When we talk about snoring, it is usually in a humorous manner, poking fun at our spouses or friends over a light-hearted conversation. That’s because many of us do not see snoring as something to be worried about. In actual fact, loud and persistent snoring may be a sign of obstructive sleep apnoea (OSA).

Obstructive sleep apnoea is a common and potentially serious disorder that causes the sufferer’s breathing to be interrupted during sleep. The condition occurs due to an obstruction to your airflow such that your breathing repeatedly starts and stops during sleep – each breathing pause typically lasting for about 10 seconds or more.

Besides snoring, other common symptoms of sleep apnoea include daytime fatigue, excessive sleepiness and lack of concentration. Untreated sleep apnoea may be detrimental or even dangerous to one’s health. If you suspect that you may have the condition, it is important to see your doctor or consult a sleep physician about your concern.

Do you have obstructive sleep apnoea?

One of the reasons that obstructive sleep apnoea remains an under diagnosed condition is because most of the prominent symptoms occur when you are asleep, so it can be difficult to identify the signs on your own. There are two ways you can counter this problem: Ask a bed partner to observe you when you sleep or by making an audio/video recording of yourself sleeping. If loud and persistent snoring is observed, accompanied by pauses between the snores or choking and gasping after the pauses, these are telling signs that you have obstructive sleep apnoea.

Besides observing your nocturnal habits, you should also look out for the ‘daytime’ symptoms. The repeated breathing pauses – approximately once per minute – can significantly rob you of the adequate rest you need during sleep. The effects of sleep deprivation are likely to manifest during the day, when the sufferer would experience them most profoundly.

Let’s take a summarised look at these sleep-time symptoms and daytime effects:

Night:

  • Loud and chronic snoring
  • Breathing pauses
  • Choking and gasping following pauses in breathing
  • Waking up feeling shortness of breath
  • Going to bathroom frequently

Day:

  • Dry mouth or sore throat in the mornings
  • Consistent morning headaches
  • Lack of concentration/ forgetfulness
  • Impotence
  • Uncharacteristic irritability and mood swings
  • Depression
  • Insomnia
  • Excessive sleepiness

Sleep apnoea in children is harder to identify. Children are usually brought to see a physician when caregivers observe their loud and continuous snoring. Other less obvious symptoms (that may also relate to other conditions) include: Excessive perspiration when they sleep, bed-wetting or night terrors (suddenly waking in the night with feelings of intense fear). If you observe these symptoms in your child, you may wish to consult a paediatrician who specialises in sleep disordered breathing (SDB). For children with OSA, surgical removal of tonsils and adenoids is typically the first line of treatment.

Self-help treatments and lifestyle remedies

When you have been diagnosed with obstructive sleep apnoea, it can be a worrying experience. However, you should also be encouraged by the fact that it is a treatable condition. For mild to moderate forms of sleep apnoea, you can even employ home remedies and lifestyle modifications to alleviate the symptoms. While lifestyle changes and home treatment methods can go a long way to help with the condition, they do not replace proper medical diagnosis and treatment, as performed by, or under the supervision of, a trained healthcare professional.

Here is a list of lifestyle changes and self-treatment methods that are known to improve the quality of sleep for OSA sufferers:

Lose weight: One of the major influencing factors in sleep apnoea is being overweight. The majority of OSA sufferers are at least slightly overweight. Even a marginal amount of weight loss of between 5-10 per cent can open up the throat and improve the sleep apnoea condition.

Exercise regularly: It is important for OSA sufferers to commit to an exercise program. Not only does it help in weight loss, it can help to reduce sleep apnoea symptoms and improve the duration and quality of your sleep.

Quit smoking: Cutting back on smoking will help, especially if you are a heavy smoker. The nicotine in cigarettes is a strong stimulant that is known to induce insomnia in people who smoke before going to bed. It is also believed to increase fluid retention and inflammation in your throat, thereby contribute to blockages in the upper airway.

Reduce alcohol intake: Alcohol significantly reduces the firmness of your muscles, causing the breathing muscles to sag. Excessive alcohol intake can lead to airway congestion and breathing difficulty.

Sleep regular hours: OSA sufferers need to relax and get plenty of sleep in order to reduce the number of apnoea episodes.

Pre-bedtime abstinence: Stay away from caffeine, heavy meals, sleeping pills and sedatives before bedtime. They are known to relax your throat muscles and interfere with breathing.

Change sleeping position: Sleeping on your side can help to reduce the sleep apnoea symptoms. That’s because your tongue and surrounding soft tissue tends to slip towards the back of your throat – and possibly – obstruct your airway when you sleep on your back.

Oral appliance therapy

If you have been diagnosed with Obstructive Sleep Apnoea, your doctor or sleep physician may have recommended oral appliance therapy as a treatment of choice. While Continuous Positive Airway Pressure (CPAP) is the most commonly prescribed treatment, many patients struggle to comply with its directives. Depending on the nature and severity of their sleep apnoea condition, CPAP users who experience compliance issues can successfully transition over to oral appliance therapy. The dental solution is typically recommended for the treatment of mild to moderate OSA cases.

The Mandibular Advancement Device/ Splint (MAD/ MAS) is a TGA-approved oral device that is most commonly used in the treatment of obstructive sleep apnoea. Consisting of two splints that are worn over the upper and lower teeth, the Mandibular Advancement Device helps to push the user’s lower jaw forward relative to the position of the upper jaw. By advancing the lower mandible (lower jaw), the device opens up the user’s airway and prevents the surrounding soft tissue from collapsing on it. In so doing, the oral appliance helps to reduce snoring as well as the number of apnoea events that occur throughout the night.

The oral device is custom-made so that it fits snugly on your teeth, conforming exactly to your teeth structure for optimum comfort and precision. Offering a pain-free alternative to surgery, the procedure is no different from an athlete fitting a mouthguard. Like the mouthguard, it is small and unobtrusive, allowing the wearer to talk and drink without removing the splint.

Oral appliance therapy involves a safe, painless and non-invasive therapy that can be administered by a dentist with specific training and education in the application of sleep apnoea oral devices. Based on the severity of your condition, tongue size, bite quality, jaw structure and other factors, the dentist would be able to recommend and supply the best possible oral appliance solution to address your specific issues.

CPAP vs Oral Appliances

Obstructive Sleep Apnoea Treatment infographic
Infographic by Sound Sleeper.

If you have any questions about the type of oral appliance that is suitable for your sleep apnoea condition, please contact Albany Dental for a consultation at (07) 3264 9590.