Customized Sleep & Snoring Appliances
Imagine life with quality sleep and no more snoring! Get the relief you need with our dental appliances that treating snoring and sleep apnea. Before coming in, please fill out the Sleep Habits & History Form and bring it with you to your first appointment.
What Is Sleep Apnea?
Snoring! This is what Obstructive Sleep Apnea (OSA) is most known for. While not all snorers have OSA and snoring alone is not a health issue, snoring is one of the predisposing factors of OSA. OSA is estimated to afflict approximately 30 million Americans, the majority of whom never receive diagnosis or treatment. While many people know that they snore, far too many never look into whether they may suffer from apnea. While everyone knows snoring can put a damper on one's personal life, it seems fewer realize the seriousness of the health effects of leaving apnea untreated. These concerns include obesity, hypertension, type II diabetes, cardiac arrest, stroke, and fibromyalgia.
Health Issues Related To Obstructive Sleep Apnea
OSA-related health issues stem from the level of oxygenation maintained throughout sleep. An apnea event occurs when breathing ceases to take place during sleep for at least 10 seconds. This happens when an OSA sufferer experiences a collapse of the soft tissue in the back of the throat, primarily the tongue. An obstruction in the back of the throat makes breathing very difficult, causing a drop in your blood's oxygen saturation. As oxygen saturation drops, various organ systems experience unusual stress, and these stresses can lead to numerous systemic diseases. The American Heart Association (AHA) considers untreated sleep apnea to be just as bad as smoking cigarettes.
Perhaps even more dangerous is the daytime fatigue and exhaustion that sufferers feel when struggling with sleep apnea. Each year, falling asleep at the wheel accounts for thousands of car accidents. Imagine how many tragedies could be avoided if the drivers involved had gotten better sleep?
Screening For Obstructive Sleep Apnea
As a member of The American Academy of Dental Sleep Medicine, Dr. Willard and Dr. Gerlach perform screening* for snoring and OSA using a home monitoring device. Dr. Gerlach specializes in dentistry's role in treating sleep disordered breathing. This device records one's snoring, oxygen levels, and apnea incidences. The screening information is interpreted by a board-certified sleep physician. The physician can then determine if a problem exists, if further testing is required at a sleep center, and what appropriate treatment(s) may be. If the physician prescribes a custom oral sleep appliance, Gerlach & Willard will fabricate and fit it to your mouth.
If you are a current CPAP user and found it is not for you, give us a call. We can help!
*It's important to know that only a physician can diagnosis a sleep breathing disorder and prescribe a dental appliance, CPAP therapy, or combination therapy.
Sleep Apnea Treatment Options
With obstructive sleep apnea, there are two primary treatment choices: CPAP therapy and oral appliance therapy (OAT). Surgical options also exist for the most severe cases, and occasionally your sleep medicine team will combine multiple therapies.
Most patients who suspect they have OSA contacting their physician for a diagnosis. Often, after referral to a sleep center, it is common for those diagnosed with OSA to begin treatment with CPAP (Continuous Positive Airway Pressure). CPAP has a 100% chance of success even with very severe cases. CPAP therapy involves wearing a face mask during sleep. This mask attaches to a machine that pumps air down the airway, keeping it open and allowing for proper breathing. This also puts an end to snoring.
However, a large percentage of CPAP patients do not like wearing their masks and do not have severe apnea, making them perfect candidates for oral appliance therapy. According to the American Academy of Sleep Medicine (AASM), a physicians' organization, the initial treatment modality for mild to moderate OSA can be an oral appliance. These appliances reposition the lower jaw in a forward direction, thus holding the base of the tongue away from the pharynx. This allows for continuous airflow during sleep and cessation or reduction in snoring.
While an oral appliance is comfortable and easily tolerated, a properly adjusted CPAP remains the standard of care for all levels of OSA. When worn, a CPAP eliminates OSA. However, as compliance is often low with a CPAP, the AASM now recognizes that an oral appliance is often more effective due to higher compliance rates. Due to simplicity, most people prefer putting in a mouthpiece before bed as opposed to putting on a facemask attached to a pump.
Oral Appliance Therapy (OAT)
"Although not as efficacious as CPAP, oral appliances are indicated for use in patients with mild to moderate OSA who prefer OA's to CPAP, or who do not respond to CPAP, are not appropriate candidates for CPAP, or who fail treatment attempts with CPAP or treatment with behavioral measures such as weight loss or sleep position change."
SLEEP, vol. 29, No. 2, 2006, page 242
Although OAT shows tremendous success for mild-moderate OSA, severe cases require CPAP. As stated earlier, the most severe cases sometimes require a combination of CPAP with OAT, known as a hybrid appliance.
Only dentists with proper training in dental sleep medicine can craft these oral appliances. Dr. Gerlach has received extensive training and has considerable experience treating OSA with oral appliances. He works closely with various medical groups in the Plano/Dallas area in the interest of optimizing his patients' treatment. These appliances take skill and knowledge to properly create and adjust to each patient's unique mouth.
If you would like to find out whether you could be suffering from OSA, or if you currently struggle with a CPAP and would like to try an oral appliance, call Gerlach & Willard today.