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Snoring and sleep apnea

Loud snoring, waking up tired, and gasping in the night can all point to obstructive sleep apnea, where the airway collapses during sleep. A dentist cannot diagnose it, which needs a sleep study, but can screen for it and treat snoring and mild to moderate cases with a custom oral appliance that holds the jaw forward.

What obstructive sleep apnea is

During sleep the muscles holding the airway open relax. In some people the airway narrows enough to reduce airflow, or closes completely for seconds at a time. The body responds by briefly waking to restore breathing, over and over, often without the person remembering any of it.

The result is a night of sleep that does not restore anything, and over years it is associated with raised blood pressure and other cardiovascular problems. It is worth taking seriously.

The signs

  • Loud, habitual snoring
  • Someone reporting that your breathing stops
  • Waking with a gasp or a choke
  • Waking with a dry mouth or a headache
  • Sleeping a full night and still being exhausted
  • Falling asleep during the day when you did not intend to

What a dentist can and cannot do

Can: screen for it, recognise the signs in the mouth, refer you for a proper sleep study, and treat snoring and mild to moderate diagnosed apnea with a custom oral appliance.

Cannot: diagnose it. That needs a sleep study interpreted by a physician, and saying otherwise would be both wrong and outside what any dentist is qualified to do.

Dr. Diala holds a certification in dental sleep medicine from the American Academy of Dental Sleep Medicine and has spent time in the pulmonary department at CMC, which is why this is offered here at all. More about her training.

What happens at a screening appointment

A conversation about your sleep and your daytime tiredness, a structured questionnaire, and an examination of the airway, jaw and tongue. If the picture suggests apnea, the next step is a sleep study, and we refer you for one.

Where a sleep study confirms mild to moderate apnea, or where the problem is snoring without apnea, an oral appliance is a reasonable treatment and we can make one.

Where a study shows severe apnea, CPAP is the better treatment and we will say so rather than sell you a device that is not the right answer.

Referral

Where a sleep study or a CPAP assessment is needed, we refer you to a sleep physician. Ask at the appointment and we will make the arrangement rather than leaving you to find someone.

In more detail

Questions people ask

No, and be wary of anyone who says otherwise. Diagnosis requires a sleep study, which measures how often your breathing stops and how far your oxygen falls, and it is interpreted by a physician. A dentist can screen you, tell you whether a study is warranted, and treat certain cases once diagnosed.

No. Plenty of people snore without their breathing stopping. The features that point towards apnea are pauses in breathing that someone else notices, gasping or choking awakenings, waking unrefreshed after enough hours, and heavy daytime sleepiness. Snoring alone is a reason to ask the question, not an answer.

Because the airway collapses in a space bounded by the jaw and the tongue, and a dentist can change the position of both with a custom appliance. Dentists also see the consequences early: worn teeth from grinding, a dry mouth, and a scalloped tongue are all things we notice before anyone has mentioned sleep.

That is one of the clearest reasons to look at an oral appliance. CPAP is more effective when it is worn, but an appliance that is worn every night beats a machine in a cupboard. This is a conversation to have with your sleep physician and us together.

Appointments

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