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Have you ever noticed how often snoring is used to get a laugh on TV sitcoms and cartoons? Actually, thereâ??s nothing funny about it. Snoring is a serious medical and social problem that can cause social ridicule, sleeplessness, and a host of serious health problems including obstructive sleep apnea. 25% of adults snore habitually. And without treatment, it doesnâ??t get any better. While overweight males are at the greatest risk, women are not immune, and the problem only grows worse as we age.

Why Do We Snore?

Snoring occurs when the passages at the back of the mouth and nose do not have a free flow of air. This is called â??obstructionâ?? and usually occurs when the soft tissues in that area collapse during sleep, causing the tongue to meet briefly with the soft palate (top part of your mouth in the back) and the uvula (the â??bellâ?? in the back of your throat). The vibrations are what cause the snoring sound.

Snorers may also suffer from:

· Poor oral muscle tone. Relaxed tongue and throat muscles can cut off airflow. Deep sleep, alcohol and sleep medications can contribute to poor muscle tone.

· Large tonsils and adenoids. Excess throat tissue can cause snoring. This is why children sometimes snore. Being overweight can cause excess neck tissue, which is why snoring is more common in overweight individuals. Rarely, a cyst or tumors can be the problem.

· Long uvula and/or soft palate. Individuals with a â??long palateâ?? have a narrower opening between the nose and throat that can create noise during the relaxed breathing of deep sleep. A longer than normal uvula worsens the situation.

· Nasal airway obstruction. Stuffy noses do not have a free flow of air. The extra effort it takes to breathe through a stuffed up nose creates a strong pull on floppy throat tissues, causing a snoring sound. That is why some people experience snoring only during hay fever attacks, a cold or a sinus infection.

· Nose or nasal septum deformities, such as a deviated septum, can cause obstruction.

Obstructive Sleep Apnea (OSA)

Obstructive sleep apnea often begins with snoring, but can be far more serious. Obstructive sleep apnea occurs when snoring is punctuated by long absences of sound lasting ten seconds or more that can happen up to 300 times per night. This lack of sound means the individual is not breathing in between bursts of snoring. Health risks are great and include low blood oxygen levels that make the heart work much harder to bring oxygen to the blood.

Individuals affected with sleep apnea sleep lightly and cannot relax deeply enough to allow sufficient airflow to the lungs. The snorer is left with night after night of poor rest, as well as:

· Daytime sleepiness

· Increased mood swings

· Depression

· Impaired job performance

· Hazardous driving, especially if the individual operates heavy equipment

· Elevated blood pressure

· Enlargement of the heart

Have you ever noticed how often snoring is used to get a laugh on TV sitcoms and cartoons? Actually, thereâ??s nothing funny about it. Snoring is a serious medical and social problem that can cause social ridicule, sleeplessness, and a host of serious health problems including obstructive sleep apnea. 25% of adults snore habitually. And without treatment, it doesnâ??t get any better. While overweight males are at the greatest risk, women are not immune, and the problem only grows worse as we age.

Why Do We Snore?

Snoring occurs when the passages at the back of the mouth and nose do not have a free flow of air. This is called â??obstructionâ?? and usually occurs when the soft tissues in that area collapse during sleep, causing the tongue to meet briefly with the soft palate (top part of your mouth in the back) and the uvula (the â??bellâ?? in the back of your throat). The vibrations are what cause the snoring sound.

Snorers may also suffer from:

· Poor oral muscle tone. Relaxed tongue and throat muscles can cut off airflow. Deep sleep, alcohol and sleep medications can contribute to poor muscle tone.

· Large tonsils and adenoids. Excess throat tissue can cause snoring. This is why children sometimes snore. Being overweight can cause excess neck tissue, which is why snoring is more common in overweight individuals. Rarely, a cyst or tumors can be the problem.

· Long uvula and/or soft palate. Individuals with a â??long palateâ?? have a narrower opening between the nose and throat that can create noise during the relaxed breathing of deep sleep. A longer than normal uvula worsens the situation.

· Nasal airway obstruction. Stuffy noses do not have a free flow of air. The extra effort it takes to breathe through a stuffed up nose creates a strong pull on floppy throat tissues, causing a snoring sound. That is why some people experience snoring only during hay fever attacks, a cold or a sinus infection.

· Nose or nasal septum deformities, such as a deviated septum, can cause obstruction.

Obstructive Sleep Apnea (OSA)

Obstructive sleep apnea often begins with snoring, but can be far more serious. Obstructive sleep apnea occurs when snoring is punctuated by long absences of sound lasting ten seconds or more that can happen up to 300 times per night. This lack of sound means the individual is not breathing in between bursts of snoring. Health risks are great and include low blood oxygen levels that make the heart work much harder to bring oxygen to the blood.

Individuals affected with sleep apnea sleep lightly and cannot relax deeply enough to allow sufficient airflow to the lungs. The snorer is left with night after night of poor rest, as well as:

· Daytime sleepiness

· Increased mood swings

· Depression

· Impaired job performance

· Hazardous driving, especially if the individual operates heavy equipment

· Elevated blood pressure

· Enlargement of the heart

Snoring can be more than annoying to your bed partner. It can mean you have a serious health problem. This is because snoring may be a sign of obstructive sleep apnea (OSA). Millions of Americans suffer from OSA, and millions of people who snore – and those who share their bed – seek out over-the-counter medications to alleviate this problem. The problem is rarely fixed, and the suffering continues. One thing those who have OSA or snore can do is to see a dentist who can provide relief. Dental sleep medicine may be the best way to help end snoring and the dangers of OSA.

Oral Appliance Therapy

You have probably seen oral appliance devices sold in the store or advertised in magazines and on TV that promise relief from snoring. They may have the basic concept down: Put this mouth guard in and your snoring will end. However, the problem is that these are usually one-size-fits-all, and may increase the chance for damage to your teeth or jaw. An effective oral appliance is custom-made so that it can address your individual needs, and fit comfortably. Custom-made oral appliances can help when you sleep by:

· Holding the tongue in position

· Pushing the jaw forward

· Tightening the soft tissue to keep your airway open

· Increasing muscle tone

Behavioral Therapy

Many people who snore or have OSA may find their symptoms alleviated by simply changing aspects of their life. People who drink alcohol regularly can cut down on the amount they drink or avoid drinking three hours prior to bedtime. People who smoke can, and should, stop. The effects of smoke on the throat and lungs create problems that can worsen snoring or sleep apnea. Individuals who are overweight or obese often suffer the most severe cases of OSA or snoring. By losing weight, the occurrence of breathing difficulties is reduced. Other behavioral modifications that will help include:

· Avoiding eating heavy meals close to bedtime

· Going to bed at a reasonable hour

· Avoiding antihistamines close to bedtime

· Reducing allergens in the home

Medication

Over-the-counter medications may target those who have trouble falling asleep, but not those who snore or have OSA. Dental sleep medicine targets these issues by prescribing supplements such as anti-snoring pills to be taken before bed. These pills contain different herbs and plant enzymes that reduce congestion and swelling of the tissue in the nose and throat. There are also certain nasal sprays or nose drops that may be beneficial.

Due to the dangerous health problems, such as heart attack or stroke that can arise from OSA you should see a specialist with dental sleep medicine experience.

If your sleep patterns have been disrupted by snoring or believe you may have obstructive sleep apnea, please contact Dr. Ira L. Shapira or visit ihatecpap.com to schedule an initial consultation.

Sleep apnea and one of its most common treatment options, Continuous Positive Airway Pressure or CPAP, contain an array of questions and answers for those with obstructive sleep apnea. This provides you with an overview and helps you find further information.

What is sleep apnea?

During sleep, some peoples’ breathing briefly stops many times throughout the night. Obstructive sleep apnea is caused by the soft tissue at the back of the throat collapsing and blocking the airway. Central sleep apnea occurs when air cannot flow into or out of the person’s nose or mouth through efforts to resume breathing because of confused signals from the brain to the diaphragm.

What causes sleep apnea?

Mechanical and structural problems in the airway interrupt breathing during sleep. The throat muscles and tongue relax too much during sleep, blocking the airway.

Am I at risk for sleep apnea?

This can affect anyone, however, it’s more prevalent in men. Loud snoring, weight problems and high blood pressure are risk signs. If you never feel rested, suffer from being overweight, smoke, or notice behavioral changes, such as depression, see an experienced sleep apnea specialist. Snoring is also a sign of sleep apnea, but isn’t the only indicator.

Does obstructive sleep apnea require surgery?

Oral appliance therapy is an alternative to surgery. Therapeutically, they reposition the lower jaw and tongue to reduce apneic occurrences.

If I use a CPAP do I still need surgery?

By correctly adhering to treatment, Continuous Positive Airway Pressure, or CPAP, can be very successful. However, studies also show only 23-45% of patients attain success. CPAP is a commitment, those who think they can’t devote themselves to the program should look into oral appliance therapy. Surgery is a last resort.

For many, CPAP is uncomfortable. Less cumbersome methods use simpler mouthpieces that properly align the jaw for safer sleep. These mouthpieces resemble sports mouth guards and helps patients breathe through the nose and mouth. If CPAP is uncomfortable, look into the alternate treatment options.

Why should I seek treatment for sleep apnea?

Quality sleep is essential to wellness. Sleep apnea creates lack of energy, inhibits concentration and slows metabolism. Even worse, lost sleep increases chances for high blood pressure and heart attacks.

Snoring may seem like a mere annoyance to most people. But sometimes, snoring is a symptom of sleep apnea, a serious medical condition that affects over 20 million Americans and drastically reduces their quality of life. In extreme cases, it can lead to death.

The word “apnea” is derived from a Greek word that means “want of breath.” In order to be diagnosed with sleep apnea, one must experience stoppage of breathing for a period of at least ten seconds more than five times in one hour. All of this counteracts the healing, restorative effects that nourishing deep sleep is meant to provide. Sleep is critical to health, just as important as a healthy diet and physical activity.

If it goes untreated for lengths of time, obstructive sleep apnea leads to hypertension, strokes, muscle pain, heart attacks, morning headaches and excessive daytime drowsiness. Many who have mild sleep apnea know that they snore while they sleep. At the same time, they may not link this and their daytime fatigue to the potentially life-threatening larger problems that could eventually make themselves known.

Symptoms

Sleep apnea makes its presence known in a variety of ways. And with the wide array of symptoms, different people may experience widely different combinations of the following:

If you notice you’re experiencing any of these, please keep in mind that they could be indicators of sleep apnea. Ignoring them could potentially result in major health risks, not to mention the diminished day-to-day concentration, which affects things like your job and being an active member of society. One potentially disastrous after-effect to keep in mind is experiencing drowsiness while driving, too. In children, academic underachievement and substandard mental development have been linked to sleep apnea.

Lower airway surgery is normally done for two reasons - to increase the size of the airway to improve breathing and to prevent the airway from collapsing. It also helps to minimize or prevent snoring for sleep apnea sufferers.
There are several types of lower airway surgery:
Genioglossus Advancement
The muscle called the genioglossus connects the back of the tongue to a spot on the rear of the chin. Genioglossus advancement moves the tongue forward to leave more space for air to circulate. This surgery is done via an incision inside the patient’s lower lip.
Hyoid Advancement
Slightly above the Adam’s apple is a C-shaped bone called the hyoid bone. This bone connects the muscles at the edge of the lower throat to the back of the tongue.
Hyoid advancement surgery is done to increase the space behind the tongue, allowing air to flow more freely. In this procedure, an incision is made in the hyoid bone which is then brought forward and attached to either the jawbone or the Adam’s apple.
Lingualplasty
In some cases, the reason air is obstructed is because the tongue is too big. In a surgical procedure called a midline glossectomy, a small part of the center of the tongue is removed to make it smaller.
Lingualplasty is a similar procedure, with even more of the tongue being removed. In some cases, a temporary tracheostomy may be performed to ease breathing during recovery because of the swelling that takes place.
Bimaxillary Advancement
In some cases, the doctor will move both the upper and lower jawbones forward, including the patient’s teeth. This increases the space for the tongue to rest and improves airflow. This procedure is called bimaxillary advancement and is usually either performed when the patient has a small jaw or when they have not had any improvement from other soft tissue surgeries.
Realignment of the teeth is sometimes necessary after this surgery, which requires orthodontic work. It can also affect the facial appearance, but to what degree will depend on how severe the work was.

Sleep Apnea is part of the spectrum of what is called “Sleep Disordered Breathing” or “SDB.” The condition Sleep Apnea is commonly broken into three main categories. The three main categories of Sleep Apnea are as follows:

Obstructive Sleep Apnea (OSA)

Central Sleep Apnea (CSA)

Mixed Sleep Apnea (MSA)

The three main categories, or types, of Sleep Apnea will be discussed in more detail below. Sleep Apnea is commonly and effectively treated with CPAP therapy (Continuous Positive Airway Pressure). Keep in mind that this is not a comprehensive treatment on the subject of Sleep Apnea. For more information please reference the citations at the end of the article or speak with your doctor.

Obstructive Sleep Apnea (OSA)With Obstructive Sleep Apnea, the soft tissue of the upper airway collapses during the night and slows air intake, eventually eliminating air intake altogether. When oxygen intake is reduced or eliminated and blood oxygen levels fall significantly, the brain sends an emergency signal to wake up and resume a normal breathing pattern. This process can happen as many as a few hundred times a night for some people with severe OSA. The use of a CPAP machine either drastically reduces these “apneic” events or eliminates them altogether. This results in the restoration of a normal breathing pattern and the CPAP user is able to achieve deep, REM(3) sleep, allowing the body to do routine maintenance and restore many healthful functions in the body.Central Sleep Apnea (CSA)Central Sleep Apnea is similar to OSA in its final effect on the sufferer, however, the mechanism of oxygen reduction is different. The principal mechanism of oxygen reduction in CSA is due to a failure of the brain to send a proper breathing “signal” to the muscles that control the breathing process. This type of Sleep Apnea is more rare than OSA and according to the Mayo Clinic accounts “for less than 5 percent of sleep apneas.”(4) Even though CSA is different in function than OSA, the outcome for the sufferer is the same–reduced oxygen intake through out the night, failure to reach deep sleep cycles and general fatigue throughout the day. Fortunately, in most cases, CSA can be treated with the same equipment that is used for those that suffer with OSA. Most CPAP, BiPAP and APAP machines have sophisticated circuitry which allows for the detection of different types of apneas, allowing the machine to adjust to the needs of the user throughout the night.Mixed Sleep Apnea (or Complex Apnea)According to the National Institutes of Health, Mixed Sleep Apnea is defined as a combination of both Obstructive Sleep Apnea and Central Sleep Apnea. The technical explanation for Mixed Sleep Apnea according to the NIH is as follows: “intervals of ten seconds or longer during which there was a complete cessation of airflow accompanied by an absence of respiratory effort in the early part of the apneic episode and a resumption of respiratory effort in the latter part.” Basically, this means that a CSA-related apneic event occurs, followed by an OSA-related apneic event. Interestingly, according to the study by the NIH, the sequence of events is always from CSA to OSA and never in reverse. In other words, the brain fails to send a signal to breath, resulting in an apneic event, followed by a collapse of the airway that further impedes oxygen flow. This makes sense, as it would not seem vary likely that an airway collapse related to an OSA-type event would cause the brain to misfire a breathing signal, however, a misfire by the brain would include the muscles involved in breathing and may lead to a loss of good muscle tone in the upper airway.

(1)http://www.webmd.com/sleep-disorders/sleep-apnea/sleep-apnea(2)http://www.sleepapnea.org/info/index.html(3)http://www.webmd.com/sleep-disorders/guide/sleep-101(4)http://www.mayoclinic.com/health/central-sleep-apnea/DS00995

Many studies on sleep patterns have been done throughout the years. Sleep experts say we need between six and eight hours of sleep to feel rested and function at our best during the day. For some, this simply means going to bed at a reasonable time. However, there are people who cannot feel rested no matter what time they go to bed because they snore, share the bed with someone who snores, or suffer from sleep apnea. Losing an hour or more of sleep a night because of snoring can add up over time. In the case of obstructive sleep apnea (OSA), the consequences can affect the health of the individual.

OSA is a condition in which an individual stops breathing due to their airway collapsing during sleep and blocking their breathing for up to ten seconds each time. When the OSA is serious, this cessation can occur more than 30 times an hour. These cessations in breathing cause the blood oxygen levels to decrease dramatically. Lower oxygen levels in the blood raise the threat of heart attack, high blood pressure and stroke.

Causes of Sleep Apnea and Snoring

As we sleep, our muscles are relaxed. When the tongue and throat muscles relax, they can block the airway. A partial collapse of the airway results in the sound we call snoring. A complete collapse of the airway cuts off breathing and results in an apneic event. When this happens, you will wake up and begin breathing again because your muscles are no longer relaxed. This may happen as little as five times every hour, or as many as 30 or more times an hour. Obviously, your sleep pattern is going to be affected.

People who are obese, smoke, or consume alcohol have a higher chance of snoring and a greater risk of OSA. Men are more likely to suffer from OSA than women are.

Oral Appliances

If you suffer from snoring or have been diagnosed by a sleep apnea specialist, you may find treatment through oral appliance therapy. Oral appliances are custom-fitted for each patient to minimize the effects of snoring or sleep apnea in a variety of ways. By correcting the position of the jaw, or repositioning the jaw, the tongue and soft tissue will no longer interfere with your airway. One of the most effective oral appliances is the SomnoDent mandibular advancement splint (MAS), manufactured by SomnoMed.

SomnoDent MAS

The SomnoDent MAS is worn over the teeth, much like a sports mouth guard, as you sleep. It pushes the jaw forward from its natural position and, like other oral appliances, keeps the tongue in position and tightens the soft tissue to keep your airway open. Studies have shown that over 60% of patients who wear SomnoDent MAS experience a complete halt in OSA, and those who still have symptoms have a 50% decrease in the severity of their sleep apnea. Episodes of snoring decreased 43% in studies and lowered the volume of snoring (something your bed partner would probably be grateful for).

SomnoDent MAS features a patented â??fin-couplingâ? component which allows the wearer to speak and drink as they normally would.

If you suffer from snoring or believe you may have obstructive sleep apnea and are interested in finding out if SomnoDent MAS by SomnoMed is right for you, please contact Dr. Ira L. Shapira at the Snoring and Sleep Apnea Treatment Center for a free consultation.

Many studies on sleep patterns have been done throughout the years. Sleep experts say we need between six and eight hours of sleep to feel rested and function at our best during the day. For some, this simply means going to bed at a reasonable time. However, there are people who cannot feel rested no matter what time they go to bed because they snore, share the bed with someone who snores, or suffer from sleep apnea. Losing an hour or more of sleep a night because of snoring can add up over time. In the case of obstructive sleep apnea (OSA), the consequences can affect the health of the individual.

OSA is a condition in which an individual stops breathing due to their airway collapsing during sleep and blocking their breathing for up to ten seconds each time. When the OSA is serious, this cessation can occur more than 30 times an hour. These cessations in breathing cause the blood oxygen levels to decrease dramatically. Lower oxygen levels in the blood raise the threat of heart attack, high blood pressure and stroke.

Causes of Sleep Apnea and Snoring

As we sleep, our muscles are relaxed. When the tongue and throat muscles relax, they can block the airway. A partial collapse of the airway results in the sound we call snoring. A complete collapse of the airway cuts off breathing and results in an apneic event. When this happens, you will wake up and begin breathing again because your muscles are no longer relaxed. This may happen as little as five times every hour, or as many as 30 or more times an hour. Obviously, your sleep pattern is going to be affected.

People who are obese, smoke, or consume alcohol have a higher chance of snoring and a greater risk of OSA. Men are more likely to suffer from OSA than women are.

Oral Appliances

If you suffer from snoring or have been diagnosed by a sleep apnea specialist, you may find treatment through oral appliance therapy. Oral appliances are custom-fitted for each patient to minimize the effects of snoring or sleep apnea in a variety of ways. By correcting the position of the jaw, or repositioning the jaw, the tongue and soft tissue will no longer interfere with your airway. One of the most effective oral appliances is the SomnoDent mandibular advancement splint (MAS), manufactured by SomnoMed.

SomnoDent MAS

The SomnoDent MAS is worn over the teeth, much like a sports mouth guard, as you sleep. It pushes the jaw forward from its natural position and, like other oral appliances, keeps the tongue in position and tightens the soft tissue to keep your airway open. Studies have shown that over 60% of patients who wear SomnoDent MAS experience a complete halt in OSA, and those who still have symptoms have a 50% decrease in the severity of their sleep apnea. Episodes of snoring decreased 43% in studies and lowered the volume of snoring (something your bed partner would probably be grateful for).

SomnoDent MAS features a patented â??fin-couplingâ? component which allows the wearer to speak and drink as they normally would.

If you suffer from snoring or believe you may have obstructive sleep apnea and are interested in finding out if SomnoDent MAS by SomnoMed is right for you, please contact Dr. Ira L. Shapira at the Snoring and Sleep Apnea Treatment Center for a free consultation.

A tracheostomy is a type of surgery used in the treatment of sleep apnea. It is a serious treatment, used as a last resort for people who either haven’t had success with any other types of treatment or whose sleep apnea is severe enough to be life-threatening.
This surgery has a high success rate but it can have some serious side effects. It involves an incision being cut in the throat, through the windpipe, roughly the size of a quarter. A tube is inserted into this incision to allow easier airflow in and out of the lungs. It can lead to other health problems, both medical and psychological.
The tube that is inserted allows the air to flow freely, eliminating the sleep apnea. During the day, a valve lets the patient shut the tube to allow them to breathe and speak naturally. The valve is opened at night while asleep to allow the air to flow.
Recovery from a tracheostomy can vary - some people will take longer than others.
There are multiple risks associated with this type of surgery. Scar tissue can form where the incision is made which can lead to changes in the appearance of the person’s neck.
Infections can sometimes develop where the incision is made, leading to swelling, redness and fluid drainage. Bleeding is also often a complication.
Some patients who have undergone this surgical procedure have difficulties with speech. Some have problems immediately after the surgery but show improvement with time while others have a permanent change in their speech.
A tracheostomy can also increase the chances of a lung infection.
Psychological and emotional problems can also be an issue for some patients who undergo the surgery. Self-consciousness can be an issue in some cases due to the appearance of the neck when the tube has been inserted.
After undergoing a tracheostomy, proper hygiene is very important. Keeping the neck clean and free of debris is paramount.