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Honey, You’re Snoring Again!
By Dr. Ian Shuman

If your bedroom sounds like a monster truck rally, then you sleep with a snorer and it’s likely that both you and your noisy partner are exhausted during the day. Medical experts estimate that more than 30 million American adults snore. Snoring may seem like an annoying but relatively harmless part of an average night's sleep, but for some, severe snoring can be a symptom of sleep apnea, a more serious sleep disorder. Snoring and sleep apnea are related, but not all snorers will develop sleep apnea and not all sleep apnea patients snore. What's the difference between snoring and sleep apnea?

WHAT CAUSES SNORING?
Snoring is not life threatening, but it can cause excessive daytime sleepiness, memory impairment, morning headaches and poor work performance. Snoring happens when throat muscles relax, causing the soft palate and the uvula (the fleshy structure that hangs from the back of the soft palate) to vibrate.
A variety of treatments and therapies exist for snoring, from surgery to oral devices. The mandible, or jaw, sometimes falls backward, depending on the sleeping position. This partially blocks the airway and causes snoring. Snoring devices made by your dentist move the mandible forward and are about 80 percent to 90 percent effective according to research conducted by the American Academy of General Dentistry.

WHAT IS SLEEP APNEA?
Sleep apnea is more serious and occurs when the upper airway becomes obstructed. When sleep apnea is caused by complete blockage of the airway, normal breathing can be prevented for prolonged periods of time. Sleep apnea patients can experience a minimum of 20 to 30 blockages in a single night. Typically, the frequency of waking episodes in a single night is somewhere between 10 and 60. A person with severe obstructive sleep apnea may have more than 100 waking episodes. People with sleep apnea usually do not remember waking up during the night.

According to the National Institute of Health, there are over 12 million Americans who suffer from undiagnosed and untreated sleep apnea. This disorder may raise blood pressure and decrease the flow of oxygen to the brain. Studies have shown that patients with this potentially life-threatening disorder are so fatigued during the day that when driving, their performance is similar to a drunk driver. If left untreated, sleep apnea can lead to impaired daytime functioning, high blood pressure, heart failure and possibly stroke. If your partner hears loud snoring punctuated by silences and then a snort or choking sound as you resume breathing, this pattern could signal sleep apnea. Indications of the problem may include the following:

HOW DO YOU TREAT THESE PROBLEMS?
Both problems are treatable. Patients can consult a dentist knowledgeable in treating sleep disorders about any symptoms they may have. The dentist can take a history and if necessary refer you to a specialist. If the dentist suspects sleep apnea, he or she may refer you to a physician or a sleep specialist. For a proper diagnosis, you may have to undergo an overnight sleep study, which measures heart rate and how many times breathing is interrupted. In many cases, the dentist can help you directly. If you have been diagnosed with snoring or obstructive sleep apnea, your dentist will work closely with the diagnosing physician to implement and manage the prescribed therapy.

PREVENTING SNORING, SLEEP APNEA AND THE DENTIST
For the majority of snorers however, the most affordable, non-invasive, comfortable, and effective snoring solution remains oral snoring preventative devices. These devices prevent snoring because these custom fabricated dental devices worn at night move the lower jaw into a forward position. This increases the three-dimensional space in the airway tube, which reduces air velocity and soft tissue vibration. Increasing the volumetric capacity of the airway and preventing soft tissue vibrations eliminate snoring. As previously mentioned, in clinical research studies, these dentist prescribed oral devices have exhibited initial snoring prevention success rates of between 80 to 90%.

Two such devices, The Herbst Sleep Appliance and the Silent Nite positions the lower jaw into a forward position by means of special connectors that are attached to upper & lower forms. The forms are custom laminated with heat and pressure to the dentist’s model of made of your mouth. The fit is excellent and comfortable. These devices do not interfere with breathing through the mouth. Even in cases of congested nasal passages the devices prevent snoring and allow uninhibited oral breathing.

Small movements of the jaw (temporomandibular joint or TMJ) are possible while wearing these devices. This movement potential helps minimize stiffness in the joints of the jaw in the morning. These devices may produce a slight sensation of the jaws being out of alignment upon wakening. This feeling is due to lymphatic fluid build up in the jaw joint that occurs overnight and will rapidly subside in minutes. Devices such as the Herbst and Silent Nite help to promote deeper, more restful sleep by preventing snoring.

If you suffer from snoring or sleep apnea, or know someone who does, consult with a dentist or medical doctor who has knowledge and expertise in this area.