Oral Appliances for
Snoring and Sleep Apnoea
Snoring
What is snoring?
During sleep, the soft tissues, muscles in your tongue and throat relax, causing your airway to become smaller. If your airway becomes small enough, the rapidly moving air in a narrow airway causes the soft tissues of the throat (tonsils, soft palate and uvula) to vibrate when you breathe in and out. This vibration is the sound of snoring. The narrower your airway becomes, the greater the vibration and the louder your snoring.
A narrow airway in snorers could also be due to large tonsils, a long soft palate or uvula (the dangly part at the back of your throat), and in overweight people, excessively flabby tissue or more commonly, a large tongue that relaxes too much during sleep.
How common is snoring?
Snoring is very common, with approximately 40% of men and 30% of women affected. Snoring occurs in all age groups but is most common in the middle-aged population. In children, large tonsils and adenoids are a common cause of snoring.
What contributes to snoring?
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Obesity
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Alcohol, sedative and tranquiliser use
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Nasal congestion
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Breathing through the mouth
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Sleeping on your back
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Allergies and hay fever
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Smoking
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Abnormality of the upper airway or oral and facial structures
How serious is snoring?
While snoring can be harmless in the short-term, it can also develop into or be a symptom of a more serious medical condition known as obstructive sleep apnoea.
Snoring is also a major social problem for families. Snoring deprives both the sufferer and their bed partner of good sleep, which has consequences for daytime functioning. A snoring partner may be forced to sleep in a separate room.
How is Snoring diagnosed?
As snoring may be a sign of obstructive sleep apnoea, it is important to consult your medical general practitioner (GP). Your GP will typically ask you regarding common signs and symptoms and carry out a physical examination. If your history and examination suggest you may have obstructive sleep apnoea, your GP will then refer you for a sleep study under the care of a specialist sleep physician. The sleep study is necessary to establish a diagnosis and rule out obstructive sleep apnoea. This is important, as your diagnosis will determine the best treatment option for you.
A sleep study is performed overnight in either a sleep laboratory or at home using a portable appliance. Although a home-based sleep study may be more convenient, current evidence suggest that a laboratory based sleep study is more accurate. During a sleep study, electrodes and sensors are attached to the scalp, face, chest, legs and finger.
The sleep study will record the following information:
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Blood oxygen levels
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Body position
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Brain waves
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Breathing rate
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Electrical activity of muscles
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Eye movement
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Leg movement
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Heart rate
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Number of times breathing stops
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Snoring
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Teeth grinding
A sleep study may also detect other sleep disorders such as narcolepsy, periodic limb movement disorder, central sleep apnoea and sleep bruxism.
PATIENTS MUST HAVE A CURRENT SLEEP STUDY (WITHIN 5 YEARS) PRIOR TO FABRICATION OF A MANDIBULAR ADVANCEMENT APPLIANCE FOR SNORING AND OBSTRCUTIVE SLEEP APNOEA. TREATMENT CANNOT BE COMMENCED WITHOUT THIS INFORMATION.
Treatments for Snoring
There are several treatments available for snoring and obstructive sleep apnoea and should be directed by your sleep physician or medical GP based on your diagnosis and clinical presentation. Choosing the best treatment option will increase the likelihood for success. The Perth Oral Medicine and Dental Sleep Centre specialises only in Oral Appliance Therapy and you will require a referral to visit our practice.
Oral Appliance Therapy
Oral appliance therapy is often used for snoring and has been proven to be a very effective treatment. These appliances are commonly used to treat some forms of obstructive sleep apnoea as well.
There are two types of oral appliances:
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Mandibular Advancement Appliance – is the most common type of oral appliance used. They are also known as Mandibular Advancement Splint or Mandibular Repositioning Appliance. This is an area of speciality at the Perth Oral Medicine and Dental Sleep Centre. Click here for further information regarding the mandibular advancement appliance.
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Tongue Repositioning Device – engage and hold the tongue in a forward position by means of a suction bulb without affecting the mandible or teeth. When the tongue is in a forward position, it prevents the back of the tongue from collapsing during sleep and obstructing the airway in the throat. Tongue repositioning Appliances are non-adjustable.
Lifestyle and Behavioural Changes
These factors may also improve your snoring over time. Please be guided by your medical practitioner and specialist as to the most appropriate therapy for your individual needs.
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Exercise
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Weight loss
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Good sleep hygiene (e.g. have a regular sleeping pattern, avoid caffeine and eating large meals late at night)
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Sleep position – sleeping on the side is beneficial
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Avoid sedatives and tranquilisers such as sleeping pills
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Avoid alcohol
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Avoid smoking
EPAP (Expiratory Positive Airway Pressure) – Provent Therapy
Provent is a small, disposable nasal appliance, which covers each nostril and secured by an hypoallergenic adhesive. Provent uses microvalve technology and the pressure of your own breathing to keep your airway open. The microvalves allow you to inhale normally but let only a small amount of air out when you exhale, increasing the pressure inside your airway and preventing it from collapsing. This creates an “expiratory positive airway pressure”.