Sleep Apnea/Snoring

It’s Time to Wake Up to the Importance of Sleep Disorders

An awakening is taking place to the importance of sleep disorders and their relationships to our general health. One important and common disorder is snoring, which affects approximately 82 million Americans in our society (40% of middle-aged men and 30% of middle-aged women). Snoring may be an annoying social problem and a subject for humor, but at its worst may be a reflection of a significant medical problem — obstructive sleep apnea. Obstructive sleep apnea (OSA) is defined as a cessation of breathing / airflow for 10 seconds or more (full obstruction of the airway), which may occur many times during the evening. Snoring is a narrowing of the upper airway, which leads to the vibration of the pharyngeal (throat) soft tissues (partial obstruction of the airway).

Health issues that are associated with such sleep disorders for inadequate sleep ranges from depression and anxiety to high blood pressure, pulmonary, hypertension, congestive heart failure, irregular heart rate, coronary artery disease, and even stroke, all of which are estimated to cost 3.4 billion in medical cost annually.

Signs and Symptoms of Obstructive Sleep Apnea

  • Loud snoring due to intermittent pauses (due to cessation of breathing)
  • Excessive daytime sleepiness
  • Awakenings during sleep that may include gasping or choking
  • Fragmented or non-refreshing sleep
  • Poor memory or difficulty with concentration
  • Irritability and personality changes
  • Decreased sex drive
  • Morning headaches

Other Facts

70 million Americans experience sleep disturbances and sleep apnea approximately 20 million Americans.
32% of Americans get less than 6 hours of sleep.
Over long periods, sleep apnea results in intellectual and memory deterioration.
Inadequate or poor sleep can result in fatigue and impaired alertness on the job, which can be hazardous when operating heavy machinery or driving a motor vehicle.
The U.S. National Highway Traffic Safety Administration cited drowsiness as a factor in 100,000 police-reported crashes annually, involving 80,000 injuries and deaths.
In one survey of drivers, 55% answered that they had driven when drowsy in the past year, and 23% said that they had fallen asleep while driving.
4% of all motor vehicle fatalities are attributed to driving while sleepy. Therefore, sleep deprivation poses imminent risks to individuals and society.

Snoring and obstructive sleep apnea are obstructive respiratory medical disorders that occur during sleep. After medical evaluation, common treatment procedures are CPAP (continuous positive airway pressure, a nasal mask worn while sleeping) or surgery. Dentistry also offers a treatment for these medical conditions. Oral appliances can provide a possible treatment alternative for managing patients who are suffering from the symptoms of sleep-disordered breathing. Such oral appliances reposition the patient’s jaw in order to open and maintain the patient’s airway at night to maximize oxygen flow, to reduce or eliminate snoring, and to decrease the number of respiratory obstructed events to an acceptable level.

How much and in which dimension to reposition the patient’s jaw can be pre-determined by an instrument called a Pharyngometer / Rhinometer. This instrument uses technology referred to as acoustic reflectometry, whereby sound waves are broadcast through a tube (around which the patient places their lips) into the oral cavity down into the pharynx (throat). As the sound waves rebound back into the transmitter and sensors in the tube, a computerized imagery displays a graphic representation of the patient’s airway from the teeth down 15 to 20 cm to their hypopharynx. Distance vs. volume is plotted, and the practitioner is then able to have a perception of where the narrowest (least volume) and most unstable areas of the patient’s airway are located. By monitoring this display as the patient opens and moves their jaw forward, the dentist is able to determine in advance if an oral appliance would be helpful to establish more pharyngeal volume (total airway space) in cases of snoring and diagnosed cases of sleep apnea. Such technology not only serves the dentist by providing information as to where the best positioning for the mandible is located to maintain a stable airway, but also serves as a crucial tool to assist in screening for obstructive sleep apnea and referral for a medical diagnosis. In addition, the common understanding by lay people is that snoring is caused by obstruction in the nasal passage. The use of the Rhinometer can tell immediately if there is a nasal obstruction and then the patient can be referred to an Ear, Nose and Throat doctor for evaluation / correction.

Communication between the physician and dentist in managing patients with snoring and sleep apnea is vitally important. Such technology as precisely fabricated appliances by means of the Pharyngometer / Rhinometer allow the dentist and physician to more effectively coordinate patient care.

Note: Dr. Wolfe provides complimentary screenings for sleep apnea by appointment at 505-299-6950.

“I was diagnosed with sleep apnea about 18 months ago. The treatment recommended was the C-Pap machine which is thought to be the state of the art for sleep apnea. After dedicating myself to this treatment for several months trying a variety of different masks for comfort, I became frustrated with the device as this technology is uncomfortable on the face/nose, ill fitting, and awkward at best. I spent many nights attempting to accommodate to the C-Pap machine with little to show for my efforts other than a very poor nights sleep.

“Some web based research had peaked my interest in dental solutions for sleep apnea and I called Dr. Bill Wolfe to see if he could offer a solution from a dental perspective. At the appointment Dr. Wolfe made a convincing case for trying the TAP dental device for sleep apnea and impressions were made of the teeth and mouth. On a subsequent visit the TAP device was fitted expertly by Dr. Wolfe and I began to use the appliance every night.

“The accommodation period was very short with little to no discomfort. The freedom experienced and the resultant better nights sleep were simply amazing and very much appreciated on my part. It has been about 18 months since first seeing Dr. Wolfe and I could not be more pleased. This is a very satisfactory and viable alternative to the rigors of the C-Pap machine with all of it’s complications especially when traveling. By the way, when traveling the C-Pap machine must be hand checked through security at the airport and will always be screened by the TSA agents. Meanwhile the TAP appliance nicely checks through.

“When it is all said and done the expertise of Dr. Bill Wolfe and the TAP appliance have made life so much better and my sleep apnea condition has been solved. I am truly grateful.”

Herbert M Beatty DC FICC

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