Obstructive Sleep Apnea & Snoring

American Academy of Dental Sleep Medicine

“ENHANCING SLEEP…ENRICHING LIVES”

Obstructive Sleep Apnea
Obstructive Sleep Apnea (OSA), which causes then to stop breathing up to hundreds of times a night for anywhere from a few seconds to more than a minute. OSA is a chronic condition that occurs when your muscles relax during sleep, allowing soft tissue to collapse and block the airway. As a result, repeated breathing pauses occur, which reduces your oxygen levels. these pauses in breathing are followed by brief awakenings that disturb your sleep. Common signs of OSA include snoring and gasping or chocking sounds during sleep. Like snoring, OSA is more common in men, but it can occur in women too, especially during and after menopause. Having a few extra pounds, a narrow airway, misaligned jaw, teeth rotations, crowing or enlarged tongue all increase the risk of OSA.

Is Treating OSA Important?

Treating OSA is incredibly important to your overall health and well being. When left untreated, OSA can cause excessive daytime sleepiness or fatigue, as well as morning headaches and memory loss. OSA is a threat to your safety as it increases your risk of drowsy driving and workplace accidents. Untreated OSA raises your risk for serious health problems including: high blood pressure, stroke, heart disease, diabetes, chronic acid reflux, erectile dysfunction, early onset alzheimers and dementia. Sever untreated OSA even increases your reik of death.

How is OSA and Snoring Diagnosed?

A medical doctor must determine and diagnose you having either mild, moderate or severe OSA. A doctor who is a sleep specialist can provide you with a complete sleep evaluation. This may involve either an overnight sleep study at one of our areas sleep centers or a home sleep test (HST). Based on this study, your sleep physician will interpret the data to make a clinical diagnosis.

How are OSA and Snoring treated?

Your sleep physician will discuss treatment options with you and may include positive airway pressure (PAP) therapy, a Mandibular Repositioning Device therapy or in extreme cases surgery.

*PAP therapy involves wearing some type of face mask connected by tubing to a constantly running machine.

* A mandibular Repositioning Device therapy involves the use of a mouth-guard like device worn during sleep to bring the lower jaw to a comfortable forward position during sleep to maintain an open unobstructed airway.

*Surgical options include a variety of procedures with varying side effects and rates of success.

Snoring

Snoring is a sound that occurs during sleep when soft tissue in the upper airway vibrates as you breath. Snoring is extremely common in men, but also occurs frequently in women, especially during pregnancy and menopause. Obesity, nasal obstruction, alcohol and smoking increase the risk of snoring. The sound of snoring tends to be most disturbing to a bed partner or roommate, but loud snoring can wake the person who snores, too. Loud and frequent snoring is a common sign of obstructive sleep apnea.

Oral Appliance Therapy

Research shows that oral appliance therapy is an effective treatment option for OSA and snoring. A Mandibular Repositioning Device is worn in the mouth only while you sleep and is similar in fit to a sports mouth guard or orthodontic retainer. Oral appliances support and advance your lower jaw in a forward position to help maintain an open upper airway.

Many patients consider an oral appliance to be more comfortable to wear than a PAP mask. The “gold standard” and the best treatment recommendation for a person with severe OSA is a PAP mask. In cases where a person cannot tolerate a PAP oral appliances are quiet, easy to care for and portable.

If you and your doctor decide that oral appliance therapy is the best treatment option for you or if you cannot tolerate your current PAP then please contact our office. There are more than 100 FDA cleared oral appliances on the market. Dr. Knight and his team will work closely with you to select the best appliance for you. Oral appliance therapy for the OSA is often covered under a patients medical health insurance plan.

How We can Help?

Dr. Knight will work closely with your sleep physician in order to treat your OSA and snoring. At your first visit, Dr. Knight will review with you in detail a your complete medical and dental health, a copy of your sleep study from your physician. He will complete a thorough evaluation including a clinical examination including an examination of your teeth, upper and lower jaws, tongue and airway and possibly a new panoramic or 3-D cone beam image showing our important skeletal features. 

Dr. John H. Knight, Jr. DDS completed a mini-residency in Dental Sleep Medicine at the University of North Carolina at Chapel Hill in 2017. He has received advanced training in treating patients with the sleep disorder obstructive sleep apnea. He works with many of the areas sleep physicians at both Sentara Martha Jefferson and The University of Virginia Health Systems. Dr. Knight works closely with patients and their sleep physicians tailoring treatment solutions for mild, moderate and severe sleep apnea. Dr. Knight and his team can fabricate a Mandibular Repositioning Device that can maintain a patient’s airway in an open position which reduces or eliminates a patient’s apnea events. 

Snoring may be one symptom of a dangerous underlying sleep disorder known as Obstructive Sleep Apnea. Patient’s may wake throughout the night choking or gasping for air. Partners may witness a patient actually stop breathing during sleep. These highly episodes may occur numerous times throughout the night. Left untreated, OSA increases a patient’s risk of diabetes, heart attack, stroke, early onset dementia, alzehimers or even death.

The first step in determining if you or a loved one has Obstructive Sleep Apnea is to have an evaluation by one of our communities Sleep physicians. After a comprehensive evaluation your sleep physician will likely recommend some type of sleep test. This test may consist of a take home sleep test which will record pall necessary information to enable the physician to diagnose the severity of your condition. This home sleep test (HST) is done in the comfort of your own home. In cases where your evaluation gives the physician reason to believe you may have a more serious form of OSA a recommendation may be made for an overnight test in one of our sleep labs in Charlottesville.

Based on one or the other of these sleep tests you will be diagnosed as having Mild, Moderate or Severe OSA. If you are diagnosed with Severe OSA your physician will most likely recommend you begin treatment with a CPAP (Continuous Positive Airway Pressure machine). The CPAP is the gold standard for treatment of severe OSA. Patient’s wear a mask that provides a positive airway pressure to provide the necessary oxygen your body systems need. Often times patients may be able to adjust to the CPAP and don’t or won’t use the machine as directed. In cases such as this Dr. Knight can fabricate an appliance that works in conjunction with the CPAP ( A Hybrid appliance) or an appliance that helps to maintain an open airway.

For patients with Mild or Moderate OSA Dr. Knight and your sleep physician may recommend the fabrication of a mandibular repositioning device to maintain an open airway reducing or eliminating nightly apnea events.

If you or someone you know is suffering with OSA please contact our office to schedule an appointment. Remember the first step is a thorough evaluation by a sell physician and some type of sleep test

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