Did you know that a snoring problem could be a sign of dangerous conditions such as heart disease or stroke?
And did you know that many dentists – yes, dentists – can help?
And that their revolutionary sleep apnea diagnosis and treatment is faster and cheaper than what your physician provides?
Please get in touch with your healthcare professional if you have any questions or concerns about your health! I have not been compensated for any product or information in this post.
Snoring is, as everyone knows, irritating as hell for your sleeping partner.
But it may be worse for you than you thought.
Not all snorers suffer from obstructive sleep apnea (OSA), which is when breathing ceases for a period while sleeping due to airway obstruction in one or more places within the nasopharyngeal area.
However, if you do have sleep apnea, or other sleep-related disorders, snoring problems are not just a consequence, but serious warning signs.
To be clear, obstructive sleep apnea may signal bad news for your health.
It’s awful to snore in the first place; no earplugs have ever been devised that are strong enough to enable bed-sharing spouses to tolerate it for very long. Invariably, snorers and their spouses’ lack of good sleep causes them to end up suffering from exhaustion and irritation.
"Sleep studies conducted on 942 patients complaining of insomnia … diagnosed 91% of them with sleep apnea in the moderate to severe range. The real reason for the vast majority of us having difficulty sleeping is OSAs." -Dr Krakow, Mayo Clinic Proceedings 9/15/2014
Everyone knows someone who can’t stay awake during the day because of poor sleep. In my young adult son’s case it’s because he’s up playing videogames half the night. If that’s not you, and you do try to sleep but have poor results, keep reading.
Sadly, OSA, of which snoring problems are a major symptom, can indicate serious heart troubles or strokes in your future.
As a result of researching for this post, I’ve learned some, frankly, frightening statistics:
Untreated OSA could take up to 12-15 years off your life (worse than smoking or diabetes).
Men aged 40 to 70 with severe sleep-disordered breathing were twice as likely to die from any cause as healthy men the same age.
Despite these sobering statistics, less than 10% of OSA sufferers have ever been diagnosed. Of those, less than 25% have been successfully treated.
What are the risk factors of OSA?
Various situations beyond excessive daytime sleepiness may mean OSA is a disorder you’ll want to investigate.
Specifically, these risk factors include:
- Obesity and Large Neck Circumference
- Mouth Breathing
- Family History of OSAs
- GERD (acid reflux)
- Morning headaches
- Sexual Dysfunction
- Social Problems
- Memory Problems
- Bruxism (teeth clenching/grinding)
- Nocturia (getting up in the middle of the night to pee)
So how can my dentist help?
As I underwent my quarterly teeth cleaning (I have been cursed with gum disease), I chatted up Shawna, my fabulous dental hygienist. Having to visit her four times a year, I like to hear how her family is doing and vice versa. My favorite is when she asks me just about anything and all I can respond is, “Gsshadtsssppppp.”
Anyway, with her Juan de Torquemada-inspired dental instruments hacking away at the yuck in my mouth, I mentioned something unintelligible about my lack of sleep. Luckily, Shawna understands my garbled English. She told me about a new program at the dentist’s where they would determine if I had sleep apnea, and, if so, whether a specially constructed mouth guard would help.
Two special benefits would result from this alternative process of diagnosing and treating OSAs: First, I could dispense with undergoing an expensive night at a sleep lab. It is notoriously difficult to sleep well at these facilities, and paying well over a thousand dollars out of pocket to have a test done doesn’t help!
Second, if it was determined that I have OSA, I could potentially benefit from the special mouth appliance they would fashion me. These appliances are custom made and specially designed to keep the airway from collapsing.
To CPAP or Not to CPAP
Now, you or someone you know probably uses a CPAP machine to help with their OSA. CPAPs are a safe and effective treatment; however, compliance with their use is 10-60% only in the long term.
Many CPAP users, it seems, complain of sore skin where the material contacts their nose, mouth and face all night long. CPAPs can exacerbate claustrophobia, and they can cause chest discomfort and congestion.
It made sense to me that a mouth appliance could provide a reasonable alternative to CPAPs, and that a specially-trained dentist could fashion it.
I mentioned to Shawna, my hygienist, that as it happens, I’m studying sleep and stress therapies for my website. I had hit a road bump when it came to products to help people with a snoring problem. There didn’t seem to be anything worthwhile “over the counter,” and I knew affording a sleep study was out of the question given everyone’s super high deductibles.
I said I had seen some oral appliances for sale on Amazon but when I researched them, they looked like they could do some damage to one’s jaw alignment. Shawna’s eyes bugged out as she indicated they were far worse than even that. She said for some poor folks with OSAs, using these appliances had the effect of cutting off users’ breathing entirely!
Hard pass on those, thank you.
The Dentist’s Pre-Diagnosis Procedure
As someone who suffers from a few of the listed associations with OSA, it was a no-brainer for me to undergo the free testing offered right there at my dentist’s office. I was eager to see whether I could qualify to move forward with this special OSA therapy Shawna and I discussed.
The dentist office’s techs took my blood pressure and did a pulse ox. They asked whether I clenched or grinded my teeth. They wondered whether I suffered from morning headaches, GERD, or a few extra pounds. The circumference of my neck was measured.
I also filled out a short questionnaire about whether I fell asleep during the day and if so, under what circumstances. It seems if you score high enough on the questionnaire, your medical, not dental, insurance will cover your treatment.
Do I even need to mention that I do snore?
So far, so bad good. I sat in a chair next to their equipment for a sort of pre-test to determine whether to move forward in obtaining a diagnosis.
My tech started off with a non-painful, non-invasive “Rhinometer Test.” An apparatus that looked like a solid turkey baster was placed under my left nostril, and I was instructed to breath normally.
Then after a beep, I was told to hold my breath until told I could release it. Another beep, and I could breathe again. The apparatus was placed by my right nostril, and the breathing instructions repeated. The tech noted I had a slight nasal obstruction on my right side.
After the nasal fun was complete, a different apparatus was inserted into the front of my mouth for my “Pharyngometer Test.” Again, I breathed normally, then stopped when instructed.
At the end I was told to exhale and expel every last bit of breath possible. I raised my hand when I had done so, and that was the end of the testing.
It didn’t hurt at all. It turned out that, lo and behold, I suffer from poor airway stability causing my snoring problem and likely OSA.
The Next Step in Treatment
The dentist and tech recommended, given my unstable airway, that I take a special tester home with me known as an ARES (Apnea Risk Evaluation System). You sleep with it for two nights in a row.
The ARES (Apnea Risk Evaluation System) tester is a small device worn on the forehead, wrapped gently around your head; short little tubes from it are inserted into your nostrils and record data such as when you’re lying still, when you’re upright, and when you’re not breathing (as happens with sleep apnea). Other data such as air flow, pulse, and oxygen saturation are taken into account.
The machine and associated record keeping costs a fraction of the expense of an overnight sleep lab. Best of all, you can do the testing while slumbering blissfully right there in your own bed!
My plan at this point is to save some pennies and grab the testing apparatus for an official OSA diagnosis next time I go in for a teeth cleaning.
Since I probably do have OSA, the next step post-diagnosis will be to have the oral appliance custom made for me. I'll keep you all up to date on my progress with these steps towards restful sleep.
Because according to the article "Dental Appliance Treatment for Obstructive Sleep Apnea" from the scientific journal CHEST,
Oral appliances have been shown to have a beneficial impact on a number of important clinical end points, including the polysomnographic indexes of OSA, subjective and objective measures of sleepiness, BP, aspects of neuropsychological functioning, and quality of life.
The authors point out that patients tend to prefer the oral devices to CPAPs.
Avoid the twin dangers of unchecked OSAs and sleepless spouses. To learn more about the innovations in treating sleep and snoring problems -- at the dentist’s, no less – I highly recommend you check in with your dental professional and see if he or she practices “Dental Sleep Medicine.” Grab a reading pillow, get comfy, and let me know what transpires in the comments!
Many thanks to Dr Thunga, Shawna, and all the staff at Optimal Family Dental in Mason, Ohio! I have been a happy patient there for years. If you are local to the Cincinnati area, please check them out!