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Treating Sleep Apnea with Oral Appliance Therapy

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ating Sleep Apnea with Oral Appliance Therapy
Article By: Soft Touch

Every night, millions of Americans go to their beds and slip into a night of sleep that is anything but relaxing and rejuvenating. They snore and gasp for breath throughout the night, a condition known as sleep apnea. This results in persistent drowsiness and an increased risk of heart disease, hypertension, Type 2 diabetes, and other medical conditions.

Sleep disorders have become a significant health issue worldwide. However, sleep apnea in the United States affects 22 million individuals every year, with 80 percent of moderate and severe obstructive instances. Despite this, most of those who suffer from it never get a diagnosis. They struggle night after night, putting their health at risk.

Read on to learn all you need to know about sleep apnea, including a brief history and some of the most effective methods for detecting and, in some cases, curing it.

Brief History of Sleep Apnea

Sleep apnea, commonly known as obstructive sleep apnea (OSA), is a medical condition that has been around for a long time. While it may seem that the prevalence of sleep apnea-like diseases is increasing due to the rise in obesity over the last few decades, this is not the case. Symptoms have been recognized for centuries, dating up to roughly 2,000 years ago.

Remember Charles Dickens’ classic The Pickwick Papers, where a character called Joe, who is overweight, displays sleep disorder symptoms? Initially, sleep apnea was solely attributed to excess body fat; therefore, in the nineteenth century, “Pickwickian syndrome” was coined to describe a group of symptoms associated with sleep apnea.

The study moved forward, and in the 1950s and 1960s, researchers started to dig more into the condition. They finally discovered that it was caused by a person’s inability to breathe correctly when sleeping and had nothing to do with obesity.

Later, in the 1970s, research intensified with dogs being the initial test subjects for proposed treatments, such as tracheotomies. Eventually, in the late 1970s and early 1980s, Colin Sullivan invented the Continuous Positive Airway Pressure (CPAP) machine, which became the standard therapy for sleep apnea. However, many patients find CPAP machines completely intolerable and noisy, causing many to quit using them.

A more conservative therapeutic option, oral appliance therapy, was eventually introduced by clinicians, notably dentists, who maintained the airway’s opening using a tiny, custom-made mouthpiece. Pierre Robin is widely regarded as having performed the first clinical study on OAT in 1902 when he published the description of a “monoblock” device to treat glossoptosis. This technique was shown to be the most effective for people suffering from mild to moderate sleep apnea, and it is now used across the globe to help patients suffering from the condition.

How to Tell if You Have Sleep Apnea

Because sleep apnea happens while they’re asleep, millions of individuals who suffer from it are completely unaware of their condition. So, how do you determine whether or not you are one of them? A simple quiz prepared by the American Sleep Apnea Association (ASAA) might provide you with some information. If you answer yes to any of the questions mentioned below, you might be suffering from sleep apnea. *Make sure you read carefully.

  • Do you snore loudly or frequently?
  • Do you get a headache when you first wake up?
  • When you first wake up, do you feel drained or exhausted?
  • Do you find yourself feeling sleepy or exhausted during the day?
  • Do you have trouble focusing or remembering things regularly?
  • Is it common for you to nod off whether sitting, reading, watching television, or driving?
  • Have you ever been caught gasping for air while sleeping?

Types of Sleep Apnea

Sleep apnea is divided into three types: obstructive, central, and mixed. Obstructive is the most common, affecting nearly 1 billion adults aged 30–69 worldwide.

Obstructive Sleep Apnea (OSA):

This is a condition in which the neck muscles relax while the tongue and soft palate collapse against the throat’s back, blocking the airway. Breathing may become extremely shallow, and an individual may even stop breathing for a short period.

Central Sleep Apnea (CSA):

A condition in which breathing stops and begins periodically while an individual is sleeping. Since the brain does not provide correct signals to the muscles that regulate breathing, central sleep apnea may occur throughout a sleep cycle.

Mixed Sleep Apnea (also known as Complex Sleep Apnea Syndrome):

As the name implies, it is a mixture of Obstructive Sleep Apnea (OSA) and Central Sleep Apnea (CSA).

Oral Appliance Therapy (OAT) for Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a worldwide health burden, with negative consequences for cardiometabolic health, chronic illness, productivity loss, and accident risk. When appropriately used, oral appliances (OA) are an effective treatment for sleep apnea. They function by expanding and stabilizing the pharyngeal airway to minimize breathing blockages during sleep.

However, even though they are indicated in clinical recommendations for OSA treatment, they are often only regarded as second-line therapy when positive airway pressure (PAP) therapy fails. Long-standing barriers have prevented patients from choosing OA over PAP treatment because of the impossibility of predicting the effectiveness in individual OSA patients.

Oral Appliance Therapy Step By Step Guide

At Soft Touch, Dr. Andrew Owyoung has provided oral appliance treatment to patients suffering from obstructive sleep apnea (OSA) for many years. When patients hear about this, many imagine they can contact the clinic and pick up an appliance the same day. Unfortunately, this is not exactly how the procedure works. Instead, a person must go through a considerable process to get an oral appliance and guarantee that it is the most appropriate therapy for them.

You might be wondering – what is the best way to get started? Today, we’ll take you step by step through the process of getting sleep apnea treatment so you can understand precisely what to expect.

Initial Appointment

Physical problems that would make it exceedingly painful for the patient to wear an appliance, such as acute temporomandibular joint discomfort and gum or dental disorders that would prevent the device from adhering to the patient’s teeth, are disqualifiers for oral appliance therapy. The patient’s sleep test is evaluated and analyzed at this visit to determine whether they are an ideal candidate for oral appliance treatment.

A review of procedure papers, an explanation of the ins and outs of oral appliance therapy, and alternative treatment options are all covered. In contrast, the selection of relevant device alternatives is explained, and demonstrations are shown. Treatment and administrative procedures are described, followed by a preauthorization request to the medical insurance provider to estimate the patient’s expected out-of-pocket expenditures in advance of treatment.

Consultation and Examination

After taking a detailed medical history, a thorough head, neck, and throat assessment is carried out. We discuss with you the appropriate oral appliance therapy, as well as the risks, advantages, and realistic expectations associated with treatment, based on our examination and clinical information supplied by your physician. Upon deciding to continue treatment, imprints are taken of your upper and lower teeth, along with different measurements, and a record of your bite is prepared.

Delivery of Oral Appliance

We will be able to deliver your appliance two to three weeks following the appointment. We check the fit and make any required changes to ensure that the device performs appropriately and that you are comfortable with it. An explanation of the insertion procedure, titration, and home care are provided, along with a discussion of probable adverse effects. We keep in touch with you via phone throughout your first few nights using the appliance. We plan a return follow-up visit for three weeks to ensure that everything is working well.

Follow Up –Titration and Evaluation

We will work closely with you for the first 90 days after the delivery of the appliance to ensure that you are comfortable and that the therapy is working correctly. During this time frame, we will need two face-to-face meetings with you. We check the device, make any necessary modifications, and keep track of your sleep progress in a log.

After completing this phase, you should schedule an appointment with your sleep physician for a polysomnogram. It is recommended that patients be examined once a year to check their progress and evaluate the device. An oral appliance may survive for up to three to five years; however, it may need to be replaced when needed.

How Does Oral Appliance Therapy Work?

Using an oral device during sleep may benefit sleep apnea treatment by removing physical obstructions from the upper airway. TSDs (tongue-stabilizing devices) allow the patient to move the tongue forward. In contrast, a mandibular advancement device (MAD) moves the jaw forward to help clear the airway. In the end, rapid maxillary expansion (RME) devices are used to permanently increase the breadth of the roof of the mouth, which allows for faster clearance of the airway.

Care Tips for Extending the Life of Your Oral Appliance

Oral appliances are great to cure sleep apnea; however, like with many other items we use daily, they may get worn out. Since they also spend a significant amount of time in the mouth, they may become a desirable breeding ground for germs that cause infection. Cleaning and maintaining your appliance regularly can help increase its lifespan. Here are four pointers to keep in mind.

Only Use a Mild Detergent

You should only clean with mild detergent rather than toothpaste or bleach. Although your appliance may have the appearance of teeth or gums, it is not formed of living tissue and should not be cleaned in the same manner. The abrasives in toothpaste can cause minor scratches in device materials, allowing germs to spread. Using bleach is also not recommended. Although it effectively kills germs, it also breaks down the nature of many appliance plastics. Ordinary home soaps, such as dish detergent, are fine to use.

Ditch Hot Water

Use warm water instead of hot water. Although near-boiling water is adequate at killing germs, it may soften many dental polymers and disrupt the exact fit of your device. For the most part, warm soapy water is sufficient enough to clean your equipment. Make sure to use a different brush than your ordinary toothbrush, preferably one that is specifically made for cleaning appliances.

Invest in an Ultrasonic Cleaner

You will not be able to ultimately reach microscopic crevices in your appliance with a regular toothbrush, no matter how diligent you are in your cleaning—and this is where an ultrasonic cleaner comes in. It may be a good investment for those with a permanent appliance for sleep apnea treatment. An ultrasonic cleaner is a device that delivers high-frequency sound vibrations to release plaque in difficult-to-reach areas, offering a thorough clean.

Protect Appliance When Not In Use

Placing a soft towel in the sink while washing your appliance can reduce the possibility of it being damaged by an accidental drop into a metal or hard porcelain basin. Additionally, don’t leave it lying about since dogs and even small children may find it to be an interesting “toy.” Be careful to keep it in its case or a cleaning solution at a safe distance from children.

Before You Go…

While sleep apnea is not a new medical condition, research has only recently developed several treatment methods that have been scientifically demonstrated to alleviate the symptoms. Oral appliance therapy might be a conservative and pleasant therapeutic option for people suffering from mild to severe sleep apnea and snoring. It may benefit individuals intolerant to CPAP or those searching for a simple answer to their sleep problems.

Oral Appliance Therapy at Soft Touch

Can’t tolerate CPAP? Oral appliance therapy (OAT) at Soft Touch could be the alternative you need. Since 1990, Dr. Andrew Owyoung’s practice has been making a difference in the lives of individuals desiring the relief of a good night’s sleep. So, whether you are battling with lousy sleep, daytime drowsiness, low energy, or want to fix snoring that is interfering with the sleep of your loved ones, we’ve got you covered! Contact us to find a solution that works best for you.

Soft Touch
1108 Corporate Way, Suite 1,
Sacramento, CA 95831

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