What is Sleep Apnea?

The National Council on Aging estimates about 40 million Americans suffer from obstructive sleep apnea (OSA) and it is suspected that nearly one billion individuals around the world have mild to severe OSA. OSA is typically caused by an abnormality in the bones, muscles, and/or facial topography that structure the mouth, nose, and throat. Improper nasal breathing, allergies, tongue posture, and other factors can also cause OSA. In any case, OSA arises from obstruction to the airway during sleep.

OSA is a potentially life-threatening condition due to insufficient body and brain oxygenation. Sleep apnea, which causes a lack of oxygen and sleep, can create detrimental long- and short-term health effects for adults and children, especially for the latter, who need proper oxygenation for health and development. At a minimum, the negative effects of OSA appear on a daily basis through drowsiness and poor sleep. 

Sleep Apnea Therapy

Treatment for sleep apnea does not look the same for everyone. Typically, treatment consists of a variety of lifestyle changes sometimes including but not limited to the use of a breathing assistance machine while sleeping. One of these often-used devices, a continuous positive airway pressure CPAP, machine which uses pressurized air to keep airways open and the user asleep. 

Before assigning a specific treatment plan or device, your dentist will engage in the Seattle Protocol: a set of six diagnostic steps used to identify the best course of treatment. Doctors create multiple sleep appliances and examine the effects of each appliance to find a best fit. The Protocol typically begins with either a sleep study or a sleep quality screening device to obtain baseline information. 

The first step includes nasal breathing therapy for two weeks, taping the lips shut to emphasize and focus on proper nasal breathing. Steps 2 through 6 introduce a variety of temporary sleep appliances. Patients end on the step which improves their sleep quality and the symptoms they face. Then, patients receive a permanent device, enabling further treatment to locate additional advantages and strategies to even further improve symptoms. Consult with your dentist about the Seattle Protocol.

Another OSA appliance, which is typically given at step 6 of the Seattle Protocol, is the Mandibular Advancement Device. Custom-fitted and worn in the mouth overnight, the device encourages the lower jaw to move forward, opening the airways by moving the tongue forward. 

Advanced Therapies

Myofunctional therapy is an additional lifestyle practice recommendation which retrains the face, mouth, and throat muscles to minimize the effects of OSA. Myofunctional therapists develop a specialized and personal treatment and exercise plan to strengthen muscles and thus open airways. Likewise, nasal breathing therapy is recommended for mouth breathers who have additional pain or symptoms. Nighttime therapy is conducted at home for two weeks. Each night, the nose is cleaned and tape seals the lips together to encourage healthy breathing habits. 

If the lower jaw, the mandible, is misaligned or too narrow, several procedures can be recommended in a process of "Mandibular Arch Expanison". For children, a lip bumper helps relieve pressure on the teeth. Moreover, a screw-activated mandibular expander can push the lower molars outward to make the mandible less crowded. For adults, surgically-facilitated orthodontic therapy (SFOT) safely improves bone volume and teeth position. SFOT can move teeth 2-3 times faster and farther, shortening treatment times while taking at least four months to fully heal. Other surgical operations reposition the jaw and teeth with screws or attachments which may be permanent. Surgical procedures such as these are more advanced and require an advanced interdisciplinary team. 

Ask your dentist about obstructive sleep apnea treatment options and strategies you can take to alleviate symptoms and issues caused by OSA.