December 2, 2018
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 Apnoea (OSA).
What is Obstructive Sleep Apnoea?
People who suffer from OSA can stop breathing during sleep due to a complete or partial blockage of the upper airway. This happens often during the night and results in poor sleep and fatigue. OSA also influences our overall health, impacting 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 further to identify signs of 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 medical practitioner can only make a final diagnosis of OSA after conducting a sleep study. Sleep studies can be done in your home or a hospital setting. Ideally, your GP or sleep physician would refer you for a sleep study.
Getting a sleep study done and reported on through your dental clinic may also be possible. Once a diagnosis of OSA has been made, your GP or sleep physician must be 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 airway obstruction’s location and the condition’s severity. It often includes a combination of:
Behaviour and lifestyle changes
Behaviour and lifestyle changes may include weight loss, increased exercise, and reduced alcohol and other drugs. Sleep positioning devices may also be used in combination to prevent 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 open the airway. They are very effective in treating OSA, however, many patients find these devices uncomfortable to wear.
Oral Appliance Therapy
Oral appliances help hold the lower jaw forward, minimising the collapse of the airway muscles. This appliance is suitable for patients with mild to moderate sleep apnoea.
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 apnoea today.