Your sleep impacts every aspect of your life and daily health. Continual research is linking sleep problems/ sleep disordered breathing to chronic health conditions and even shorter life expectancy. There are many ways a sleep problem can be harmful to your health and well-being. One of the most common types of sleep disordered breathing is snoring. Snoring can be a major cause of daytime dysfunction and cardiovascular disease, yet it is often ignored.
Snoring is a sound that occurs during sleep when soft tissue in the upper airway vibrates as you breathe. Snoring is more common in men, but also occurs frequently in women, especially during pregnancy and after menopause. In fact, women are the most undiagnosed population with sleep disordered breathing including disturbances from snoring. Obesity, nasal obstruction, alcohol and smoking all increase the risk of snoring. Snoring is reported to affect 90 million American adults, 19% to 37% of the general population, and more than 50% of middle-aged men. Approximately one out of two snorers suffers from sleep apnea.
Snoring can occur in inspiration and less likely during expiration. It can occur during any stage of sleep but is more common during stages 2, 3, and 4. This is because airway elasticity and muscle tone are different during rapid eye movement (REM) and non-REM sleep. It is during REM sleep when your airway is most likely to be compromised as the body goes into deep paralytic sleep. Multiple predisposing factors can lead to a snoring abnormality, including age (middle or advanced), obesity, weight gain, body posture, use of alcohol and muscle relaxants, deficiencies in facial development, nasal blockages, development of asthma, and smoking.
Snoring is the most common symptom in both children and adults of sleep apnea. Children should never regularly snore and should always be evaluated further if they snore. Due to growth factors, children age 2-5 are most likely to present with snoring, and this maybe a crucial time in their development to monitor and instill healthy habits to prevent sleep disordered breathing. Not all patients have sleep apnea and not all patients with sleep disordered breathing snore, but it is important to remember symptoms of sleep disordered breathing are likely to worsen with age.
There is controversy over whether benign snoring (snoring not deemed significant) is really insignificant. Benign snoring may have minimal disruption to sleep in its early stages. Over time as the patient ages or has changes in health their snoring or upper airway resistance may increase and lead to snore arousals. The snoring begins to cause many arousals during sleep without affecting the blood oxygen levels and essentially this is what robs the individual of their restorative sleep. This is why patients who have non-symptomatic snoring as young children or adults can become symptomatic later in life. Thus, it is important to recognize signs and symptoms early in a child’s development to best prevent and develop healthy airways.
While dentists provide a crucial role in screening for sleep disordered breathing, a doctor must determine if your snoring is a sign that you have a sleep disorder. A doctor who is a sleep specialist can provide you with a complete sleep evaluation and diagnosis after a sleep study (polysonogram) or home sleep study. There are many treatment options for sleep disordered breathing that causes snoring. The consequences of the patient’s snoring, the probability that apnea is present, and compliance factors can all influence successful treatment.
How is Snoring Treated?
Treatment options range from mouth taping or nasal dilators cones/strips to ensure nasal breathing, mandibular advancement devices and a CPAP (continuous positive airway pressure). Especially in children, evaluation by other professionals, such as ENTs, is crucial towards treatment of sleep disordered breathing involving snoring. Lifestyle modification should be addressed in all patients who snore, including reduction of risk factors such as obesity, alcohol consumption, tobacco use, and use of muscle relaxants. In addition, practicing good sleep hygiene and getting quality sleep needs to be a priority.
Oral appliance therapy in the hands of a qualified dentist using the proper protocol is the first line of treatment for mild and moderate sleep apnea
When the less invasive strategies fail, the most common treatment for sleep disordered breathing including snoring and apnea is oral appliance therapy. Research shows that oral appliance therapy is an effective treatment option for snoring and sleep apnea. An oral sleep appliance is worn in the mouth only while you sleep and fits like a sports mouth guard or an orthodontic retainer. Oral appliances support your jaw in a forward position to keep the oral airway open. Oral appliances are quiet, portable and easy to care for. In 1995, the Task Force for the Standards of Practice Committee of the American Sleep Disorders Association recommended offering oral appliances to all non-apneic snorers. In addition, oral appliances are most recommended for those with mild to moderate apnea or when a patient cannot tolerate a CPAP.
The most common and effective treatment for severe apnea is the CPAP. The CPAP machine requires you to wear a mask and keeps your airway open by providing forced air through flexible tubing when you are sleeping. Although CPAP therapy is effective, some people are unable to tolerate it. If you are unable to tolerate CPAP therapy, or prefer an alternate treatment, talk to your doctor or dentist about an oral appliance. Many people like an oral appliance because it is comfortable, quiet, portable and easy to wear. In some severe cases of sleep apnea, upper airway surgery may be another treatment option.
At Rock Valley Dental we can assist you with any concerns you have about sleep disordered breathing, particularly snoring. It is part of our mission to provide the best resources for your health no matter where you lie on the sleep disordered breathing spectrum. Contact us to learn more about how dentistry can help you or a loved one with snoring.