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Snoring and teeth grinding/clenching (bruxism) can be two relatively common occurrences during sleep. However, both can be signs of a more serious medical condition known as Obstructive Sleep Apnea (OSA).

What is Obstructive Sleep Apnea?

People who suffer from OSA can stop breathing during sleep due to a complete or partial blockage of the upper airway. This happens many times during the night and results in poor sleep and fatigue. OSA also influences our overall health as it impacts on our body’s ability to heal and repair itself.  There are known links between OSA and diabetes, heart disease and mental illness.

Common symptoms of OSA include:

• Restless sleep and waking unrefreshed
• Unexplained daytime sleepiness
• Loud snoring or periods of silence followed by gasping or choking
• Teeth grinding/clenching
• Temporomandibular Joint (TMJ) Pain
• Headaches
• High Blood Pressure
• Poor concentration and forgetfulness
• Unexplained weight gain
• Heartburn/reflux

The Epworth Sleepiness Scale and Stop-Bang Test are useful screening tools to assess whether you may be at risk for OSA.

Your dentist will also be able to assess your mouth and teeth to further identify signs for this condition. Signs may include:

• Cracking and wear of your teeth, fillings or crowns
• Size and shape of your tongue
• Condition of your gums
• Condition of the soft tissues at the back of the mouth

A final diagnosis of OSA can only be made by a medical practitioner after conducting a sleep study. Sleep studies can be done in your home or in a hospital setting. Ideally, your GP or sleep physician would refer you for a sleep study.

It may also be possible to get a sleep study done and reported on through your dental clinic. Once a diagnosis of OSA has been made, it is important your GP or sleep physician are made aware of the results. This way, the most appropriate treatment plan can be established for you.

How can OSA be treated?

Treatment for OSA varies depending on the location of the airway obstruction and the severity of the condition.  It often includes a combination of:

Behaviour and lifestyle changes

Behaviour and lifestyle changes may include weight loss, increasing exercise, reduction in alcohol and other drugs.  As well, sleep positioning devices may be used in combination to prevent you from falling onto your back during sleep.

Referral to an ENT surgeon

Ear, Nose and Throat surgeons can examine the tissues at the back of your mouth to see if there is excess or floppy tissue that may occlude the airway.

They can also examine your nose to determine if there is soft tissue overgrowth (e.g. due to allergies) or a deviated septum that may prevent you from breathing properly through your nose.

Use of a CPAP machine

CPAP (continuous positive airway pressure) devices involve a mask worn over the nose and/or mouth. The blower then pushes air through the mask to create enough pressure to keep the airway open. They are very effective in treating OSA, however, many patients find these devices uncomfortable to wear.

Oral Appliance Therapy

Oral Appliances help to hold the lower jaw forward which minimises the collapse of the airway muscles. This appliance is suitable for patients with mild to moderate sleep apnea.

In many cases, they are more easily tolerated by patients in comparison to CPAP machines. Custom-made appliances involve your dentist taking impressions of your upper and lower teeth and a bite record. These impressions are then sent to a high-quality Australian laboratory for fabrication.

There are also ‘off the shelf’ appliances that can provide a cheaper alternative. Although, the fit may not be as comfortable or effective.

Our dentists who have been specially trained in OSA, in conjunction with your medical doctor, can help determine the most appropriate treatment option for you. Contact us about obstructive sleep apnea today.