A diagnosis of sleep apnea can be alarming for some patients, a relief for others. After year’s complaints about snoring by a partner, jerking awake and gasping for breath, sleepless nights and drowsy days, and a host of other symptoms, finding out that sleep apnea is the culprit can help patients begin to turn the corner on their health.
If you’ve been recently diagnosed with sleep apnea or any other form of sleep-disordered breathing, here are some of the treatments available depending on your diagnosis and situation.
CPAP (continuous positive airway pressure). Depending on the severity of the diagnosis, a CPAP machine is a common choice of treatment. A CPAP supplies the patient with a continuous flow of air during sleep. CPAP is the best treatment for patients diagnosed with severe or extremely severe sleep apnea. Severe sleep apnea is defined as 30 or more disruptions in the sleep cycle—that’s 30 or more times an hour that a person wakes from sleep.
However, some patients refuse to consider CPAP as a form of treatment since it involves wearing a facemask that is connected to the air supply by a hose. In fact, it’s estimated that compliance with CPAP only occurs around 30 to 40 percent of the time.
Intraoral appliance therapy. An oral physician can create a custom-made intraoral appliance, which helps a patient’s jaw carefully, diligently, and methodically move forward. That repositioning of the jaw also helps move the tongue out of the back of the throat, which is the main cause of the airway obstruction that leads to disruptions that are the hallmark of sleep apnea. Since the oral appliance is much easier to manage than a CPAP, compliance tends to be around 90 percent.
Appliances are tested for efficiency, efficacy, and their success in reducing snoring, sleep apnea, and teeth clenching/grinding. There are a number of appliances on the market, and it’s up to the oral physician to decide which appliance is best.
Beware: Some appliances are designed only for bruxism (clenching and grinding) or to alleviate snoring. These are not solutions for sleep apnea, in fact, they may make the situation worse—they may silence the snore (the primary symptom of sleep apnea) without opening the airway. Beware of appliances sold over the internet as they create or worsen sleep apnea.
Laser therapy. The unique NightLase cold laser can tighten up a soft palate at the back of the throat to help open an airway during sleep. The treatment works by tightening up the muscles of the soft palate and promoting production of new collagen, the protein in the body that tightens skin. The treatment lasts for 12 to 18 months. The Julian Center for Comprehensive Dentistry is one of the few providers in the United States for this innovative treatment.
Myofunctional therapy. Myofunctional therapy involves exercising the muscles of the face and mouth to retrain the tongue to rest in the proper position and function properly during a swallow. That can help reduce a reflex learned in childhood where the tongue curls back into the mouth during a swallow. When the reflex carries over into adulthood, it can lead to the tongue resting too far at the back of the throat, blocking the airway and contributing to sleep apnea. It is necessary to evaluate for a tight lingual frenum that causes a tongue tie.
Structural changes. There are a number of treatments to change the structure of the mouth to improve a patient’s ability to breathe. Some of these may even prevent or alleviate sleep apnea.
In younger patients, for instance, expanding the upper and lower arches can create more space for the tongue while expanding the roof of the mouth can help open the nasal cavity to increase airflow through the nose.
In adult patients, surgery to change the shape of the jaw and surgically move the lower jaw forward may help open the airway. Although highly invasive, the treatment has proven very successful.
These are some of the options available for patients with sleep apnea. To determine which is best, consult a qualified oral physician. You may be referred to a board-certified sleep physician also.