Snoring & Sleep Apnea

WHAT IS OBSTRUCTIVE SLEEP APNEA?

Sleep Apnea is a condition characterized by breathing interruptions during sleep. It's caused by the narrowing of the airway blocking the airflow for 10 seconds or longer and can also include partially blocked airways, both of which may decrease the body’s oxygen concentration and fragment sleep creating a fatigued individual.

The pauses in breathing can occur dozens or even hundreds of times. One out of every two Americans snore, and snoring is a key warning sign that normal breathing is not happening, but many individuals are not even aware that they snore. If you snore and are fatigued you may have sleep apnea.

An elongated soft palate narrowing the airway

Apnea events sometimes can be life threatening and have been shown to play a key role in many processes like: fatigue, excessive daytime sleepiness, headaches, irritability, depression, memory problems, sore throat, waking frequently to urinate, acid reflux, gout, congestive heart failure, type 2 Diabetes, ischemic heart disease, angina, asthma, obesity, hypercholesterolemia, chronic renal failure, and hypertension (high blood pressure).

Large tonsils narrow the airway

Dr. McCarty is Board Certified with the American Board of Craniofacial Dental Sleep Medicine and understands the importance of having training in both the arenas of Craniofacial Pain and Dental Sleep medicine. (See Reference- Position Paper).

In the State of Texas a dentist is required to work closely with the medical sleep physician to treat cases of Apnea, usually those that are mild to moderate but on occasion severe patients. Dr. McCarty requires that a qualified physician diagnose your Apnea, and then make a referral for treatment with Oral Appliance Therapy (OAT).

Dr. McCarty will fit you with the appliance and work with the physician to verify the therapy is affective. Please contact our office for further information, and the office will be pleased to discuss your next steps.

CAUSES

Some of the conditions that can lead to snoring or Sleep Apnea include:

• Overweight
• A small retruded jaw
• Sedatives
• Allergies
• Alcohol before retiring
• Airway obstruction
• Sleep posture

Small airway

DIAGNOSTICS

Patients are diagnosed by the sleep physician with an overnight study called a PSG or by home sleep study.

Dr. McCarty will also administer these airway examinations:

• CBCT airway analysis including pharyngeal airway size, soft palate length, and turbinate size.
• Occlusal signs of bruxism
• Tongue elevation, size, and scalloping
• Elongated or edematous uvula
• Tonsil and soft tissue pharyngeal airway width

Constriction of the airway

TREATMENT

Dr. McCarty treats sleep apnea but works along side the sleep physician. If Dr. McCarty suspects sleep apnea, he will refer you to a sleep specialist for evaluation with may included a full sleep study or at home study. Once a sleep study confirms that sleep apnea is present, and the sleep physician and patient desire to  tray an oral appliance, then the proper treatment procedures can be initiated.  It is the responsibility of the medical doctor to determine the diagnosis and order treatment.  Treatment is usually CPAP or Oral Dilating Appliance also known as Oral Appliance Therapy (OAT). If you require an oral appliance for sleep apnea, your doctor will need to request the fabrication of the appliance, and Dr. McCarty will fabricate it for you. 

The oral appliance approach is a conservative treatment to traditional treatment of CPAP (continuous positive airway pressure) with the use of an air compressor and mask and surgery. Appliances are light and easy to wear. Its purpose is to move the lower jaw forward, causing a positive change in tongue position that opens the airway.  There are many types of oral appliances for airways.  These appliance should have adjustments, so that the airway can be titrated.  Dr. McCarty normally works with appliances that are also most useful to solving jaw pain, as many of his clients also have pain.

Normal airway

Worn during sleep, it helps prevent the airway from collapsing by creating extra airway space. We are able to conservatively and successfully treat those suffering with snoring or mild to moderate sleep apnea. When poor sleep interferes with your daily activities of reading, watching television, driving or operating equipment, discuss it with Dr. McCarty.

If it is determined that the patient is suffering from obstructive sleep apnea, Dr. McCarty will work closely with the sleep physician to fabricate and oral appliance to fit the needs of the sleep patient. There are many appliances to choose from, and Dr. McCarty will use appliances that are FDA approved for sleep apnea.