Obstructive Sleep Apnea (OSA)

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OSA is a serious medical condition. More alarming than the seriousness of OSA is how few people are aware that they are suffering from OSA. It is estimated that 20 million people suffer from some form of sleep apnea. Only 10% - 20% of those patients have been diagnosed.

What is OSA? OSA is a condition that occurs while you are sleeping. While you are asleep, your muscles relax which allows your tongue to fall back and block your airway. When this happens your airway is temporarily partially or completely obstructed. This causes your body and vital organs to be starved of oxygen and will disrupt normal sleep patterns. When this occurs, signals from your brain tell you to wake up so you will open your airway and start breathing again. This cycle of blocking and unblocking your airway will starve your body of oxygen and disrupt normal sleep patterns. Some people wake up gasping for air, most people are unaware of apnea events that are occurring all night long.

Some of the most common signs that you may have sleep apnea are:

  • Loud snoring
  • Waking throughout the night. Even to use the bathroom
  • Gasping for air during sleep
  • Daytime sleepiness
  • Memory loss or difficulty concentrating
  • Irritability
  • High blood pressure
  • Irregular heartbeat
  • Type II diabetes

What are the consequences of untreated obstructive sleep apnea?

  • High blood pressure
  • Heart attack
  • Stroke
  • Irregular Heartbeat
  • Sexual Dysfunction
  • Headaches
  • Diabetes
  • Early onset Dementia
  • Fatigue leading to accidents
  • Arterial sclerosis

It is estimated that untreated obstructive sleep apnea take 12 – 15 years off your life. Smoking only takes 7 – 10 years off your life. Severe untreated obstructive sleep apnea increases your risk of premature death by 46%. A male with severe untreated obstructive sleep apnea has three times the risk of a stroke than a male without apnea. As was stated before, obstructive sleep apnea is a serious health risk and only 10% - 20% of people have been diagnosed.

What are the treatment options for OSA?

The treatment of choice is CPAP. Continuous Positive Airway Pressure. CPAP works by forcing room air into your lungs. The pressure can be adjusted to push the air pass your obstruction. It is very effective, but compliance is low.

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Oral appliance therapy. Oral appliances for the treatment of obstructive sleep apnea works by holding the lower jaw in a forward position. This pulls the tongue away from the back of the throat which is where the most common site of an obstruction occurs. The success rate depends on the severity of the apnea, but the compliance rate is very high. This options is noninvasive and does not disturb your sleep partner.

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Surgery. Surgical options include may include removal of tonsil, uvula, or resection of the soft palate. This methods are effective to a point initially. However, the snoring or apnea tend to resurface.

You are probably wondering about the cost of treatment and the possibility of using your insurance. The cost of treatment with an oral appliance varies by the type of design that is chosen. At your consultation appointment we will discuss a few of the 140+ possible appliances and cost will be discussed at that time. The average cost of an oral appliance is $2,500 - $3,000. This cost is for a custom fit appliance that cover the upper and lower teeth. The upper and lower fit together to hold the lower jaw in a forward position. Here are a few examples of appliances.

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This cost includes all adjustments needed in the first 90 days of use, a morning repositioning device (if needed), and the cost of the sleep study required to check the effectiveness of the appliance.

So what is involved in fabricating a sleep appliance either for OSA or snoring?

First we will start with a free consultation. It is important to understand that a sleep study that is diagnosed by a sleep physician is needed prior to treatment. The results of the sleep study will either result in a diagnosis some form of OSA or rule out OSA. Regardless if you feel that your problem is simple snoring, the study and diagnosis is still required.

If you have been previously diagnosed with OSA we will be happy to review your sleep study and if it is acceptable we can contact your sleep physician regarding oral appliance therapy. If you have not been diagnosed, we have the ability to complete a sleep test in the privacy and comfort of your own bed. We can send you home with a sleep monitor for one night to collect data regarding your sleep. That data can be sent electronically to a board certified sleep physician. The sleep physician will analyze the data and provide a diagnosis and treatment recommendations. It is important to note that a dentist cannot diagnose obstructive sleep apnea.

Once a diagnosis had been obtained and a decision to proceed with oral appliance therapy we will have some paperwork to complete. We will contact your primary care physician regard the results of your sleep study and the recommendations made by the sleep physician. We will forward paperwork needed by the insurance company to your physician. Once your physician returns the paperwork we will contact your MEDICAL insurance company regarding coverage. It can take a couple of weeks to get the detail about coverage from your insurance company, but by taking the time we will avoid any surprises. Impressions will be taken at this point and they will be sent to a laboratory. The time the lab needs to fabricate the appliance is approximately 2 weeks.

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