Frequently Asked Questions
- Who gets sleep apnea?
- What should I do if I think I have sleep apnea?
- What is an Oral Appliance (OA)?
- How do I know if I am a candidate for an Oral Appliance?
- How do I know which Oral Appliance is right for me?
- How does the OA prevent snoring and OSA?
- How successful is OAT (Oral Appliance Therapy)?
- Does insurance cover the cost of OAT?
- Are there any long term health consequences to snoring/obstructive sleep apnea(OSA)?
- What will Dr. Schapansky do if I need an oral appliance?
- What are the side effects associated with Oral Appliance Therapy?
- Why worry about snoring? Isn’t it just an annoying, but normal, sleep habit?
- Are there people who aren’t good candidates for OAT?
Who gets sleep apnea?
Sleep apnea occurs in all age groups and both sexes but is more common in men. At least 4% of middle-aged men and 2% of middle-aged women have sleep apnea with excessive daytime sleepiness. People who are most likely to develop sleep apnea include:
- Those who snore loudly
- Are overweight
- Have high blood pressure
- Have a physical abnormality in the nose, throat/or other parts of the upper airway
- There is also some evidence for familial tendencies, suggesting a possible genetic basis
Discuss your symptoms with your physician or Dr. Schapansky. If Dr. Schapansky suspects that you have OSA, he will send you home with a special sleep monitoring device – worn on your wrist. This device will then record your critical sleep data thus allowing the doctor to better treat your sleep issues. After the results of the test are reviewed and a diagnosis is made, different treatment options are discussed.
Oral appliances (OA) that end snoring, UARS, and OSA are devices worn in the mouth similar to sports mouth guards or orthodontic retainers. They are made of plastic and fit partially or completely within the mouth. Currently there are over 40 different types of oral appliances available. OA’s may be used alone or in combination with other means of treating sleep apnea, such as weight management, surgery and CPAP. There is no one particular appliance that will work for every patient. Any dentist supplying oral appliances must be familiar with several different types.
Advantages of using an Oral Appliance:
- Oral Appliances are small and convenient, making them easy to carry when traveling
- Treatment with oral appliances is reversible and non-invasive
- Easily adjustable
- Easy to wear and more comfortable than CPAP, resulting in increased compliance
How do I know if I am a candidate for an oral appliance?
Your sleep specialist will evaluate the severity of your condition. If he/she feels that you are a good candidate for OAT, Dr. Schapansky will further evaluate your oral condition and discuss your treatment options.
As a specially trained dentist in the treatment of OSA and Oral Appliance therapy, Dr. Schapansky considers many factors before choosing which appliance may be best suited for each individual. After your primary care provider or sleep physician confirms your diagnosis and decides that you are a candidate for OAT, the Central California Sleep Center begins with a very comprehensive examination of your oral cavity. Along with evaluating your PSG results, CCSC will then discuss lifestyle factors and sleeping habits such as:
- Manual dexterity
- Travel destinations (3rd world countries, etc.)
- Preferred sleep positions
- Oral cavity restrictions (anatomical structures)
Oral appliances work in several ways:
- By repositioning the lower jaw, tongue, soft palate and uvula
- By stabilizing the lower jaw and tongue
- By increasing the muscle tone of the tongue
- Through the above actions, the tissues and tongue are prevented from collapsing in keeping the airway open and unobstructed. Since air flows freely into the lungs, the forced flow of air and vibrations of the tissue (known as snoring) do not occur.
Most medical insurance policies will cover the OA when OSA is diagnosed. In the case of simple snoring, most policies do not currently pay for the OA. However, there is no question that for a snorer, the OA is the best investment he/she can make in his/her health and domestic tranquility.
Are there any long term health consequences to snoring/ Obstructive Sleep Apnea (OSA)?
In patients with untreated sleep apnea, the lowering of blood oxygen levels can contribute to the development of heart irregularities. In addition, blood pressure can be elevated due to the stress on the heart, and at least 33% of people with sleep apnea have high blood pressure. Because of the cardiovascular effects, sleep apnea is known to be a cause of sudden death during sleep, although this is an uncommon occurrence.
What will Dr. Schapansky do if I need an oral appliance?
On your first visit, Dr. Schapansky will examine your teeth and mouth thoroughly and may confirm your oral health status with x-rays. If it is concluded that OAT is the best treatment option for you, dental impressions may be taken. These impressions are used by the laboratory to fabricate your custom made oral appliance. Once you have been wearing your appliance regularly and symptoms such as snoring or daytime sleepiness has been reduced, Dr. Schapansky will refer you back to your physician to determine how effective the appliance is for you. Regular recall visits to the Central California Sleep Center are important to maintain or modify your oral appliance over time.
Patients using Oral Appliance Therapy may experience the following side effects:
- Excessive salivation or dryness
- Morning soreness in the teeth or jaw muscles
- Minor/moderate tooth movements
Most of these side effects improve within a few weeks of regular use and some adjustments of the appliance. Periodic recall maintenance by Dr. Schapansky is important to track any potential side effects such as tooth movements as well as to maintain/adjust the appliance. Patients with arthritis and chronic jaw joint dysfunction may have difficulty tolerating an OA.
No. Since it’s so common, most people assume it’s only a nuisance to the bed partner. However, besides being disruptive to close relationships, snoring is a sleep-breathing disorder and can lead to serious health problems.
It is always best to evaluate if you are a good candidate for OAT during your initial consultation with Dr. Schapansky. There are several conditions that may be contraindicated for OAT:
- Central Sleep Apnea as opposed to Obstructive Sleep Apnea
- Fibromyalgia and severe arthritis
- Poor dental health
- Chronic untreated TMJ symptoms
- Very obese individuals
- Limited jaw movements