Dr. David S. Binder is a Diplomat of the Academy of Dental Sleep Medicine and one of New York City's experts on treatments for sleep apnea and snoring, Dr. Binder has over 17 years of experience treating sleep apnea. Dr. Binder also lectures on snoring and sleep apnea treatment. For more information see David S. Binder’s bio.
Whether it’s your husband, wife, bed partner or a friend, we all know someone who snores. Snoring is not only disruptive, but more importantly can be a sign of a serious disorder called Obstructive Sleep Apnea (OSA).
What is obstructive sleep apnea?
Obstructive sleep apnea is a common disorder in which you have one or more breathing interruptions or blockages while you sleep.
In the condition known as Obstructive Sleep Apnea, the throat can close, leading to cessation of breathing. Apnea is defined as “a cessation of airflow for at least 10 seconds.” People with sleep apnea stop breathing while they sleep, sometimes hundreds of times a night, sometimes for a minute or longer. Sleep apnea affects 25 million Americans of all ages.
Typically, someone with obstructive sleep apnea will snore heavily, then stop breathing. The bed partner will observe that the person struggles to breathe but there is no snoring sound. These periods of lack of breathing are followed by sudden attempts to breathe, often accompanied by a gasping or choking sound. The person with OSA will partially awaken leading to fragmented, non-refreshing sleep which can be the cause of excessive daytime sleepiness. The lack of breathing also causes the oxygen level in the blood stream to fall, leading to multiple medical problems.
- Symptoms of sleep apnea
- Loud snoring
- Choking and gasping during sleep
- Memory loss
- Daytime sleepiness
- Drowsy driving
- Medical diseases associated with sleep apnea
- High blood pressure
- Erectile dysfunction
- Coronary heart disease
Diagnosis and Treatment for Obstructive Sleep Apnea
Diagnosis is based on the results of an overnight sleep study, called a Polysomnogram (PSG). Other factors in determining OSA are patient evaluation and history.
Treatment Options: Good sleep hygiene (it’s best not to sleep on your back), weight loss if necessary, and regular exercise are some helpful OSA treatments patients can practice on their own. Medical and dental treatments include Continuous Positive Airway Pressure (CPAP), Oral Appliance Therapy (OAT), and surgery.
Continuous Positive Airway Pressure (CPAP): This is pressurized air generated from a bedside machine like a ventilator. Air is delivered through a mask, covering the nose. The force of the pressurized air pushes the airway open.
Oral Appliance Therapy
Oral appliances can be worn in the mouth to treat snoring and OSA. These devices are similar to orthodontic retainers or sports mouth guards. Oral Appliance Therapy involves the selection, design, fitting and use of a custom-designed oral appliance worn during sleep. This appliance then attempts to maintain an opened, unobstructed airway in the throat.
Oral appliances work in several ways:
- Repositioning the lower jaw, tongue, soft palate and uvula
- Stabilizing the lower jaw and tongue
- Increasing the muscle tone of the tongue
There are many different oral appliances available. Approximately 40 appliances have been approved through the FDA for treatment of snoring and/or Sleep Apnea. Oral appliances may be used alone or in combination with other means of treating OSA. These treatments include general health, weight management, surgery, or CPAP.
Dentists with training in Oral Appliance Therapy are familiar with the various designs of appliances. They can determine which one is best suited for your specific needs. The dentist will work with your physician as part of the medical team in your diagnosis, treatment, and on-going care. Determination of proper therapy can only be made by joint consultation of your dentist and physician. Initiation of oral appliance therapy can take from several weeks to several months to complete. Your dentist will continue to monitor your treatment and evaluate the response of your teeth and jaws.
Dr. Binder is a member of Snoring Isn't Sexy®, a global organization that seeks to educate the public about the dangers of Snoring and Obstructive Sleep Apnea, and dentistry's role in treating these conditions with Oral Appliance Therapy.
If you think you are suffering from sleep apnea, talk with The Manhattan Dentist, Dr. Binder. He will discuss which treatment is right for you.