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Sleep Apnea

What Is Sleep Apnea?

Sleep apnea currently affects about 20 million people every night here in the U.S. alone, making it the second most prominent sleep disorder in the country (behind insomnia). Rates of sleep apnea are steadily growing every single year, and researchers believe this is due to an increasingly sedentary lifestyle that leads to higher rates of obesity (which is a prominent risk factor for sleep apnea).

Sleep apnea is the condition when a person frequently stops breathing for brief periods of time during sleep. When this happens, the concentration of oxygen in your blood decreases which  puts physiological stress on the body, activates the sympathetic nervous system (fight-or-flight), and causes you to partially wake up to restore normal breathing. This can occur 20, 50, or even 100 times an hour without that person realizing it. Overall, this condition prevents a person from completing an entire sleep cycle, which means they don’t get the deep, restful sleep they need to stay awake and feel focused the next day.

There are two distinct types of sleep apnea. Obstructive sleep apnea (OSA) is by far the most common. This occurs when the soft tissues in the mouth and throat relax into and block the airway during sleep. This often presents with loud, persistent snoring.

The less common type is called central sleep apnea (CSA). This is a neurological issue where the brain simply stops sending the body signals to breathe while asleep. It’s also possible for a person to have both kinds of sleep apnea at once, although this is quite rare.

The most common symptoms and warning signs of sleep apnea include:

  • Loud, chronic snoring
  • Gasping for air or waking up feeling out of breath
  • Morning headaches
  • Sore throat or dry mouth in the morning
  • Severe daytime fatigue despite the number of hours slept
  • Difficulty focusing or remembering things
  • Mood swings and other changes in behavior
  • Sexual dysfunction
  • High blood pressure

Diagnosing Sleep Apnea

In reality, it can actually be quite difficult to know if you have sleep apnea or not because the most telling symptoms—short cessations of breathing—occur while you are completely asleep. In most cases, it’s actually a bed partner that initially notices a person may have sleep apnea.

The first step to getting treatment for this condition is to get a proper diagnosis, and our team is ready to walk you through this process step by step. The easiest way to get started is to take our short Epworth Sleepiness Scale assessment. It’s only 8 yes or no questions, and it will give Dr. Baughman important information as to your probability of having a sleeping disorder. After completing it, we’ll contact you to schedule a consultation with Dr. Baughman, and from there, he can recommend you to a local sleep doctor who will perform a sleep study.

A sleep study is a very common medical test that is used to monitor your vital signs while you sleep, and it enables a sleep doctor to definitively determine whether or not you have sleep apnea. You can have the study performed either at-home or in a sleep lab, and afterward, the doctor will recommend the appropriate treatment. If they believe that you would benefit from oral appliance therapy, you’ll then return to Clearwater Dentistry where Dr. Baughman will design and fit you for an appliance.

Don’t Ignore Snoring

Sleep Apnea

To most people, snoring is simply thought of as an unconscious, if not annoying, habit. However, snoring can also indicate serious issues with a person’s sleep. The sound that we’re all familiar with is created by air vibrating the tissues in the mouth and throat as it passes by, and this happens because those tissues are partially blocking the airway. For many people, snoring is a precursor to sleep apnea.

Whether a person has sleep apnea or not, snoring reveals that they are not breathing normally during the night, and this prevents them from getting the best quality sleep possible. Fortunately, oral appliance therapy can be used to help those patients who snore and may be at risk of developing sleep apnea in the future.

Your CPAP Alternative

Continuous positive airway pressure (CPAP) therapy is currently the most often prescribed treatment for sleep apnea in America and around the world. It works by having a patient wear a facial mask to bed that is connected via a hose to an air pump that literally forces oxygen into the airway to keep it open while a person sleeps. As you can imagine, many find this extremely uncomfortable.

The mask can feel very constrictive, leading many patients to experience feelings of claustrophobia. Also, the machine itself can create significant of noise, which can be disturbing not only to the wearer, but more often disturbing to their sleep partner. CPAP machines are also quite bulky, which can limit a patient’s movement while they are trying to fall asleep. This also makes them practically impossible to travel with.

However, at Clearwater Dentistry, a patient can now benefit from an alternative treatment that easily solves all of these problems—oral appliance therapy. With it, all a patient has to do is wear a small, custom-made mouthguard to bed each night to sleep symptom-free.

These appliances work by gently shifting the jaw forward in order to prevent the tissues in the mouth and throat from obstructing the airway. It’s primarily used to treat patients with mild to moderate sleep apnea, but it can also be used in conjunction with a CPAP for combined therapy. The appliances are small, portable, and very easy to use, making them the most patient-friendly sleep apnea treatment available today.

Treatment For Sleep Apnea

Custom oral appliance therapy is an effective treatment for many people with sleep apnea and is approved by the American Academy of Sleep Medicine for the treatment of sleep apnea and snoring. Oral appliance therapy involves wearing a custom made, mouthguard-like appliance that positions the lower jaw forward to open the airway while you sleep. This allows you to breathe and sleep better at night. Most people strongly prefer this over CPAP. Custom oral appliance therapy is covered by most medical insurances. 

Only Dentists with specialized training can provide custom oral appliance therapy. Other treatments for sleep apnea include a combination of custom oral appliance therapy with CPAP or surgery. When thinking about whether to pursue sleep apnea treatment, it is important to remember that untreated sleep apnea can have serious health consequences including stroke, high blood pressure, early-onset dementia, and obesity to name a few.Dr. Baughman partners with board-certified sleep physicians to help determine what is best for you. 

Does Insurance Cover Sleep Apnea Treatment?

In general, yes, but with some insurance carriers and plans things can get complicated very quickly.

Sleep apnea treatment using oral appliance therapy is typically not covered by dental insurance plans despite the fact that the treatment itself is provided by a dentist. However, it is usually covered by medical insurance and Medicare, and this can all make it really confusing for a patient to know how they are covered. To make things even more complicated, more and more dental insurance plans are starting to cover oral appliance therapy as well.

Fortunately, this is where our team of insurance experts can help. When you get oral appliance therapy from Clearwater Dentistry, we’ll help you find the best way to maximize your insurance benefits, no matter where they come from. We’ll file the claim, deal with the paperwork, and help walk you through the process to make saving on your care nice and simple.

12 Important Facts About Sleep Apnea & Sleep Disorders

Sleep Apnea

1. Healthy adults should only need about 7-9 hours of sleep a night to feel fully rested and not develop fatigue during the day.

2. Sleep apnea patients often have persistent problems with their weight due to being too tired to exercise.

3. Chronic sleep deprivation can affect the brain just like alcoholism, drug addiction, and even Alzheimer’s.

4. Sleep apnea is frequently self-misdiagnosed as insomnia because it can cause a person to wake up multiple times during the night and/or sleep very lightly.

5. People who snore but do not have sleep apnea have a higher chance of developing it in the future than those who do not snore. Fortunately, this can be effectively prevented using oral appliance therapy.

6. Driving while fatigued is just as dangerous as driving while drunk! In a closed course test, tired drivers were 15x MORE likely to get into an accident than ones who were sober and adequately rested.

7. Most of the people with sleep apnea (80%) are either undiagnosed or misdiagnosed. Furthermore, the majority of those who are diagnosed with sleep apnea never seek out treatment.

8. People with untreated sleep apnea tend to have a much shorter life expectancy, only averaging the age of 55.

9. Sleep apnea is one of the biggest and most unrecognized causes of sexual and erectile dysfunction.

10. People who frequently wake up to urinate during the night might actually be waking up due to sleep apnea.

11. Many people who suffer from nocturnal bruxism, or unconscious nighttime teeth grinding, may also be suffering from sleep apnea.

12. A larger than average tongue or neck can also be big risk factors for sleep apnea.

Frequently Asked Questions

If I snore, do I have sleep apnea?

Snoring frequently accompanies sleep apnea but it is not always an indicator of whether this sleep condition is present. However, snoring can indicate that bulky throat tissue could potentially obstruct airways – especially if patients have certain lifestyle factors that contribute to sleep apnea. Fortunately, the treatment we offer for sleep apnea and snoring is the same. By prescribing a custom oral appliance, the diameter of the airway can be widened to prevent the sounds of snoring as well as episodes of apnea. These oral appliances are soft and comfortable to wear. They work by positioning the lower jaw slightly forward so that the airway is no longer obstructed.

Is it possible that I have sleep apnea even if I don’t snore?

Anyone of any age can have sleep apnea. Even though snoring can accompany sleep apnea, it is not always a symptom of this sleep disorder. For this reason, Dr. Baughman at Clearwater Dentistry will set up a sleep consultation for you with a board-certified sleep physician using telehealth. The board-certified sleep physician may recommend an at-home sleep study in the comfort of your own bed. Our at-home sleep tests are accurate, convenient, and cost-effective. If we find that sleep apnea is present or that snoring is obstructing one’s quality of life, we will provide treatment recommendations.

What causes sleep apnea?

The exact cause of obstructive sleep apnea (OSA) is different for each person. Anyone can develop it, regardless of age or gender. The most common risk factors include:

– Being over age 40
– Having a large neck (over 17 inches in men, 16 inches for women)
– Being overweight – approximately half of OSA sufferers are overweight
– Being male – more men than women suffer from OSA
– Having a large tongue or small jaw
– Enlarged tonsils and adenoids (particularly in children)
– Using alcohol or sedatives which relax the muscles in the airway
– Nasal obstruction due to a deviated septum or sinus and allergy problems

What is the difference between a CPAP and an oral appliance?

While CPAP is very effective in treating sleep apnea, many people cannot tolerate the discomfort of the mask and the inconvenience and noise of the machine. Therefore, a high percentage of users have difficulty or will not wear them. An oral appliance is a popular alternative to the CPAP. This device is small, portable, fits more comfortably, and in many cases works just as well as CPAP.

How do you confirm the effectiveness of the oral appliance?

You will have a follow-up sleep study at home in the comfort of your own bed while using your oral appliance to confirm the effectiveness of the device. Our at-home sleep tests are accurate, convenient, and cost-effective. Dr. Baughman at Clearwater Dentistry will coordinate a consultation with a board-certified sleep physician using telehealth to interpret the results and determine if this therapy is effective.

Does insurance cover sleep apnea treatment?

Because insurance plans vary widely, our experienced team will work with you to see if your insurance company will cover the oral appliance. If for any reason it is not covered, we will let you know and work with you to develop a financial plan if needed.

If coverage is available for oral appliances, it will come from your medical insurance carrier. The cost of untreated sleep apnea, in the long run, is high. Left untreated, sleep apnea contributes to high blood pressure, heart disease, cognitive disorders including dementia, mood disorders, and increases your risk of having a stroke. Studies show untreated sleep apnea can shorten your life expectancy by up to 10 years and results on average in double the number of doctor’s office visits. This often costs patients thousands of dollars every year in medical bills. Our patients tell us it is well worth the investment of their time and money to treat their sleep apnea because of the improved quality of life they experience.

What if I don’t have insurance?

We offer financing options and will work with you to find a solution that fits your needs.

How long will it take to get used to my custom oral appliance? Will it hurt my teeth?

The majority of patients will adapt to their custom oral appliance in less than a month. It will take some time to get used to having a device in your mouth while you sleep. There is often some mild discomfort initially, but this goes away after a few weeks of wearing the appliance. Patients tell us that getting used to an oral appliance was much easier than getting used to a CPAP.

How often will the appliance need to be replaced?

Unlike cheap oral appliances that you can order online, a custom oral appliance is made from hard acrylic, which is very durable. They are typically replaced about every 5 years depending on wear and tear. If you grind your teeth, you may have a more frequent rate of repair or replacement. Studies have shown that the overall costs of CPAP therapy vs. custom oral appliance therapy are the same since CPAP therapy requires continually replacing tubing, filters, masks, and other supplies.

Will the appliance change my bite?

Your teeth may shift slightly with long term use of a custom oral appliance and may result in minor bite changes. Typically, this is not worrisome and does not cause problems or discomfort. Under Dr. Baughman’s expert care, the risk of bite changes is minimized. This is also minimized with the use of a custom morning re-positioning device which Dr. Baughman includes with your custom oral appliance.

Are there any side effects of the appliance?

The most common side effect is mild morning muscle soreness that usually goes away after a short time. Some patients may experience either dry mouth or excessive salivation. As mentioned above, minor tooth movement occurs in some patients, but is minimized under Dr. Baughman’s expert care.

Will an oral appliance cause damage to the jaw joint and muscles?

In most cases, a custom oral appliance that is expertly made by Dr. Baughman will not damage but instead improve the health of your jaw joint and muscles. Many of our patients experience an improvement in jaw joint and muscle soreness after wearing an oral appliance long term. This is possible in part due to Dr. Baughman’s expertise in positioning the jaw in right position that is both therapeutic and natural. When the jaw is positioned correctly by an expert like Dr. Baughman, the jaw joint is stabilized and in a more protected position. In short, the jaw joint and muscles are often happier in this protected position and therefore do not cause damage to the joint but instead provides a benefit. This is another problem with the cheap oral appliances that you can buy online. Incorrect jaw positions often occur with these “do it yourself” devices and can cause permanent damage and discomfort to the jaw joints and muscles.

How long will I have to use the oral appliance?

Obstructive sleep apnea in unlikely to decrease with age; therefore your oral appliance will probably be a lifelong therapy. However, certain wellness factors such as significant weight loss may improve your symptoms.

Can’t I just order an oral appliance online?

While there are oral appliances you can order on the internet, keep in mind when not fitted or positioned properly by an expert like Dr. Baughman, permanent tooth damage and chronic jaw pain can result. If you order a device online, you are missing out on essential components of Dr. Baughman’s custom oral appliance therapy such as:

– Protecting against chronic jaw pain and major bite changes
– Preventing dental damage by making a custom fit oral appliance
– Under Dr. Baughman’s care, you will meet with a board-certified sleep physician using telehealth to ensure all your sleep needs are met
– Pre and post home sleep testing to verify that oral appliance is effectively treating sleep apnea or snoring
– As many appointments as necessary with Dr. Baughman to calibrate your device for your unique needs to achieve the most therapeutic benefit
– Superior durability
– Long term care and maintenance

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