FAQ - Find answers to your questions about Sleeping and Snoring...

Sleep apnea is defined as the cessation of breathing during sleep. - Apnea specialists generally agree that there are three different types of sleep apnea: obstructive, central, and mixed. Of these three, obstructive sleep apnea (OSA) is the most common; central sleep apnoea is rare; mixed sleep apnea is a combination of the previous two with treatment being the same as OSA.

Obstructive sleep apnea

Obstructive sleep apnea is characterized by repetitive pauses in breathing during sleep due to the obstruction and/or collapse of the upper airway (throat), usually accompanied by a reduction in blood oxygen saturation, and followed by an awakening to breathe. This is called an apnea event. Respiratory effort continues during the episodes of apnoea. An analogy might be helpful: OSA is like putting your hand over your vacuum cleaner intake nozzle. Your hand blocks all air from getting through (upper airway collapse) even though the vacuum cleaner is still applying suction (respiratory effort continues). The vacuum cleaner is usually straining somewhat at this time, and so does the human body.

Central Sleep Apnea

Central Sleep Apnea is defined as a neurological condition causing cessation of all respiratory effort during sleep, usually with decreases in blood oxygen saturation. To return to the vacuum cleaner analogy: central sleep apnoea would be like pulling the plug on the vacuum cleaner. No power, no suction: if the brainstem center controlling breathing shuts down there's no respiratory effort and no breathing. The person is aroused from sleep by an automatic breathing reflex, so may end up getting very little sleep at all. Note that CSA, which is a neurogical disorder, is very different in cause than OSA, which is a physical blockage - though the effects are highly similar.

Mixed apnoea

Mixed sleep apnoea, as the name suggests, is a combination of the previous two. An episode of mixed sleep apnoea usually starts with a central component and then becomes obstructive in nature. Generally the central component of the apnoea becomes less troublesome once the obstructive apnoea is treated

One of the best people to help you answer this question is your bed partner. People with sleep apnoea generally have the following symptoms:

  • Loud, frequent snoring 
    The pattern of snoring is associated with episodes of silence that may last from 10 seconds to as long as a minute or more. The end of an apnoea episode is often associated with loud snores, gasps, moans, and mumblings. Not everyone who snores has apnoea, by any means, and not everyone with apnoea necessarily snores (though most do). This is probably the best and most obvious indicator.
  • Your bedmate indicates that you periodically stop breathing during your sleep, or gasp for breath
  • Excessive daytime sleepiness/fatigue: Falling asleep when you don't intend to. This could be almost anytime you are sitting down, such as during a lecture, while watching TV, while sitting at a desk, and even while driving a car. Ask yourself, "Did I used to be able to (read, drive, watch TV) for longer periods of time without falling asleep?" If the answer is yes, you may have sleep apnoea or another sleep disorder. Even if you don't literally fall asleep, excessive fatigue (that is, you got plenty of sleep and you're still really tired) could be an indicator.
  • Unrefreshing sleep with feelings of grogginess, dullness, morning headaches, severe dryness of the mouth.
    Body movements often accompany the awakenings at the end of each apnoea episode, and this, together with the loud snoring, will disrupt the bed partner's sleep and often cause her/him to move to a separate bed or room.

Probably not. Most people with sleep apnea do not realize that they are awakening to breathe many times during the night. The arousal is slight, and people become accustomed to this, but it is enough to disrupt the pattern of sleep so that they get very little deep sleep or REM sleep, and awaken feeling sleepy. A great many (probably most) apnoea sufferers go through a large part (or ALL) of their lives unaware of their condition.

Likewise regarding daytime sleepiness: people with sleep apnoea often are not aware of feeling tired or unusually sleepy. The disorder develops over a number of years, and they are not aware of the increasing symptoms and believe they feel "normal". Only after treatment do they realize how much more alert and energetic "normal" feels!

It’s estimated that as many as 15 million people suffer from sleep apnea. It’s more prevalent in men than women.

If someone suspects they may have sleep apnea, a sleep study (polysomnogram) should be done. This study will accurately measure what happens during sleep and how severe the problem is.

The most common treatment is a CPAP machine (link). CPAP stands for Continuous Positive Air Pressure. This is basically a machine that sits beside the bed. The patient wears a mask that fits across the face. The machine blows air into the nose all night. Many people who must wear a CPAP machine find that they can’t tolerate it and so end up not using it which allows the condition to go untreated. Fortunately there are alternatives to the CPAP machine.

Oral sleep appliances and therapy. These have proven to be a viable alternative to CPAP. Some of the benefits of an oral appliance over the CPAP are: no uncomfortable masks or hoses, does not promote claustrophobia like the CPAP can, tolerated much better than CPAP, no mask impression left on the face, far more convenient for travel, airports, camping, etc. The biggest benefit is that you and your spouse can actually sleep in the same bed!

Anyone who snores
Anyone who has already been diagnosed with sleep apnea
Anyone who cannot tolerate their CPAP machine
Anyone suffering from the signs and symptoms of sleep apnea

Disturbed and interrupted sleep can cause a wide variety of problems, from the minor to the very serious like Death.

Contact us right away. We will suggest a course of action that will result in better health and an improved quality of life.

Research has shown that the tongue is really one of the major factors contributing the blockage of the throat and airway. By gradually repositioning the lower jaw forward, the tongue also moves forward opening the airway and creating better muscle tone in the oral pharyngeal area.

Generally it takes 4 to 6 visits. Then we continue to follow up on the patients care even after they are properly fitted with the appliance.

Yes, as the apena is treated the snoring gradually diminishes with the proper management of the oral appliance.

Oral appliances can be used in three different manners. 
First, as an alternative for those individuals who are intolerant to CPAP. 
Second, as a hybrid therapy with CPAP the pressure can now be lowered to a more comfortable level to eliminate air leaks and tight masks.
Third, adjunctive usage means that there can be days off from CPAP usage like for camping and business trips.

No, it does not feel that much different than getting use to an orthodontic retainer.

NO. Any dentist can take an impression and send it out to a lab. It takes special advanced training and expertise to know the proper appliance selection for each individual and having the knowledge to properly manage the appliance. We have seen many patients who have been treated by an inexperienced dentist who have either developed problems or have had poor results.