ARNOLD L CHASSANOFF, DMD
Diplomat, American Board of Dental Sleep Medicine
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TREATMENT OPTIONS FOR SNORING AND OBSTRUCTIVE APNEA
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DIAGNOSING SLEEP DISORDERS
Monitoring your sleep during an overnight sleep study (at a sleep lab) is the only positive way to tell if you have a sleep breathing disorder. A sleep study records how your lungs, heart, brain, and other parts of your body function during sleep. The testing is painless, risk free and usually takes one full night. It is necessary to have a sleep study to arrive at an accurate diagnosis of any sleep problems. Without a sleep study, any treatment is guesswork.
LIFE STYLE CHANGES
Lose Weight...Sleep apnea occurs most often in overweight individuals. Losing weight may even cure snoring or sleep apnea. Diet and exercise!
Sleep on your side....Sew a sock filled with tennis balls on the back of your pajamas.
Avoid alcohol, sedatives and large meals before sleep....
Unblock a stuffed nose.... Use only a prescribed nasal spray
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LASER ASSISTED LAUP SURGERY
This procedure involves removing the uvula, and sections of the soft palate. There are also variations of this treatment to the soft palate that are done with scalpels, electro-surgery, plastic pillar inserts and botulism injections. All are attempts to modify the soft palate and/or tonsils.
These treatments are partially successful for snoring but are not considered worthwhile for treating sleep apnea because tissues further back in the throat will still block air flow. (i.e.the back of the tongue resting against the throat)
Risks and complications are:
- Foods and liquids flowing back up the nasal cavity during swallowing
- Bleeding
- Infection
- Failure of the procedure to cure snoring or sleep apnea
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CPAP MACHINES
A small electric powered air blower is connected by a flexible hose to a soft plastic mask. When you go to bed each night, you place the mask over your nose and turn on the blower. The blower sends a pressurized stream of air into your throat which keeps the throat structures from collapsing and blocking your air passage. The amount of air pressure needed to keep your air passage open is usually determined in the sleep laboratory during a sleep study. The pressure is customized to your needs and it may take some adjusting before it's right.
CPAP machines are very effective for treating sleep apnea but unfortunately, various side effects occur in up to 45% of CPAP users. These side effects include claustrophobia, chemical sensitivity and sores from the mask, dry or bleeding nose, infections, swelling or irritation of the eyes, mask or hose leaks, and air pumped into the stomach. The size, bulk and electrical requirements of these machines make them difficult to travel with.
Because of the unpleasantness of these side effects, patients may not continue to use the CPAP machine every night or for the entire night. Understandably, treatment results are compromised.
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ORAL APPLIANCE THERAPY
Oral appliances are worn in the mouth to treat Snoring and Obstructive Sleep Apnea. They are also known as mandibular advancement devices and mandibular repositioning devices. These devices are similar to orthodontic retainers or sports mouth guards. Oral appliance therapy involves the selection, design, fitting and adjustment of a custom made appliance. Oral appliances work in several ways. They:
- reposition the tongue, lower jaw, soft palate, and uvula
- stabilize the lower jaw and tongue
- increase the muscle tone of the entire airway.
They are quite effective because they act directly on the obstructed
area and strengthen the airway. Short term side effects are minimal.
There may be some excess salivation or tenderness until the body becomes accustomed to the appliance. This ranges from a few days to a few weeks. Long term side effects are rare and include an invisible slight movement of some of the teeth. Dentists with training in the proper use of oral appliances can determine which appliances will be the most comfortable and successful for each individual.
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