed. The two are safe to use together, but some people find that having an oral appliance prevents them from needing a CPAP at all.

What is the newest treatment for sleep apnea?

There are constantly new developments and discoveries for medical conditions and sleeping disorders. One of the newest treatments for obstructive sleep apnea (OSA) that’s gaining tremendous support in the medical community is the use of oral sleep appliances / sleep mouthguards. These mandibular advancement devices work by positioning the mouth in a way that allows for optimal air flow, instead of using a machine to force air into the airway (CPAP) while you sleep.

But just because oral sleep appliances are new doesn’t mean they’re gimmicky. It’s taken quite some time for sleep physicians and experts to find the correlation with dental treatments and management of sleep disordered breathing.

The great news is that some people find using a sleep mouthguard can actually eliminate their reliance on a bulky, noisy CPAP machine! But not all oral appliances are created equal (or work for every type of sleep apnea.) For an effective mouthpiece, you’ll need to see a dentist in Calgary who works with sleep apnea professionals.

Are snoring appliances painful or uncomfortable?

No. A sleep apnea clinic can provide you with an appliance that 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 snoring appliances or  sleep apnea in Calgaryplease contact us at the Southcentre Dental Clinic to schedule a free consultation.

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 who specializes in sleep apnea in Calgary. We will refer you to appropriate professional for further diagnosis

Sleep Apnea Treatments

Following your diagnosis and the severity of your symptoms, Dr. Silver 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.

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