Snoring – The Tip of the Iceberg

Snoring – The Tip of the Iceberg

mackieby Kristina Mackie, DDS
Loretto Family Dentistry, PLLC

Snoring can range from a minor nuisance problem to a deal-breaker for couples coexisting in the same bedroom. Snoring can exist by itself or may be a major red flag for a serious underlying problem called Obstructive Sleep Apnea (OSA). So what can be done about it?

First, let’s walk through a few signs and symptoms which may point to a potential problem as most patients are unaware a problem even exists. Patients with elevated blood pressure, history of stroke, loud snoring with possible choking or gasping, acid reflux, restless leg, daytime drowsiness, morning headaches, tooth breakage and wear, and TMJ dysfunction may be at risk. I’ve found in my practice of screening patients for this condition that oftentimes, nasal allergies, chronic sinusitis, and nasal obstructions will be present. The reason behind this is if we cannot breathe through our nose, we can only breathe one other way; through the mouth. As we sleep, the tone of the airway and jaw muscles decreases. Everything becomes relaxed and loose. As this occurs, the lower jaw and tongue are allowed to drop back narrowing or completely shutting off the airway. The brain does not allow for this to happen for long before it forces us to wake slightly, bite down with great force to advance the lower jaw and/or reposition ourselves in bed. As we do this, muscle tone increases and the airway is opened. We may not recall waking at all during these episodes as they may occur in different stages of sleep. This is why our bed partner may notice a problem and force us to roll over yet we may not recall much if anything at all. We may just notice how exhausted we feel the next day.

To receive proper diagnosis and treatment for this condition, sleep testing (polysomnography) is needed. This can be done in a sleep lab or through a home sleep testing device. I provide my patients with a home sleep testing device called ARES™ if there are indications OSA may be present. In my time doing this, I’ve had results ranging from mild to very severe OSA. In some instances, the patient requires referral back to their physician for CPAP treatment or surgical intervention. In other cases where mild or moderate OSA is present, a MAD (Mandibular Advancement Device) may be an option for treatment. If this is the case, I am able to treat the patient in my office.

A MAD is a mouthpiece which is worn during sleep that keeps the lower jaw in a forward and slightly open position. This prevents the soft structures of the oropharynx from collapsing. It works in a similar fashion as the “head tilt chin lift “ method to open the airway in administering CPR to a patient who has stopped breathing. Side to side movement is not impeded with the particular device I make. The device also protects the tooth surfaces from wear and breakage, a common problem in those who suffer from OSA.

Snoring can be eliminated altogether. It is vitally important to manage and treat this condition as it can ultimately lead to heart attack and stroke. Proper screening is imperative, and remember, snoring can be just the tip of the iceberg.

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