Westfield Oral Surgery
320 Lenox Avenue, Westfield, NJ 07090
Phone: (908) 233-8088
Fax: (908) 232-4662

SNORING/SLEEP APNEA

BASIC FACTS

Snoring may be a sign of obstructive sleep apnea, a serious disorder in which the snorer stops breathing several times an hour during sleep. Snoring may be loud or relatively quiet. If snoring is quiet or minimal, apneas may not be as apparent. Very often a person suffering from apnea may not be aware of the loud snoring and breathing irregularities during sleep. The bed partner is usually the first to recognize the symptoms, and is disturbed during the night. Sleep apnea can generally be treated effectively once diagnosed and categorized as to the type and severity. Treatment is patient-specific, and may include weight loss, prescriptions for equipment to help breathing during sleep, medications, dental devices, simple (Somnoplasty ®) or more invasive surgery, usually a last resort.

COMMON SYMPTOMS

  1. (EDS) Excessive daytime sleepiness
  2. Fatigue
  3. Loss of concentration, forgetfulness
  4. Irritability or over-reaction to stressful situations
  5. Depression
  6. Morning headaches
  7. Restless sleep, frequent awakening during night
  8. Involuntary nighttime leg movements
  9. Frequent nocturnal urination
  10. Non-breathing sessions witness by bed partner or other
  11. Falling asleep quickly at inappropriate times
  12. Daydreaming or desire to nap

If you have a constellation of the above complaints, evaluation by a sleep center is recommended. Once a sleep study is performed, various treatment options can be offered to you by your physician or by the sleep center, such as medication, CPAP, and others. CPAP is an air pressure machine, with a vaporizer, which keeps the airways opened during sleep.

Like all treatments, there are pros and cons, and different success rates for each type of procedure. You should make your treatment choice based upon knowledge of all available options.

At our office, we can offer the following options:

DENTAL DEVICE

A relapse of the tongue into the airway is one of the primary causes of snoring and obstructive sleep apnea. With the dental device, the tongue, which is attached to the lower jaw, is pulled forward by advancement of the lower jaw. There are various types of devices, and they are generally comfortable, as they are similar to wearing a custom mouth guard or orthodontic retainer. Average success rate for this device is 85 percent in eliminating snoring and can eliminate mild to moderate apnea, and improve severe apnea.

Note: There are some devices which combine with a CPAP unit, which also eliminates severe apneas.

RADIO FREQUENCY SURGERY - Somnoplasty®

Snoring also occurs when the floppy tissues in the airway relax during sleep and vibrate. Besides the tongue, most snoring is caused by enlarged soft palate, uvula, and tonsils. Level of snoring can be aggravated by excessive weight, alcohol intake, and smoking. Highlights or benefits of Somnoplasty over other surgical treatment methods, such as LAUP or UPPP procedures, include:

  1. Outpatient office procedure
  2. Patient can be fully awake for the procedure
  3. Local anesthesia is administered to the uvula, palate, tongue or tonsils
  4. No tissues are removed, cut, or burnt
  5. Somnoplasty electrode admits low levels of radio frequency energy, creating friction within the tissue, resulting in tissue stiffening and shrinkage
  6. Entire procedure usually takes 30 to 60 minutes
  7. Somnoplasty minimizes bleeding, post-operative pain, by preserving the mucosa
  8. Recovery time after Somnoplasty is usually one day, requiring no more than over-the-counter medications (Advil, Tylenol, etc.)
  9. Minimal complication rate, such as infection
  10. Somnoplasty procedures are successful 75 percent of the time in treating snoring and successful treatment of apnea less than 50 percent
  11. Procedure may require more than one office visit, possibly two or three, depending upon initial response, evaluated after three to six weeks.

UPPP SURGERY

This is a relatively invasive surgery, which necessitates hospitalization, general anesthesia, and cutting and/or removal of the palate, uvula, tonsils, or other offending tissues. Complication rate for this procedure is higher, which can include bleeding, infection, and regurgitation. Success rate for treatment of snoring is 80 to 85 percent, and successful treatment of significant apnea less than 50 percent.

MMA - Maxillo-Mandibular Advancement Surgery

This is a surgical procedure requiring hospitalization. The treatment consists of moving the upper and lower jaws forward to eliminate any obstruction caused by the tongue and palate. Success rate has been reported at 100 percent. See Orthognathic Surgery for more information.

SLEEP APPLIANCE POST-INSERTION INSTRUCTIONS

You just received your mandibular tongue and palatal repositioner. As with anything new, there is always a break-in period. Below are some basic instructions and information which you may find helpful during your break-in period and during your continued use of the device:

  1. During the first week to ten days, you may experience increased or decreased salivary flow. This is normal and transient.
  2. During the first week, you may experience some jaw tightness or discomfort in the mornings upon waking. This, too, is usually temporary and is self-correcting. Should the pains continue or should they increase, call our office immediately for instructions.
  3. You may experience difficulty closing your teeth to normal position during the initial use of the device. This, too, is self-correcting within ten to fifteen minutes. If this symptom persists or should you notice any changes in your bite, please call as soon as possible.
  4. Clean you dental device with a soft toothbrush and toothpaste as necessary. Do not use denture cleaners unless advised to do so; these can damage your appliance. Do not use alcohol or mouthwash.
  5. It is important for you to return to the doctor for follow-up visits initially as recommended, then at six months and one year intervals. This is so we can assess the condition and functioning of your device.
  6. If you notice any bite changes, please contact our office immediately, or they may not be reversible.
  7. Bring your device or stone models to your dental visits when larger or new restorations are being placed so that your dentist may contour your restorations of fillings to the device as close as possible. If this cannot be done, please call our office.
  8. Once you have gotten used to the device and once it's been adjusted to a maximum therapeutic level, it is indicated to return for a repeat sleep study (PSG) to determine the actual effectiveness of the device on your snoring and sleep apnea condition. This information will help us further adjust the device or consider a secondary or additional treatment plan for you.
  9. Keep all appliances and devices out of range of pets, as they like to chew them.
  10. We guarantee our devices for one year for conditions related to routine breakage, unstable fit, and the like. Damages caused by pets and extrinsic forces can be repaired at an additional charge. 

Copyright © 2001 Systect, Inc.