Sleep Apnea & Snoring

Sleep apnea is a potentially life-threatening sleep disorder characterized by repeated pauses in breathing during sleep.  Breathing pauses can last anywhere from several seconds to minutes, and happen as often as 30 times or more per hour. Ongoing disrupted breathing causes an imbalance between the carbon dioxide and oxygen levels in the bloodstream, as not enough carbon dioxide is exiting and not enough oxygen is entering the body.  Sensing this imbalance, the brain sends a message to the body, telling it to wake up to restart breathing the process. People with sleep apnea will partially awake as they struggle to breathe, and this is often accompanied by loud snoring or choking sensations. Because people with sleep apnea don’t always completely awake during the episodes, they are often unaware they have a sleeping disorder and it can remain undiagnosed. There are two main types of this disorder; central sleep apnea which occurs when the brain fails to send important signals to the breathing muscles, and obstructive sleep apnea which occurs when air cannot flow through the nose or mouth even though the body is still trying to breathe.  Obstructive sleep apnea is far more prevalent and can be treated by an orthodontist using a removable appliance.

Risks:  Untreated sleep apnea can contribute to a variety of medical conditions including high blood pressure, irregular heart beat, heart attacks, long-term sleep deprivation, depression, diabetes, obesity, and dementia.

Symptoms: Common signs of obstructive sleep apnea can include snoring, choking/gasping/snorting while sleeping, severe early morning headaches, sleepiness in the daytime, forgetfulness, depression, irritability, and insomnia. 

What should I do if I think I have sleep apnea? 
Discuss your symptoms with your physician or Dr. Scott Chong. If Dr. Scott Chong suspects you have sleep apnea, he will refer you to your physician for a sleep study. 

For sleep apnea patients, please complete this Sleep Apnea Exam Form , as well as, this Release of Records Form so that we can request your sleep study results. 

After the results of the test are reviewed and a diagnosis is made, different treatment options are discussed.

Treament:
1)  CPAP
The standard medical treatment for sleep apnea is to wear a mask connected to a Continuous Positive Airway Pressure (CPAP) machine while sleeping that delivers a constant flow of air.  This machine is highly effective, but many patients find it noisy, uncomfortable, and impractical to transport when traveling.
2)  Oral Appliance
An alternative method for treating sleep apnea and snoring is to use an oral appliance.  This appliance is worn in the mouth and is similar in design to a mouth guard or orthodontic retainer.  It is made of plastic and is worn within the mouth while sleeping.  The goal of this appliance is to gently position the lower jaw forward slightly.  This slight repositioning opens up the airway, and allows oxygen to flow freely again. Wearers of sleep apnea dental devices report that they stop loud snoring, feel more rested in the daytime, and are much more comfortable going to sleep.  

Dr. Scott Chong has received advanced training at the Central California Sleep Center with an expert in Oral Appliance Therapy for Sleep Apnea and Snoring.  He uses the Dynaflex Dorsal appliance for his patients.

Advantages of Using an Oral Appliance

  • Oral appliances are small and convenient, making them easy to carry when traveling
  • Treatment with oral appliances is reversible and non-invasive
  • After becoming acclimated to wearing the appliance, most people find them easy to wear and more comfortable than the CPAP
  • Quiet
  • Easily adjustable
  • More comfortable than CPAP resulting in increased compliance

How successful is OAT (Oral Appliance Therapy)?  
For mild Obstructive Sleep Apnea and snoring control, oral appliances have been found to be about 76% effective.  For more severe sleep apnea, an oral appliance might not be able to completely resolve the issues, but may still improve the overall quality of life, especially if a CPAP machine cannot be tolerated.

Does insurance cover the cost of Oral Appliance Therapy?
Most medical insurance policies will cover the Oral Appliance when Obstructive Sleep Apnea is diagnosed. In the case of simple snoring, most policies do not currently pay for the Oral Appliance.  To help us look up your benefits, please bring your medical insurance information to your examination appointment. 

What are the side effects associated with Oral Appliance Therapy?
Patients using Oral Appliance Therapy may experience the following side effects:

  • Excessive salivation or dryness.
  • Morning soreness in the teeth or jaw muscles.
  • Minor/moderate tooth movements.

Most of these side effects improve within a few weeks of regular use and some adjustments of the appliance. Periodic recall maintenance by Dr. Scott Chong is important to track any potential side effects such as tooth movements and to maintain/adjust the appliance. Patients with arthritis and chronic jaw joint dysfunction may have difficulty tolerating an oral appliance

Are there people who aren't good candidates for Oral Appliance Therapy?
It is always best to evaluate if you are a good candidate for OAT during your initial consultation with Dr. Scott Chong. There are several conditions that may be contraindicated for Oral Appliance Therapy:

  • Central Sleep Apnea as opposed to Obstructive Sleep Apnea.
  • Fibromyalgia and severe arthritis.
  • Poor dental health.
  • Chronic, untreated TMJ symptoms.
  • Very obese individuals.
  • Limited jaw movements