For Sleep Apnea, a Mouth Guard May be a Good Alternative to CPAP

For Sleep Apnea, a Mouth Guard May be a Good Alternative to CPAP

People with sleep apnea who can’t tolerate the noise and discomfort of a CPAP machine might benefit from a mouth guard or surgery.

By Nicholas Bakalar

Article Published May 31, 2021

Oral device that us used to treat sleep apnea

Many people wear a CPAP machine at night to treat the interrupted breathing of obstructive sleep apnea, a condition that affects an estimated 22 million Americans. But CPAP machines can be noisy, cumbersome and uncomfortable, and many people stop using the devices altogether, which can have dire long-term consequences.

Mouth guards may be a more comfortable and easy-to-use alternative for many people with obstructive sleep apnea, according to a new report. The study, published in Laryngoscope, looked at 347 people with sleep apnea who were fitted with a mouth guard by an otolaryngologist. Two-thirds of patients reported they were comfortable wearing the devices, and the devices appeared to be effective in helping to relieve the disordered breathing of obstructive sleep apnea.

The lead author of the study, Dr. Guillaume Buiret, head of otolaryngology at Valence Hospital in Valence, France, said that if he had sleep apnea, he would choose an oral appliance first.

“It’s easy to tolerate, effective and it costs a lot less than CPAP,” he said. “Thirty to 40 percent of our patients can’t use CPAP, and these patients almost always find the dental appliance helpful. I would recommend it as a first-line treatment”

Loud snoring may be the most obvious consequence of sleep apnea, but the condition, if left untreated, can lead to a broad range of complications, including high blood pressure, heart disease, liver dysfunction and Type 2 diabetes.

The problem develops when the soft tissue at the back of the throat collapses during sleep, blocking the airway. This leads to breathing cessation for brief periods, gasping for air, difficulty staying asleep, and all the problems of daytime sleepiness, from poor job performance to fatal accidents. Animals can have it too — bulldogs, for example, have a narrow airway and a soft palate that can easily block it. Their sleep apnea is almost identical to the human version.

The severity of the condition varies widely from a very mild problem that may need no treatment at all to severe or even life-threatening disease. Dr. Sara E. Benjamin, a neurologist and sleep specialist at Johns Hopkins, said that spending a night in a sleep laboratory monitored by a technician is the best way to diagnose apnea. A lab study offers the most thorough analysis, and can detect many other sleep problems besides apnea, but there are home test kits that are easy to use and cost-effective. They test breathing effort and oxygen levels, but not the brain waves, muscle tone and leg movements that a lab test records.

How can you know that you need a sleep assessment? “It’s a low standard to get evaluated, either by home testing or in a sleep lab,” Dr. Benjamin said. “If a person feels sleep problems are impacting daily activities, that’s enough to go and get evaluated. If the cause is a breathing problem, you don’t want to ignore it.”

A CPAP — continuous positive airway pressure — machine is usually the first option for treating sleep apnea. The device has a motor that delivers pressurized air through a tube attached to a mask that covers the nose, or both the nose and the mouth. This keeps the airway open. Some machines can automatically change the pressure to compensate for changes in sleep position; others require manual adjustment. Headgear varies, but all have adjustable straps to get the right fit. There are newer models that can deliver heated or humidified air, depending on the patient’s preferences, and there are small travel models as well.

“We recommend a custom device made by a dentist,” Dr. Benjamin said. “And you should be retested to see how well it’s working. There’s subjective and objective improvement that should be tracked.”

But there are people for whom neither CPAP nor dental appliances work, either because they cannot use them consistently or correctly, or because the devices themselves do not solve the problem even when used properly. For these patients, there are various effective surgical procedures.

The most common is soft tissue surgery, which involves modifying or excising tissue at the back of the mouth. Depending on the structures and musculature of the mouth, the surgeon can trim the soft palate and the uvula, remove the tonsils, shrink tissues with a heated instrument, straighten a deviated septum, or alter the position of the tongue muscles, all with the aim of improving air flow.
White plastic mouth guard for Obstructive Sleep Apnea by O2Vent Optima

There are also bone surgeries that move the jaw forward to make the entire breathing space larger, a procedure that can involve a protracted recovery period.

In 2014, the Food and Drug Administration approved a device called Inspire Upper Airway Stimulation. This is a small appliance implanted under the skin like a heart pacemaker. Using two electrical leads, it senses the breathing pattern and stimulates the nerve that controls the tongue to move it out of the way and allow air to pass freely. Implanting it is a day surgery procedure that takes about two hours.

“It doesn’t change the anatomy, and recovery is easier than with other surgeries,” said Dr. Maria V. Suurna, an associate professor of otolaryngology at Weill Cornell Medicine who specializes in surgery for sleep apnea. “It’s effective. It has the lowest complication rate of all the surgeries.

“But it’s not for everyone. It’s approved only for adults 18 and older who are not overweight and who have moderate to severe apnea.” Some people may be ineligible because of the structure of their anatomy.

“Surgery is tricky,” Dr. Suurna said. “But there’s no ideal treatment for apnea. Each has pros and cons, benefits and risks.”

What do insurance companies consider oral appliance for sleep apnea?

What do insurance companies consider oral appliance for sleep apnea?

Suffering from sleep apnea can not only disrupt your sleep, but it can be a serious health problem. This is why it’s important to get diagnosed so that you can get the treatment you need. One of the treatments that many people choose is an oral appliance. For many, this is much easier to use than some other available therapy options.

But, as with many medical treatments, the cost can be an issue. Although you have health insurance, many people still wonder, what do insurance companies consider oral appliance for sleep apnea? Let’s answer that question and look at some of the issues surrounding sleep apnea.

What is Sleep Apnea?

If you are diagnosed with sleep apnea, this means you pause when you’re breathing during sleep, or there is a reduction in your breathing. If someone stops breathing completely or takes less than 10% of a normal breath for ten seconds or more, they are experiencing an apnea or obstructive sleep apnoea.  If you are experiencing sleep apnea, you may suddenly wake up or move from a deep sleep to a more shallow sleep.

To determine if you have sleep apnea, a sleep study is generally needed. During a sleep study, sleep patterns are monitored to see if someone stops breathing during the middle of the night and at what frequency. This will help doctors determine if they have sleep apnea and what type. From there, the proper course of sleep apnea treatment can be devised.

Treating Sleep Apnea

Once you’re diagnosed with sleep apnea, it’s time to get treatment. Oral appliances are a popular option over using a continuous positive airway pressure (CPAP) machine.  Some people find these cpap therapy machines to be noisy and intrusive.

Oral appliance therapy works to treat sleep apnea by moving the lower jaw forward to open the airway and unblock the windpipe, which can improve breathing and lead to a better night’s sleep. FDA-registered oral devices can be used to treat sleep apnea when they are given by a qualified dentist trained in dental sleep medicine.  At Sleep Better Columbus, we can help you find the right oral appliance to treat your sleep apnea and get you a better night’s sleep.

Insurance and Oral Appliance Treatment  for Sleep Apnea

Since all insurance companies are different, you’ll need to contact your specific insurance company to make sure that you are covered for an oral appliance for sleep apnea. Generally, plans will at least cover a portion of the cost.

Most health insurance plans consider oral appliances or dental appliances for sleep apnea as a piece of medical equipment. This is why they will cover it. There are more than 100 FDA-approved oral appliances available to help treat sleep apnea. Your insurance may specify the type of oral appliance that they will cover instead of letting the doctor and patient choose. These are things you will need to ask your benefits department.

To get coverage for an oral appliance for sleep apnea, you’ll have to show that you suffer from the condition and not just chronic snoring. A copy of the sleep study and any medical notes from your sleep apnea screening appointment is also necessary. Your medical history will also be considered. Some insurance companies may also require other documentation, so it’s best to ask so that you are prepared.

Of course, for your insurance company to pay for an oral appliance for sleep apnea, it needs to be prescribed by your doctor. The insurance company will need to see that documentation to provide any level of coverage.

Although the equipment goes in your mouth, an oral mouthpiece is treated under your health insurance, not your dental insurance. The device is being used to treat a medical condition, not one that is specific to your dental health. An oral appliance is seen as a piece of medical equipment because it can be used to improve your health.

When people begin using oral appliance treatment for sleep apnea, they can also help to avoid serious health problems such as:

  • High blood pressure
  • Stroke
  • Diabetes
  • Heart disease

If you have a medical history of any of these or a family history of them, it’s important to get treatment for your obstructive sleep apnea as soon as possible.

How Much Do Oral Appliances for Sleep Apnea Cost?

This is a difficult question to answer because there are so many oral devices  for sleep apnea available. Since they are custom-fit to each patient and everyone may choose something different depending on their condition, it’s best to ask your doctor which ones are best for you. From there, you can price them out and get a better idea of the cost.

Once you have an estimate, you can find out how your insurance may cover it. This will also vary depending on your plan. If you have a deductible, this will come into play, as well as if you have any co-insurance. Many times patients do need to pay for a percentage of the cost. But, the exact dollar amount will depend on your insurance coverage.

Contact Us!

When you need an oral appliance to treat obstructive sleep apnea (osa), visit Dr. Mark Levy at Sleep Better Columbus.  Dr. Levy is trained in treating sleep apnea and can recommend dental appliances for sleep that can help. Let Dr. Levy and his dental sleep staff show you the alternative to CPAP machine to improve the quality of your sleep.

The dental sleep medicine staff at Sleep Better Columbus can help you find an oral device for sleep apnea that your insurance will cover so that you can get your obstructive sleep apnea under control. Once you do, you’ll notice you’re getting a better night’s sleep as well as an improved quality of life. When you have your sleep apnea treated, you’ll feel energized and healthy.

Call Sleep Better Columbus today at 614-362-7292 to find out more about oral appliances to treat your sleep apnea.

Columbus Ranked 6th Most Sleep Deprived Large City in US

Columbus Ranked 6th Most Sleep Deprived Large City in US

If you’re reading this article through blurry eyes, you’re not alone. Columbus was recently ranked one of the most sleep deprived cities in the United States by a study from RetailMeNot.

The study looked at data from the Centers for Disease Control (CDC) in which adults reported getting less than seven hours of sleep per night. Additional metrics include statistics on poor mental health and physical health, as a lack of sleep can have a drastic impact on both.

Columbus ended up in 6th place on the list of large cities with a whopping 41.8% of adults reporting getting less than seven hours of sleep per night. The only large cities to rank higher include Detroit (#1 with 51.4% of adults reporting less than seven hours of sleep per night) followed by Cleveland, Memphis, Philadelphia and Baltimore.

“Many facets of modern life contribute to the lack of sleep,” states the RetailMeNot blog post that features the results of the study. “One example is technology, as people spend more time in front of brightly-lit devices that disrupt the body’s natural circadian rhythms. But more fundamental patterns of working and living are also at play. Factors like longer commutes and longer working hours in the U.S. workforce may be key reasons why a good night’s rest is harder to come by.”

As a whole, the CDC reports that the United States has a national rate of 36.2% of adults getting less than 7 hours of sleep per night, which means that Columbus isn’t that much higher than the national average.

To view the full results of the study, visit www.retailmenot.com.

RELATED: The Future of Sleep

Source: https://www.columbusunderground.com/columbus-ranked-6th-most-sleep-deprived-large-city-in-us-we1

Sleep Apnea as a COVID-19 Risk

Sleep Apnea as a COVID-19 Risk

With almost 15 million cases of coronavirus and over 280,000 deaths in the U.S., we have fortunately learned much about COVID-19 prevention measures and treatments since the early days of the pandemic, and a vaccine is now in sight. Most of our knowledge regarding  risk factors for worse outcomes, include immunocompromised status, diabetes, older age and high blood pressure.

One risk factor remains hidden in plain sight: obstructive sleep apnea.

Read more

How Serious is Sleep Apnea?

How Serious is Sleep Apnea?

Sleep apnea is a seriously dangerous sleep disorder. It’s causing more than 18 million people to be at risk for further health problems as a result. But how serious is sleep apnea? Besides the mind-boggling figure mentioned earlier, what else about this chronic disorder makes is so dangerous?

Those are the questions we are going to answer in this article. We are going to talk about the seriousness of sleep apnea, and how so many go undiagnosed. On top of that, we’re also going to discuss the medical conditions that escalate because of sleep apnea.

Sleep apnea is ignored because so many aren’t aware of how serious it is. After this article you will have a command and awareness of sleep apnea, knowing exactly what you must do to get help.

What Is Sleep Apnea?

Sleep apnea is a disorder that causes you to stop breathing during your sleep. There are 3 types of sleep apnea. Obstructive Sleep Apnea, Central Sleep Apnea, and Complex Sleep Apnea Syndrome.

When you compare them to each other the symptoms they cause can overlap. However, there specific differences to be aware of. Obstructive Sleep Apnea is caused by a relaxation of throat muscles that block your upper airway as you sleep. This is the most common.

Up next is Central Sleep Apnea is the lack of communication between the brain and the central nervous system. Because of this disconnection your brain does not receive the signal it needs to stimulate breathing. This is severe.

Lastly, Complex Sleep Apnea Syndrome is a mix of both OSA and CSA. This is the most severe because there are two impairments preventing quality sleep to focus on.

What Are Some Common Symptoms of Sleep Apnea?

When sleep is impaired your health and wellness suffer. After all, how can you be happy or do anything safely when you are deprived of quality rest? Here are some symptoms you want to pay attention to.

Difficulty staying focused or paying attention throughout the day.

  1. Difficulty keeping your attention on tasks throughout the day.
  2. Waking up gasping for air from a nap or in the middle of the night.
  3. Difficult time insomnia or sleeping through the night.
  4. Early morning headaches.
  5. Interrupting partners or spouses from their rest because of noisy snoring.
  6. You wake and have excessive dry mouth.
  7. You suffer from hypersomnia (severe tiredness during the day).

The Seriousness of Sleep Apnea

The list above shows 7 reasons sleep apnea can’t be taken lightly. But these symptoms lead to very troublesome medical conditions and lifetime problems if left unchecked. What is even more disturbing is that childhood sleep apnea is on the rise. By you becoming aware of the signs, symptoms, and health concerns sleep apnea causes you may help your son or daughter or someone else’s.

Sleep apnea ranges between mild, moderate, and severe. Often many start out mild, and with proper attention can keep it that way. Keep that in mind when reviewing this list. Because complete neglect is a large reason for the condition worsening.

Chronic Heart Failure

With a sudden lack of oxygen circulated throughout the body from sleep apnea, the heart must work under stress.

It’s forced to pump faster and harder because of pressure build-up.

See, if you don’t breath the circulation cycle is stopped. This causes increased pressure and tissue death from lack of oxygen. On top of that, your blood begins to thicken. Because of carbon-dioxide increase in the blood. This forces your heart to work harder. Ultimately resulting in chronic heart failure.

Stroke

When your heart works harder, and your blood gets thinker blood begins to form. As these clots form, one could block blood flow to your brain. Causing a stroke.

Type 2 Diabetes

Studies have shown that untreated Obstructive Sleep Apnea increases your chance of developing or worsening type 2 diabetes. This is because of insulin resistance associated with sleep apnea.

Note: Middle-aged and older men have a high risk of developing central sleep apnea according to the Mayo Clinic.

Innovation

Many of the car accidents and accidents that involve heavy machinery are because of sleep apnea. The daytime drowsiness and the lack of focus just for a split second are all it takes to change your life forever.

But what if there was a way to improve your sleep apnea concerns effortlessly, and without a big clunky CPAP machine blowing air into your stomach. You would be able to wake up refreshed, happy, and prevent all these medical concerns. Many of them haven’t been listed.

As you can see, sleep apnea is a huge problem left untreated. And recent research states that about 80% of the United States is undiagnosed. Drowsy driving is dangerous driving.

Dr. Levy of Sleep Better Columbus created a proven and innovative way to improve your sleep apnea, preventing further health deterioration.

A New Way to Improve Your Sleep Apnea Condition

Improving your health because of your awareness of how serious sleep apnea is must be crystal clear by now. So,let’s switch gears. And give you an alternative way of treating sleep apnea. Some love their CPAP mask and find great comfort in using it.

However, at the offices of Sleep Better Columbus, the Oral Appliance is making waves, and many are finding results when traditional treatment did not work. The oral appliance is much like a mouthpiece, it’s fitted to you, it’s much more comfortable to use, and you don’t need a big machine by the bedside.

It works by position your jaw forward and making your airway free of obstruction. This is an FDA approved medical device. What is fantastic is the compliant rate of use compared to the CPAP. Because of the caring and attentive staff at Sleep Better Columbus, you will receive an oral appliance that is comfortable. They also will follow up to make sure your sleeping patterns and testing improve by using it.

Oral Appliances are for patients suffering from Obstructive Sleep Apnea. Central Sleep Apnea involves the nervous system requiring other forms of care and resources used.

In Conclusion

The main question of how serious is sleep apnea can easily be answered… very serious. Not to mention, it’s also very dangerous if left untreated. It’s important going forward you pay attention to how you feel when you wake up. If you snore that is a sign to set and an appointment with the Sleep Better Columbus for a sleep study. The friendly staff will go over all your concerns and can also offer you a way to do your study at home.

 

If you are suffering from any of the other symptoms,it’s recommended you also reach out. Don’t ignore feeling unrested or the comment from your spouse that your snoring is getting worse. You don’t need an accident to happen at work before you get help. If you feel overly tired during the day that is a sign.  Sleep Better Columbus welcomes you to call (614) 362-7292.

What Happens at a Sleep Clinic?

What Happens at a Sleep Clinic?

Have you been having trouble sleeping? If you go to your doctor, they may recommend seeing a sleep specialist. And getting a sleep study conducted. But what happens at a sleep clinic? You can ask for some information from your Doctor. However, they may not know enough to put you at ease.

It’s perfectly normal to be nervous and a bit uneasy about sleep studies. You’re not alone, many uncertain feelings swirl around the minds of new sleep clinic patients.

In this article, we are going to ease your mind about what happens at a sleep clinic and what sleep specialists do during your study. Your new awareness will make your experience much more tolerable and keep your anxiety low.

So, let’s get started by finding out exactly why your Dr. would recommend a sleep specialist in the first place.

When Is A Sleep Specialist the Best Decision?

If you have been trouble sleeping for at least 3 weeks,it’s time to see your doctor. Deciding to see a sleep doctor will depend on what disorder you doctor thinks you have. There are up to over 80 sleep disorders documented but we will discuss the 4 most common.

If your primary doctor suspects you have, Insomnia, Sleep Apnea, Narcolepsy, and Restless Leg Syndrome (RLS). These four disorders can severely harm your overall health if left untreated. This is when you will receive a referral to see a sleep specialist.

Note: Sleepwalking is another disorder that many suffer from that sleep specialist study and treat.

Let’s briefly go over the top 4 sleep disorder.

  1. Insomnia – This is a sleeping disorder where you do not sleep, your body and mind are tired, but you cannot fall asleep for long periods of time.
  2. Narcolepsy – This is when you can fall asleep at any time. If you are in a relaxing position you can fall asleep, even while driving a car or operating heavy machinery. It is sudden.
  3. Sleep Apnea – This is a disorder the causes you to stop breathing as you sleep, it can happen because of physiological characteristics like weight, neck circumference, or abnormally small airway. It can also be from a neurological disorder when your brain and nervous system don’t communicate during sleep.
  4. Restless Leg Syndrome – This is a condition that causes an uncontrollable sensation to move your legs, this usually happens because of feeling uncomfortable in some way. Happens primarily in the evenings when resting.

What is A Sleep Specialist?

It is common that sleep specialists are in the psychology or medical field respectively. They normally hold degrees such as Ph.D., MD, or DO and also hold the esteemed credential from the American Board of Sleep Medicine.

These medical professionals focus on sleeping disorders and use special techniques to determine what is happening to you as you sleep.

In a later section, we uncover exactly what happens at a sleep clinic when a sleep study is done.

Based on your symptoms and your explanation to your Dr about not getting enough sleep to feel well-rested. And having lower energy and focus throughout your day. Your primary care physician, internist, or family doctor will send you to a sleep specialist to get further details about the sleeping disorder.

What Happens When You See a Sleep Specialist?

The sleep study is a noninvasive exam done overnight. This study allows doctors to monitor what happens to you as you sleep and monitor your brain activity. It is common to go to a sleep clinic and meet with your specialist. You can set up for an overnight stay at the sleep clinic, and in some cases, you can do a sleep study from the comfort of your own home.

When you go to see a sleep doctor, they will begin the appointment with a series of questions that funnel down to a specific purpose. They are trying to see if your symptoms qualify you for a specific type of sleeping test. This test is called a polysomnogram and it’s given to help diagnose what your brain waves are doing when you sleep.

That’s not all. You also have other electrodes placed all over your body in various areas. A total of 25 to be exact. The electrodes not only monitor your brainwaves. But, eye movement, muscle twitching, chest wall movement, and airflow as you breathe through your nose and mouth.

The Atmosphere

If you choose to sleep at the clinic you will be given a room that is comfortable, dark, and decorated like a bedroom, normally you are asked to come a few hours before your bedtime. You can bring anything you want that makes you feel comfortable as you sleep.

Just before you go to bed, the sleep study technician places the electrodes we talked about earlier. The electrodes don’t hurt in any way and you still have enough room to move comfortably in your bed.

Polysomnographic technology specialists will monitor you as you sleep throughout the night. Just in case you need to use the bathroom or something else you made need. The technologist gathers all the information and gives it to the dr.

Next Steps

Now that you know what happens at a sleep clinic what happens next?

Well, first the doctor will review your test, you normally will make a follow-up appointment for 2 weeks out. So,you’re the sleep doctor can review the test and come up with a diagnosis if there is one.

On your follow up visit your sleep doctor will discuss your results, the diagnosis, and their recommendations. For example, if you are diagnosed with sleep apnea you will then be fitted and ordered a mask. At Sleep Better Columbus, you will be given one on one professional and caring attention.

The services and options available for sleep apnea are endless. You can find a CPAP device that will be comfortable, and affordable. You can also select an Oral Appliance that doesn’t evolve a mask or a machine (for OSA only).

 

Dr. Levy has been servicing the Columbus area for years and welcomes you to call and set an appointment. If you are suffering from any of the disorders mentioned above. If you’re feeling sluggish, have a lack of energy after sleeping, or your doctor recommends you see sleep specialist call (614) 362-7292 today.