By Dr. Richard Charmoy
Sleep apnea is a sleep-related breathing disorder where there are repetitive pauses in breathing, periods of shallow breathing, or collapse of the upper airway during sleep. It results in poor ventilation and sleep disruption. Each pause in breathing can last for a few seconds or up to a few minutes and occurs many times a night. A choking or snorting sound may occur as breathing resumes. Common symptoms include daytime sleepiness, snoring, and non-restorative sleep despite adequate sleep time. The disorder disrupts normal sleep patterns so those affected may experience sleepiness or feel tired during the day. It is often a chronic condition that can lead to heart attack, cardiac arrest, stroke, diabetes, heart failure, irregular heartbeat, obesity, motor vehicle collisions, Alzheimer’s disease, or premature death.
Medical professionals understand that quality sleep is potentially linked to improved overall mental and physical health. Consequently, more are prioritizing the diagnosis and treatment of sleep disorders. It is said that 90% of people with sleep-disordered breathing remain undiagnosed. The American Society of Anesthesiologists estimates that 16 million people have undiagnosed sleep disorders. A dentist can play an important role in this critical field.
It is generally accepted that the gold standard of treatment for patients with sleep apnea is the use of CPAP. This therapy uses positive airway pressure to create a pneumatic air splint, opening the airway. While CPAP provides very effective therapy, patient compliance remains a difficult obstacle to successful treatment. Many studies show compliance after 6 months is well below 50%. Patients report problems with the fitting of masks, air leakage, skin reactions to the air pressure, stomach bloating, claustrophobia, noisy machines, inability to initiate and maintain sleep, and total inconvenience.
Options for the CPAP include either a surgical procedure or oral appliance therapy. As a result of recent publicity, many consider Inspire or any type of neural stimulation a simple answer. Unfortunately, not only is this not the solution for many patients, but it is actually a surgical procedure. The other option is the use of an oral appliance.
Oral appliance therapy has proven to be an effective treatment for mild to moderate sleep apnea. Follow-up studies have even shown success in using this therapy for severe apnea in some cases. Many sleep specialists consider oral appliance therapy the treatment of choice for primary snoring.
It can also be used in conjunction with other treatments. Many patients who use CPAP therapy successfully use oral appliance therapy when traveling or in combination with their CPAP device, which allows lower pressures to be more effective.
Many patients who do not comply with CPAP therapy choose an oral appliance as their treatment of choice. The long-term compliance of oral appliance therapy is much higher than that of CPAP therapy. Oral appliance therapy is a great option for the treatment of obstructive sleep disorders.
Dr. Charmoy and Somerville Dental Sleep Medicine have been treating patients for snoring and sleep apnea for 20 years. He has a close working relationship with many sleep physicians in Somerville and surrounding areas. Dr. Charmoy is in-network with many insurance companies. Call today for an appointment at 908-722-9266. We are located at 78 East Main Street, Somerville.
