OSA 2017-11-01T21:39:03+00:00

Now that you know the symptoms of OSA are you experiencing any of them?  How will you know if it is really sleep apnea?  Click here to take a short quiz that will let you know the likelihood of you having OSA.  This test is a great tool to use when you discuss your symptoms with your doctor.  It is surprisingly accurate.

What are some of the risk factors and causes of OSA?

  • Small mouth
  • Large tongue
  • Narrow arches of the mouth and/or small jaw bone
  • Large neck (women >16” and men >17”)
  • Missing or extracted teeth (making less room for the tongue)
  • Obesity
  • Medications
  • Large tonsils, adenoids and/or poor nasal airways
  • Pregnancy
  • Family history
  • Irritability
  • Middle age (over age 40)
  • Male gender

Untreated OSA can lead to…

  • High Blood Pressure
  • Stroke
  • Heart attack
  • Depression
  • Reduced sex drive
  • Type 2 diabetes
  • Metabolic syndrome
  • Liver problems
  • ADHD
  • Work and driving related accidents
  • Sleep deprived partner

I’m fairly certain I have sleep apnea, how do I find out?

A sleep study is the next step.  There are two types of diagnostic sleep tests, a PSG (Polysomnography) or HST (Home Sleep Test). Depending on your medical insurance, you may or may not need a referral from your primary care doctor for a sleep test. Also depending on your medical insurance coverage, you may be eligible for an HST rather than a PSG. 

A PSG is more comprehensive than an HST in that it is a comprehensive recording of the biophysiological changes that occur during sleep.  It is usually done at a sleep center and it monitors many functions including the brain, eye movements, muscle activity and heart rhythms. 

If the idea of sleeping overnight in a lab is keeping you from seeking a diagnosis, the HST may be a better option.  An HST, also called an unattended sleep test, can be done in the comfort of your own bed and it is usually done over 1-3 nights.  This test monitors oral and nasal airflow, oxygen levels in your blood and respiratory effort.  Even if your insurance will not cover an HST, there are currently companies that will provide you with an HST unit for under $300.00. 

In addition, if you just don’t want that diagnosis of “OSA” on your permanent medical record, paying out of pocket for an HST may be the answer.

I have sleep apnea, now what?

There are several different treatment methods for OSA.  The treatment methods differ depending on the type of OSA you have and the severity of it.  It is important that you know and understand all of your treatment options, and the pros and cons and risks vs. benefits of each option.  It is also important to know what you can do to try to decrease the severity of your OSA, or possibly correct it. 

  • Weight loss (if overweight)
  • Avoiding alcohol and / or sleeping pills
  • Changing sleeping positions to improve breathing and avoiding sleeping on your back
  • Stopping smoking
  • Improving airways (removing large tonsils/adenoids, repair deviated septum, treat allergies, orthodontic arch development)
  • CPAP (Continuous positive airway pressure)
  •  BPAP (bi-level positive airway pressure)
  • Implanted upper airway stimulator devices
  • Surgery, from soft tissue to jaw advancement there are many options, several of which the long term effectiveness is unknown
  • Dental Devices, aka, Oral Appliance Therapy – WE DO THIS!!!

ORAL APPLIANCE THERAPY FOR SLEEP APNEA

How does a dental device treat sleep apnea?

OSA occurs when there are repeated occurrences of the upper airway being blocked during sleep. “Apnea” is defined as the cessation of breath. An oral appliance treats mild, moderate and severe OSA by moving the lower jaw slightly forward. This movement tightens the soft tissue and the muscles of the upper airway, which prevents obstructions while you sleep. The oral appliance also prevents the tissues of the upper airway from vibrating as air passes over them, thus frequently reducing snoring.  

Though oral appliances for the treatment of sleep apnea are recommended primarily for patients with mild to moderate OSA, we have several patients that are being effectively treated with severe OSA.  The way that we know for sure is by having a sleep test with the appliance in to confirm the efficacy of it.  Then you can make a choice.  There doesn’t have to be one answer.  Some patients chose the oral appliance instead of the CPAP.  Some patients alternate, using the oral appliance for travel or camping, etc. or when they need a break from the CPAP.  In cases where the oral appliance reduced the apneas but not to 5 or less per hour, some patients chose a combination therapy where they used the oral appliance together with the CPAP, but the CPAP was set at a lesser, more tolerable pressure.   Then there are those patients that can only tolerate the CPAP for a few hours before they unconsciously remove it.  Those patients can keep the oral appliance next to their bed and put the appliance in upon the removal of their CPAP.  The point is, you have choices and options.  Take control of your treatment and do what is best for you.

 Why choose Dr. Brown to be my OSA dentist?

Dr. Brown does not just assume that by moving the lower jaw forward and open, the obstruction is corrected. Instead, he uses an acoustic ecchopharyngometer to measure each patient’s airway. This diagnostic tool fits in the patient’s mouth like a snorkel. The patient then breathes thorough their mouth while the ecchopharyngometer sends clicking sound waves down their airway, capturing a baseline measurement. Next the patient is instructed to move their lower jaw open or forward, or both until the ideal position can be recorded. We order the appliance to be made to accommodate this position. On rare occasions the airway size isn’t increased enough by repositioning the jaw.  The ecchopharyngometer will show us that.  In this case, other treatment options will be discussed. Dr. Brown will not make an oral appliance when it shows that it won’t help.

 The Eccovision® Acoustic Pharyngometer allows users to quickly and easily measure a patient’s pharyngeal airway size and stability from the Oral Pharyngeal Junction to the Glottis.

The Pharyngometer graphically displays the relationship between the cross-sectional area of the airway and distance down the airway in centimeters.

Studies have shown a clear relationship between the existence of OSA and a narrow, collapsible, airway. The Pharyngometer accomplishes these measurements using acoustic reflection technology, similar to a ship’s sonar.

Sound waves are projected down the airway and reflected back out in such a way that the Pharyngometer software can analyze and quantify changes in the airways cross-sectional area. The test is minimally invasive and takes 2-5 minutes to complete.

Is Oral Appliance Therapy for OSA covered by medical or dental insurance?

Oral appliance therapy is a medical service, not dental.  Most medical insurances do cover this treatment method, including Kaiser and Medicare.  Though we are out of network with many of the medical insurance companies, we can verify your benefits and request that a GAP waiver be allowed to cover our services.  We are in network with Kaiser Permanente.

Outside of the insurance companies, we do offer no interest payment plans, Care Credit and accept all major credit cards.  Our services are also eligible for Flex and HSA plans.

Our goal is to minimize your stress by providing you with optimal service.