Many people with sleep apnea feel tired even after a good night’s sleep. Other symptoms include snoring, headaches or depression. A sleep specialist may recommend a CPAP machine. This provides a constant flow of air pressure to keep the throat open. Other treatment options include oral appliances, surgery or a change in sleeping habits.Oral appliance therapy can reduce snoring, obstructive sleep apnea treatment and daytime sleepiness. However, it is important to note that oral appliances can cause side effects like excessive salivation; tongue enlargement or retraction; changes in teeth and bite; gum recession; soreness of the temporomandibular joints; and bruxism. Follow-up care is needed to monitor for these side effects and make adjustments. Visit your local dentist regularly, and bring your sleep apnea device with you to all future dental appointments.
Oral Appliances
A variety of specialized dental appliances can prevent the soft tissue from collapsing during sleep and occluding the airway. These devices are worn in the mouth and range in design from one-piece appliances that do not leave room for lateral movement of the lower jaw, to two-piece appliances that differ in permissible lateral jaw movement and coupling mechanisms. A qualified dentist trained in dental sleep medicine will select the appliance best suited to your mouth and bite, and ensure it is properly fitted and used.
A custom-made titratable mandibular advancement device (MAD) has been proven effective in reducing the severity of obstructive sleep apnea in the vast majority of patients. Tongue-retention appliances and tongue stabilizing devices (TSDs) can also be helpful in some patients, but are not as effective as MADs.
Upper Airway Stimulation
The muscles in your mouth and throat relax when you sleep, which can cause a narrowing or blockage of the airway. This is called obstructive sleep apnea. Stimulation of these muscles during sleep may help to keep the airway open. This is an emerging treatment option for some people with obstructive sleep apnea.
A device that monitors breathing and sends a gentle electric pulse to the hypoglossal nerve while you’re sleeping may help to open your airway. This type of therapy is called upper airway stimulation or uAST. The device can be used alone or with other therapies, such as oral appliances or CPAP.
An alternative to a uAST device is an NMES (non-invasive stimulation) oral device that provides a gentle electrical stimulus during wakefulness. A dentist who specializes in sleep disorders can design and fit the mouthpiece for you.
Untreated obstructive sleep apnea can lead to serious health problems. It may reduce your quality of life and lead to accidents in the workplace or at home. Be sure to follow the treatment plan that you and your provider develop for the best results. This will include regularly scheduled appointments for follow-up. Then you can be sure that your sleep apnea is being effectively managed. This will allow you to feel more alert throughout the day and decrease symptoms such as snoring, gasping and choking while sleeping.
Surgery
Obstructive sleep apnea occurs when the throat muscles relax too much, allowing soft tissues to collapse into the airway. If you don’t find relief from CPAP therapy or oral appliances, we may recommend surgery.
A jaw procedure called maxillomandibular advancement repositions the upper and lower parts of the mouth (the maxilla and mandible). This moves the back of the tongue and soft palate forward, which makes breathing easier and lessens snoring. However, this type of surgery isn’t very effective for people with central sleep apnea.
Other surgery options include a palatal expansion or tonsillectomy to remove excess tissue in the throat and nose. Another surgery reduces the size of the uvula and palate by inserting rods in the tissue that stiffen when scarred, improving airway opening and easing snoring. Another option is a hyoid suspension, which repositions the hyoid bone in the front of the neck to keep it from falling into the airway during sleep.
All surgical procedures carry risks. Regardless of the procedure you undergo, follow your doctor’s advice for recovery. Also, follow a regular exercise program to maintain a healthy weight and avoid sedatives and alcohol. You should also see your doctor if you experience any symptoms of sleep apnea after surgery. These can be a sign that your treatment isn’t working or that your condition has returned.