Take a Breath: How a Dentist Can Help With Your Sleep Apnea – #wellbeingwednesday By Dr. Richard Goodfellow

Do you snore? Do you stop breathing at night? Are you tired during the day? These are classic symptoms of obstructive sleep apnea (OSA). If you have OSA, when you sleep, your airway collapses causing you to temporarily stop breathing. This can occur repeatedly during the night, interrupting your sleep. Left untreated, you are at an increased risk of developing cardiovascular disease, including heart attack, high blood pressure, stroke, and congestive heart failure. The good news: OSA is treatable. Two of the most common treatments for adults with OSA are CPAP (continuous positive airway pressure) and oral appliances that hold your jaw and tongue forward (a.k.a. mandibular advancement devices), making more space in the airway for you to breathe and preventing your airway from collapsing while you sleep. If you have severe OSA, your doctor can prescribe CPAP, which is the standard of care for severe OSA. CPAP works—if you wear it. However, studies have shown that in many cases, CPAP is not well tolerated by patients, resulting in low compliance rates, leading to limited effectiveness. If you have mild-to-moderate OSA, or you cannot tolerate CPAP and do not want surgery, your dentist can make you an oral appliance. Don’t be afraid to visit a Dentist Parlin if you struggle with CPAP at all. Patients wearing oral appliances are generally more compliant, resulting in comparable effectiveness to CPAP.1 Why are patients more compliant wearing oral appliances? What do patients think of them? To find out, a survey was sent to 1150 adults who were treated with an oral appliance for OSA.2 On the survey were 70 questions, including questions about changes in symptoms, quality of life and daytime sleepiness, and the value of treatment. Of those who responded to the survey, 83% said treatment with an oral appliance relieved their symptoms. Quality of life and cognitive symptoms improved significantly and daytime sleepiness decreased significantly with frequent use of their oral appliance. Over 85% of respondents said they would recommend this treatment to a friend.2 In people with OSA, both oral appliances and CPAP are effective at decreasing the risk of cardiovascular disease. When patients with OSA were treated with oral appliances, their blood pressure decreased significantly. Oral appliances and CPAP worked just as well to decrease blood pressure.1 In patients with severe sleep apnea, CPAP and oral appliances were equally effective in reducing the risk of cardiovascular death.3 If you have any symptoms of OSA, tell your dentist or doctor. DR. RICHARD GOODFELLOW is a general dentist with a special interest in temporomandibular joint dysfunction and sleep-related breathing disorders in adults and children. His TMJ & Sleep Therapy Centre of Toronto is located at Yonge and Eglinton.
1. Van Haesendonck G, Dieltjens M, Kastoer C, et al. Cardiovascular benefits of oral appliance therapy in obstructive sleep apnea: a systematic review. Journal of Dental Sleep Medicine 2015; 2(1):9–14. 2. Nordin E, Stenberg M, Tegelberg A. Obstructive sleep apnoea: patients’ experiences of oral appliance treatment. Journal of Oral Rehabilitation 2016. 3. Anandam A, Patil M, Akinnusi M, et al. Cardiovascular mortality in obstructive sleep apnoea treated with continuous positive airway pressure or oral appliance: an observational study. Respirology 2013; 18(8):1184–1190.

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