Oral Appliance for Sleep Apnea Treatment by a Dentist
Sleep apnea occurs when a person stops breathing during sleep for an extended period of time repeatedly. This causes sleep disturbances and if one is sleep deprived during the night, making up for it in the daytime becomes inevitable. An oral appliance for sleep apnea treatment by a dentist may eliminate the need for the less convenient and uncomfortable CPAP.
For a better understanding of this condition, let’s talk briefly about what happens when we breathe. This is ventilation and oxygenation. Simply put, ventilation is inhalation and exhalation, the movement of air in and out of the lungs, while oxygenation is the exchange of oxygen from the lungs into the blood. These 2 processes happen simultaneously in normal conditions but they are very independent activities and if anything is wrong with either of them it can be very fatal.
The benefit of inhalation and expiration of air is for blood to become oxygenated and for the Carbon dioxide present in deoxygenated blood to be expelled in exchange. Then this blood is then transported throughout the body supplying oxygen to the tissues and various systems.
Normally, there are few moments that breathing doesn’t take place just after air has been inspired and expired, right at the end. But the body already has us covered, with the intervention of the functional residual capacity that steps in to prevent the shunting. It acts as a buffer in these short periods of breathing cessation.
Blood never stops flowing through the lungs, since the heart keeps pumping it into circulation under normal circumstances. So, when there is no Oxygen present at the time the exchange with Carbon dioxide is meant to occur, intrapulmonary shunting occurs, making the deoxygenated blood move out of the lungs into the body circulation without being oxygenated. This condition is called Hypoxemia meaning low oxygen concentration in the blood. When the blood containing insufficient oxygen is delivered to tissues and organs we have tissue hypoxia.
Types of Sleep Apnea
Obstructive sleep apnea and Central sleep apnea
In central sleep apnea, there’s no respiratory effort being made due to injury to the brain, heart failure or opioid use. It is commonly found in premature infants who are devoid of the respiratory drive. Caffeine is the drug of choice for treatment.
The more popular of the two is the Obstructive sleep apnea. In this case, an effort is being made to breathe but there’s a presence is of obstruction in the airway. Sometimes, the collapse of the soft palate may cause the blockage or the tonsils may get so swollen they obstruct the respiratory channel.
The typical victims are obese males with very short necks, causing lungs hypoxia, the body tries to compensate by vasoconstriction, resulting in pulmonary hypertension or even cor pulmonale.
Sleep Apnea Treatment
The basic approach to treatment is weight loss and lifestyle changes like avoiding alcoholic drinks as they may worsen the condition. Another therapy used is the CPAP (Continuous positive airway pressure) which keeps the airway open and intact constantly due to positive pressure.
A similar treatment to CPAP is BPAP (Bi-level Positive Airway Pressure), it differs from the former as it has 2 pressure settings, one for inhalation and the second one for exhalation eradicating the challenges some face in exhaling against the positive pressure with CPAP.
Surgeries like tonsillectomy for tonsil hypertrophy or adenotonsillectomy can be done, as well as soft palate and uvula excision (UPPP) in life-threatening situations.
The introduction of the oral appliances is a much-welcomed intervention for the management of obstructive sleep apnea but not central sleep apnea, as the latter is a malfunction of the brain and not the regular collapsing of the airway.
How Much Does a Sleep Apnea Test Cost?
Although the price varies from one place to another, the cost of oral appliances and test can be covered by many medical insurance plans, once you can fulfill the necessary requirements.
Some home tests cost as low as $150 and as high as $500 because they collect a smaller amount of data compared to that of medical establishments where extensive studies are being carried out. In Stanford University it costs as high as $8,500. Averagely for enterprises, $3,500 is charged but it can either be as cheap as $600 or as expensive as $5,000.
Can Sleep Apnea Cause High Blood Pressure
The answer to that question is a resounding yes. Imagine what the heart goes through in compensating for the resulting hypoxia the body suffers in sleep apnea. The heart tries to pump faster to supplement for the inadequately oxygenated blood. This causes cardiac stress on the organ.
You might be familiar with the phrase fight or flight response. This is a reaction we snap into when presented with a threatening situation and it is controlled by a system called the sympathetic nervous system. The body thinks it is dying and forces you to wake up, raising your heart rate, blood pressure as many times as your sleep is disturbed. The amount of adrenaline that courses through the body constantly as it progresses is a lot and throws the body out the normal cycle it is used to. During this period, the heart rate is greatly increased giving more workload to the heart.
Because of the irregular rhythm of oxygen supply, the brain loses its finesse in controlling the proper blood circulation by the heart leading to high blood pressure and arrhythmias.
High blood pressure is developed in many people with sleep apnea and it can get worse depending on the severity of the sleep apnea.
Sleep Apnea Complications
If the condition persists for a long time it can lead to arrhythmias with an increased risk of cardiac death. Eye issues like glaucoma have also been connected to this condition and often treated in these patients.
It is mostly connected with obesity, loud snoring, and daytime fatigue. People suffering from this may experience chronic fatigue leading to daytime sleepiness which can lead to accidents on the road or at work.
Other issues such as partners having problems with their spouses snoring at night and getting disturbed during sleep have also been a leading factor in strained marriages.
Memory loss, headaches after waking up, mood swings, nocturia are one of the many more complications that have been also associated with sleep apnea.
Sleep Apnea Chest Pain
It may feel like a cardiac problem, so it is important to get it checked. Chest pain may be largely due to acid reflux another associated condition with apnea. It may also mimic angina due to the arrhythmia that is ensuing.
Some patients also feel pain through to the pressure level of the CPAP which can easily be corrected by reasonable adjustment.
Mouth Guard for Sleep Apnea Prevention
Dental devices are being produced to maintain an open breathing passage while going to bed. These mouthpieces are tailored to individual needs for managing sleep apnea and they are personalized and customized specifically to help in preventing hypoxia through the night. They carry this function out by fixing the jaw and the tongue in a proper position to achieve uninterrupted respiration.
After proper diagnosis and confirmation, you’ll be most likely referred to a dentist who specializes in fitting the oral guard. The oral appliances are fitted just like a sports mouth guard to suit individuals for optimal results.
Oral appliances have been tested and found to enhance hassle-free breathing, enabling rejuvenation and revitalization after a good night’s rest.
References
Losurdo, A., Vollono, C., Mazza, S. and Della Marca, G. (2014). Asymptomatic bradyarrhythmia and obstructive sleep apnea. Sleep and Biological Rhythms, 12(4), pp.305-307.
Schmitt, M. (2017). 0479 PREDICTING OBSTRUCTIVE SLEEP APNEA ON POLYSOMNOGRAPHY AFTER A NORMAL HOME SLEEP APNEA TEST. Sleep, 40(suppl_1), pp.A178-A179.
Shin, J. and Park, D. (2017). Associational analysis of sleep-related variables and sleep positional difference of apnea-hypopnea index in obstructive sleep apnea syndrome. Sleep Medicine, 40, p.e252.
Zuberi, N., Rekab, K. and Nguyen, H. (2004). Sleep Apnea Avoidance Pillow Effects on Obstructive Sleep Apnea Syndrome and Snoring. Sleep and Breathing, 8(4), pp.201-207.
