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​Are you drowsy during the day with no explanation?  Do you snore loudly or wake up breathless in the middle of the night? If you are experiencing any of these symptoms, you may be one of more than 12 million Americans who are affected by sleep apnea. 

What is sleep apnea?

Sleep apnea is a potentially life-threatening sleep disorder characterized by repeated pauses in breathing during sleep. The term sleep apnea is derived from the Greek etymology meaning “without breath”. 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.

What are the signs of sleep apnea? 

The following symptoms can indicate the presence of sleep apnea.  If you notice one or more of these, contact Dr. Renger.

  • Insomnia or difficulty sleeping
  • Loud snoring at night
  • Waking up at night short of breath
  • Snorting or choking sounds during the night
  • Headaches upon waking in the morning
  • Falling asleep unintentionally during the day
  • Extreme drowsiness throughout the day

Are there different types of sleep apnea?

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 easily treatable by Dr. Renger.

What are risk factors for sleep apnea?

Obstructive sleep apnea is more common in males than females, and more common in older adults (40+) than younger adults and children. However, anyone--regardless of gender or age--can suffer from sleep apnea.  Other risk factors include obesity, smoking, drinking, use of sedatives or tranquilizers, and family history.  Central sleep apnea strikes most often in people with heart disorders, neuromuscular disorders, strokes, or brain tumors.  It is also more common in males. 

Is sleep apnea dangerous?

It is very important to seek medical attention if sleep apnea is suspected. A sufferer can completely stop breathing numerous times per hour, and this can quickly turn into a deadly situation. Obstructive sleep apnea occurs when the soft tissue lying at the back of the patient’s throat collapses into the airway. The tongue then falls towards the back of the throat which tightens the blockage and prevents oxygen from entering the lungs.

The problem worsens when the chest region, diaphragm, and abdomen fight for air. The efforts they make to obtain vital oxygen only cause a further tightening of the blockage. The patient must arouse from deep sleep to tense the tongue and remove the soft tissue from the airway.

Because sleep apnea causes carbon dioxide levels to skyrocket in the blood and oxygen levels to decrease, the heart has to pump harder and faster to compensate for the lack of oxygen. Sleep apnea patients can technically “die” many times each night. Sleep apnea has been linked to a series of serious heart-related conditions, and should be investigated by Dr. Renger at the earliest opportunity.

What does sleep apnea treatment involve?

Initially, Dr. Renger will want to conduct an at-home sleep test in order to investigate the possibility of a sleep disorder and bruxism (clenching and grinding of teeth). Dr. Renger can offer many different treatment options which depend largely on the exact diagnosis and the health of the patient. Dr. Renger may advise the patient to halt some habits that aggravate sleep apnea such as smoking, alcohol consumption, and tranquilizer use.

Sleeping masks were traditionally used to keep the patient’s airways open while they slept, but nowadays there are some less intrusive options. Dental devices that gently tease the lower jaw forward are very effective in preventing the tongue from blocking the main air passage.  These dental devices are gentle, easy to wear, and often help patients avoid unwanted surgeries.

A medical consultation with your family physician may also be recommended depending on your test results.  Your test results will be reviewed by a board certified sleep physician, as necessary, to make the appropriate diagnosis.

If you suspect someone in your family suffers from sleep apnea, contact our office and we can refer you to a sleep apnea specialist.  The specialist may recommend a "sleep study" to diagnose the precise extent of the problem, and can prescribe appropriate treatment. Depending on the person's situation and diagnosis, treatment may involve an oral device that we can custom-create for you.

What are sleep apnea dental applicances?

There are a number of dental devices that can be used to alleviate this condition. The goal of most of these devices is to separate the jaws and push them 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.  Sleep apnea appliances work best on patients who are not significantly overweight. They offer a viable alternative to Continuous Positive Airway Pressure (CPAP).

Sleep apnea appliances fall into two categories: fixed and adjustable.  Here are brief descriptions of some commonly used sleep apnea dental appliances:

TAP® 3 (Thornton Adjustable Positioner)

The TAP® 3 is the smallest, most comfortable member of the TAP family.  It is a two-part custom-created sleep apnea appliance that fits over the teeth in much the same way as a sports mouthguard.  The TAP® 3 projects the jaw forward to prevent the tongue and soft tissues from impeding the airway.  The lower jaw positioner is adjustable, which means that it can be altered to suit the comfort level of the wearer.  The TAP® 3 appliance can accommodate the three main types of malocclusion, and allows the lips to fully close.

SomnoDent® MAS

The SomnoDent® MAS appliance is a custom-made splint, which is placed over the teeth.  The device consists of upper and lower dental plates which allows normal mouth opening and closing.  The splint moves the lower jaw slightly forward.  The lower jaw advancement is adjustable, which increases the effectiveness of the treatment by creating space in the back of the throat.  This opens the throat and reduces the chance the tissue there collapses, causing either snoring, reduced airflow or an apnea event.

NarvalTM CC

The NarvalTM CC is ResMed's premier oral appliance.  As one of the lightest oral appliances available, NarvalTM CC is designed to be discreet, comfortable and effective.  Crafted from a lightweight, flexible and metal-free biocompatible material, unlike any other oral appliance, this specially designed device allows you the freedom and flexibility to talk and drink. It works by simply holding your jaw in a forward position while you sleep to expand the space behind your tongue and help prevent obstruction and snoring.