Treating Sleep Apnea

Obstructive Sleep Apnea and Dental Sleep Medicine

Obstructive sleep apnea (OSA) occurs when your muscles relax during sleep, allowing the soft tissue to collapse and block the airway. Each pause in breathing is called an apnea. As a result, sleep apnea causes you to stop breathing up to hundreds of times a night for anywhere from a few seconds to more than a minute. When this occurs, we wake up and seriously disrupt our sleep. The cumulative effect of all these apneas is a decrease in oxygen levels. These decreased oxygen levels can effect every cell in the body, but especially the heart and brain. Snoring, excessive daytime tiredness, memory problems, irritability , fatigue, and insomnia are all signs that you could be losing valuable shut-eye to sleep apnea. If left untreated, sleep apnea can be a potentially life threatening condition. It can increase the risk for other serious health problems such as high blood pressure, stroke, heart disease, diabetes, obesity, depression and impotence.

Who should be screened for obstructive sleep apnea?

  1. Do you snore?
  2. Do you wake up gasping or choking for air?
  3. Do you feel tired during the day?
  4. Do you wake up with frequent headaches?
  5. Do you have trouble concentrating or feel “cloudy”?
  6. Do you have a tough time falling asleep or staying asleep?

If you answered “yes” to any of these questions, you may want to speak with Dr. Caesar about having a complimentary Sleep consultation.

What is a sleep consultation? At the sleep consultation, Dr. Caesar will review your medical and dental histories, ask you some more in depth questions about your sleep and sleep history, and do a detailed examination of your airway. To do this Dr. Caesar will utilize a pharyngometer and a rhinometer. These are painless state of the art devices for measuring the size and volume of your airway and nasal passages. This will give the doctor a precise picture of your airway and how much it is collapsing when you sleep. Based on these results, Dr. Caesar may recommend a sleep study.

What is a sleep study?

Obstructive sleep apnea(OSA) can only be diagnosed by an overnight sleep study that is read by a medical doctor.
There are two types of overnight sleep studies: a polysomnogram(PSG) and a home sleep test (HST)
For a PSG, the patient will sleep in a sleep lab, either in a doctor’s office or hospital setting. Leads are attached to the head and body to take measurements while asleep. HST are more preferred by patients as they can be done in the comfort of your own home, and in your own bed. There are still come leads that take measurements, but overall it is a much more comfortable experience. Dr. Caesar can administer the HST to you directly. Upon completion of the test, it is read by a board certified sleep physician who Dr. Caesar works very closely with.
Based on this diagnosis, Dr. Caesar can then sit down with you and discuss treatment options.

How is obstructive sleep apnea treated?

The traditionally prescribed treatment for obstructive sleep apnea is continuous positive airway pressure (CPAP) therapy. It involves sleeping with a face mask connected by tubing to a constantly running machine. It uses air force to keep the airway open overnight. Although CPAP is effective, more than half of the patients don’t adhere to the treatment. Dr. Caesar can provide and alternative sleep solution with oral appliance therapy.

What is oral appliance therapy?

Oral appliance therapy is an effective, non-invasive treatment option for snoring and obstructive sleep apnea that fits easily into your lifestyle. A dental oral appliance looks like a sports mouth guard and is worn only during sleep. It supports the jaw in a forward position to help maintain and open the upper airway, preventing sleep apnea and snoring. These appliances are also called mandibular advancement devices (MAD). It is designed to hold the lower jaw slightly forward in hopes of enlarging the airway and preventing it from collapsing while sleeping. This is a simple solution that is discreet, silent and comfortable. If given the option, most patients choose this MAD over CPAP.
Dr. Caesar has helped many patients with a custom-fitted oral appliance. It it fabricated by taking impressions of your teeth. The pharyngometer is again used to obtain the correct bite or “sweet spot”. This is the position of your lower jaw that will open up the airway best. There is no more “guessing” how to make your appliance. The doctor is now able to see using technology, the best position for your lower jaw.

Patients like it because it is comfortable, easy to wear, quiet, portable, convenient for travel and easy to clean.

Treating snoring or sleep apnea with oral appliance therapy can help you feel like a new person. Your will find that your symptoms, and your quality of life, can improve dramatically when you remain committed to your treatment and use it nightly. OAT can improve your sleep, restore your alertness and revitalize your health.