Sleep Apnea and Snoring

Sleep Apnea and Snoring Therapy in Chesapeake, VA

Dr. Simmons Uses Oral Appliance Therapy to Treat Obstructive Sleep Apnea and Snoring

Snoring is a nuisance to your partner and loved ones, but did you know that it may also pose serious risks to your health? Sleep apnea is a medical condition that often causes snoring and greatly increases the risk of heart attack and stroke. According to the National Sleep Foundation, nearly 60% of people experience daytime drowsiness, a side effect of sleep apnea . These people may be unaware that they have sleep apnea because many times, sleep apnea is misdiagnosed and goes untreated.

Snoring is a sign of breathing problems. It occurs when the jaw opens and the tongue and soft tissues fall in the back of the throat. This causes the airway to narrow and forces air through a smaller opening. This creates sound vibrations in the throat known as snoring. Snoring can have devastating effects on the quality of your life. It can be both embarrassing and inconvenient and cause problems in your relationships. Snoring is definitely a precursor for the more serious medical problem known as obstructive sleep apnea (OSA).

Obstructive sleep apnea (OSA) is the most common category of breathing-related sleep disorders. It occurs when the tongue and soft tissues collapse, blocking the airways and preventing airflow. This means that breathing stops completely for at least 10 seconds. Decreased oxygen flow to the heart and brain eventually causes the person to awaken from their deep sleep to inhale a gasp of air. The process repeats itself several times throughout the night, resulting in sleep loss and an increased risk of high blood pressure, heart attack, and stroke. Recent studies show that people with OSA are 30% more likely to die prematurely from a heart attack or stroke.

How harmful is decreased oxygen flow to the brain?

The normal oxygenation of the cells in our body tissues, such as the heart and brain, is 98-99%. Sleep apnea patients can have an oxygen depletion resulting in saturation in the 60-70% range. This can last for a considerable length of time and as many as seventy or more times an hour. Can you imagine the devastating effects this starvation of oxygen has on the body? It is killing people.

Symptoms of OSA include:

  • Loud or habitual snoring
  • Restless Sleep
  • Frequent dozing or sleepiness during the daytime
  • Memory loss
  • Irritability
  • Depression
  • Increased automobile accidents
  • Decreased sex drive
  • Impotence
  • Morning headaches

What are the medical results or comorbidities associated with sleep apnea?

  • High Blood Pressure
  • Heart Attacks
  • Stroke
  • Coronary Artery Disease
  • Heart Arrhythmias
  • Decreased Sex Drive
  • Impotence
  • Morning Headaches
  • Depression
  • GERD-Gastric Reflux
  • Night time Urination
  • Lung Dysfunction
  • Attention Deficit Disorder

Diagnosing Sleep Apnea

Regardless of the type, people with sleep apnea rarely know they are having difficulty breathing while sleeping. The disorder is severely under-diagnosed, and symptoms may occur for years (or even a lifetime) without proper treatment. Because OSA is a serious medical condition, it must be diagnosed by a doctor. Diagnosis is based on the results of an overnight sleep study called a Polysomnogram (PSG). The doctor will work closely with your specially trained dentist to monitor your condition and the effectiveness of therapy.

The Epworth Sleepiness Scale is a simple test designed to measure your risk for sleep apnea. If you score a nine or above, call Dr. Simmons for an appointment.

Treatment

Continuous Positive Airway Pressure (CPAP) Until recently, this has been the most common method of treatment. It is also considered to be the most efficacious method of treatment. CPAP requires a bedside generator to deliver pressurized air through a tube that is connected to a facemask. The air is forced through narrow or obstructed airways, allowing a continual flow of oxygen to reach the brain. CPAP creates many new problems for the patient, and less than 45 percent of people continue with the treatment. Intolerance is the biggest problem with CPAP.

Are you CPAP Intolerant?

Symptoms of CPAP Intolerance include:

  • Nasal congestion
  • Runny nose
  • Discomfort
  • Trouble sleeping
  • Awkwardness or embarrassment
  • The mask leaks
  • Unconsciously remove CPAP at night
  • The noise from the device disturbs your sleep
  • CPAP does not reduce or eliminate symptoms
  • Claustrophobia
  • Job prevents use

CPAP Alternatives

If you have been given a CPAP to wear to bed and you are not wearing it and would like an alternative, we can help!

If you are not wearing your CPAP to bed, then you are not treating your serious and potentially lethal condition. Oral Appliance Therapy (OAT) can give you freedom from your “hose to nose” and successfully treat your sleep apnea. CPAP Intolerant patients now have a new choice.

CPAP Alert: New guidelines recently published in Sleep (February, 2006), the journal for medical sleep specialists, recommend that dental oral appliances be used as the initial treatment of choice and not CPAP for:

  • Snoring
  • Mild Obstructive sleep apnea
  • Moderate Obstructive sleep apnea
  • Severe Obstructive sleep apnea - certain cases

For a complete view of the new guidelines and parameters, click here!

Dr. Simmons is a member of The American Academy of Dental Sleep Medicine and uses the latest in non-CPAP oral appliance therapies for both snoring and sleep apnea. Sleep apnea appliances come in a variety of designs and Dr. Simmons will custom fit your snoring or sleep apnea appliances.

Following appliance design and insertion, Dr. Simmons will monitor your progress with a take home sleep study, using the Embletta instrumentation. The Embletta does not take the place of a sleep study but does allow Dr. Simmons to monitor you progress while you sleep in your own bed.

We feel that the use of the Embletta is a state-of-the-art method for objectively assessing the effectiveness of OAT. This takes the guesswork out.

Oral Appliance Therapy (OAT)

This technology has been used for years overseas and has recently become a popular alternative to CPAP in the United States. The appliance is a mouthpiece similar to a retainer or mouthguard. It is custom designed in a laboratory. OAT technology works by:

  • Repositioning the jaw, tongue, and palate
  • Stabilizing the lower jaw
  • Increasing the tongue’s muscle tone

A Swedish study showed that oral devices were actually more effective than surgical or CPAP treatments, and the chance of medical side effects was rare. A dentist, such as Dr. Simmons, who specializes in sleep disorders, can prescribe OAT. Several appliance designs are available. The dentist will be familiar with them and will know which mouthpiece will suit your specific needs. After implementation, treatment will continue to be monitored to ensure the proper response of the jaw and teeth.

How We Can Help

As a member of the American Academy of Dental Sleep Medicine, Dr. Simmons is qualified to treat sleep apnea. He has been through advanced training, giving him the knowledge to perform thorough sleep examinations and prescribe oral sleep appliances with confidence. Dr. Simmons uses Embletta home study methods to monitor and screen OSA. He then works closely with a lab technician to develop an oral device that fits and works properly. Snoring is not always related to sleep apnea. A simple oral appliance may alleviate snoring in some patients.

Common Questions

I’ve been snoring for years and haven’t noticed any problems, why should I be concerned? 

Snoring is a sign that you’re not breathing properly, and it may cause serious risks to your health. One out of eight people who snore has sleep apnea, a serious medical condition that increases risks of heart attack and stroke. Individuals with sleep apnea don’t realize it, but while they sleep, oxygen flow to the brain and heart stops completely for up to 10 seconds to a minute or longer. This can cause serious damage to the body, in addition to daytime drowsiness and irritability.

How do I know if I have sleep apnea? 

If you snore habitually, sleep restlessly, gasp for air at night, or feel drowsy or fatigued in the daytime, you may have sleep apnea. You can take this simple test to determine your level of likelihood.

What are my treatment options? 

Treatment generally falls into three categories: medical, dental, and surgical. Medical treatment involves a bedside air generator, which is connected to a facial mask that delivers a constant flow of air to the lungs. This is known as Continuous Positive Airway Pressure (CPAP). For individuals with CPAP intolerance, custom oral mouthguards have been developed and can be prescribed and implemented by your dentist. This treatment is known as Oral Appliance Therapy (OAT). The third option is surgery, or a combination of surgeries that may include jaw repositioning or removal of excess throat tissue.

What is Oral Appliance Therapy (OAT)? 

Oral Appliance Therapy is a safe and effective way to treat sleep apnea. It works by repositioning the jaw and tongue so that air flows through the passageways without being obstructed. This treatment can be implemented by a qualified dentist who has received training in monitoring and diagnosing sleep apnea. The dentist works closely with a lab to design a custom mouthpiece that is similar to a traditional mouthguard. The patient wears the mouthpiece at night, and the dentist oversees the treatment to ensure the teeth and jaw respond properly.

What state-of-the-art technology does Dr. Simmons use?

Dr. Simmons uses the Embletta Level III Home Testing Device. He uses this as a screening device and as a means of monitoring your OAT Therapy. The Embletta boasts over half million studies worldwide, and has been designated by The American Academy of Sleep Medicine for use in their landmark study on Portable monitoring in the Diagnosis and management of Obstructive sleep apnea. Along with its user-friendly software, the Embletta is ideal for the direct measurement of sleep quality and sets the standard for diagnosing Sleep Disordered Breathing.

What oral appliances does Dr. Simmons use?

Dr. Simmons uses only high quality FDA approved appliances. He will custom fit the appliance that will work best for you. The best appliance will be the one that you will wear all night, every night. Two of Dr. Simmons’ favorite appliances are the TAP (Thornton Adjustable Positioner) and the Somnomed. Both appliances are known for their comfort, quality and durability. 

Will my insurance cover sleep apnea therapy?

Obstructive sleep apnea is a medical condition, and its treatment with Oral Appliance Therapy is covered by most medical insurance policies. You should speak with your insurance provider to find out your policy’s coverage. We have several payment and financing options available, so you can receive the care you need. Our Chesapeake dental office will help in all ways possible to help you receive maximum medical insurance benefits. You may want to have a preauthorization of benefits before any treatment begins.