Apart from being an annoying problem for partners and loved ones, snoring could be an indicator for more serious problems. Snoring occurs when small muscles at the back of your throat, or pharynx, relax and vibrate. The relaxation of these muscles also narrows the airway, making the noise even louder. The narrowing of the airway can progress to a more serious condition, called Obstructive Sleep Apnoea (OSA).
Obstructive Sleep Apnoea occurs when the airway of the pharynx repeatedly closes off, partly or completely, during sleep. Breathing may reduce or stop altogether. Blood oxygen levels drop and force you to start breathing again. Many people experience this as a sudden loud snore and even partial waking, choking or gasping, during sleep. In the morning, sufferers may still feel tired, and may even struggle to stay awake into the afternoon. This can be of significance at work, especially when operating machinery or while driving.
The significance of OSA is that such reductions in blood oxygen levels increase blood pressure and create irregular heartbeats. This can lead to general increase in blood pressure (Hypertension). People who snore, or who suffer from OSA, are often overweight, so adding the risks of the increased blood pressure to the already existing risk of diabetes and high cholesterol can increase risks of heart attack and stroke.
Both children and adults can suffer from snoring and sleep apnoea. In children it is mainly as a result of enlarged tonsils or adenoids. Adults see it more in males and more into middle age. It is often associated with being overweight, or the dimensions of the facial structures, which can lead to a narrow airway. Almost everyone who has sleep apnoea snores.
Snoring, observed apnoeas, obesity and daytime sleepiness often suggest OSA. The definitive diagnosis is made with an overnight Sleep Study, which measures sleep, breathing, and oxygen levels. Once the study is completed, and a diagnosis on the severity of the apnoea is made, treatments can commence.
As dentists, we can help in the management of snoring and mild to moderate OSA. This involves a thorough oral and dental examination, with the construction of study models of the patient’s teeth. From this, a Mandibular Advancement Splint (MAS) is constructed. This is worn like a mouthguard while you sleep. By moving the lower jaw forwards, it can increase the airway and tense the muscles that vibrate.
Follow-up is extremely important to ensure that the MAS is being worn correctly, and that there is no damage to teeth or oral structures. Follow-up sleep studies can tell us how effectively the MAS is working, and whether we need to adjust the measurements of the MAS.