The incidence of sleep apnea is much higher than generally believed. Because its symptoms occur during sleep, it often remains undetected and undiagnosed for many who suffer from this insidious condition. Taken from the Greek word “apnoia,” meaning “without breath,” an incident of sleep apnea occurs when no air reaches the lungs for at least 10 seconds. Such an event can last for up to ninety seconds and can occur many times every hour.
Every occurrence of sleep apnea results in a complete cessation of airflow, where no oxygen reaches the lungs. It can stem from a lack of input from the brain on the breathing mechanism, and is called Central Sleep Apnea.
Another type of occurrence, involving mechanical obstruction of the airway is called Obstructive Sleep Apnea (OSA). Narrowing of the throat, or more often, a backwards movement of the tongue as one falls asleep is the immediate cause of Obstructive Sleep Apnea. In this backwards position, the tongue blocks the airway and the transport of fresh oxygen into the body is interrupted.
With age, the accompanying loss of muscle tone and the accumulation of fat can also lead to airway obstruction. As some degree of apnea can occur in anyone, OSA is considered normal if one has less than five apneic events per hour. OSA is categorized as mild with the incidence of 5-15 apneic events per hour. Moderate OSA falls between 16-30 events per hour, while a severe case will consist of 30 or more events per hour. Each event lowers the body’s oxygen level and raises blood pressure.
The greater the frequency of apneic events the greater the cumulative strain on the heart, making the OSA sufferer a prime candidate for heart disease. For those who already have an underlying heard condition, sleep apnea presents an even greater risk of sudden cardiac distress.
Snoring is a partial mechanical blockage of the airway. Obstructed nasal breathing also contributes to snoring (i.e., retruded tongue position and loss of muscle tone in the air way. These all lead to reduction in airflow. Snoring can be present with or without sleep apnea.
Improved acceptance, compliance, and efficacy in the treatment of mild to moderate OSA
From a clinical perspective: acceptability, compliance, and efficacy are critical components in obtaining a favorable treatment outcome for Obstructive Sleep Apnea (OSA) patients. We practice an integrated multi-disciplinary clinical management protocol designed specifically to address these three objectives.
Clinical studies have demonstrated improved levels of subjective treatment efficacy for OSA in patients using this system, with 83% of patients reporting combined improvements in snoring, sleep quality, and daytime sleepiness. The studies also showed significant objective improvements in apnea-hypopnea index, oxygen saturation, snoring frequency, snoring intensity, arousal index, and REM sleep. The level of patient acceptance of the treatment is high, with 96% of patients in one study reporting that they would like to continue using it. Success has been demonstrated in the area of patient compliance – an area of significant clinical concern with other non-surgical treatment methods.
The treatment we offer is known as a Mandibular Advancement Splint (MAS) that treats both snoring and mild to moderate OSA by advancing the lower jaw forward. It is a custom-made device consisting of upper and lower dental plates with a unique patented fin coupling mechanism. The device is adjustable, which provides incremental jaw advancement. This feature allows clinicians to adjust therapy so that the jaw advancement can be the minimum sufficient setting to alleviate snoring and reduce OSA. The design of the MAS design that we offer incorporates a number of key features that represent significant advances on existing MAS oral appliances.