Treating Obstructive Sleep Apnea in the Durham Region

If you have been struggling with sleep apnea or intrusive snoring, the team at King Street Dental can offer a number of treatment options to our patients. Obstructive Sleep Apnea (OSA) is a partial or complete collapse of the upper airway caused by relaxation of the muscles controlling the soft palate and tongue. Snoring occurs when the tongue partially blocks the airway while the patient sleeps. Sleep apnea occurs when the tongue completely blocks the airway. Both situations are harmful since the patient is deprived of oxygen.

Sleep apnea is a serious health risk. It has been estimated that 90 million people in North America have breathing problems leading to snoring and sleep apnea. Patients who suffer from snoring and sleep apnea are at greater risk of hypertension, heart attacks and strokes. Some patients stop breathing for 30 seconds or more many times each night, causing them to wake up several times during the night gasping for air. These frequent disturbances in sleep prevent the patient from getting a good night’s sleep, and result in excessive tiredness. Nighttime grinding of teeth, loss of memory, and/or difficulty concentrating are common symptoms associated with sleep apnea.

Many patients are prescribed a continuous positive airway pressure (CPAP) unit which consists of an air compressor that forces air up the nose in order to open the airway. While the CPAP is successful, 60% of patients are non-compliant after one year. Another treatment option is an oral appliance that repositions the lower jaw and tongue forward which opens the airway. Patient compliance with oral appliances is over 90%.

Signs and Symptoms

The number one sign of a sleep apnea disorder is daytime fatigue. Excessive weight (BMI>30) is one of the main causes of snoring and sleep apnea. Men with neck sizes more than 17”, or women with neck circumference more than 16”, are more likely to have sleep apnea. Snoring and sleep apnea may cause:

  • High blood pressure

  • Chronic sleepiness

  • Stroke

  • Heart attack

  • Weight gain

  • Accidents while driving or at work

  • Heartburn (Gastroesophageal reflux)

  • Depression

  • Morning headache

  • Impotence

  • Lack of energy

  • Loss of memory

Dr. Jordon Lazare may be your solution to not only a quiet night’s sleep, but also to help treat OSA, a serious medical problem. With the use of special diagnostic equipment, including the Rhinometer (which evaluates the nasal passages) and the Pharyngometer (which evaluates the oral airway), Dr. Lazare can identify those patients at risk of OSA. This equipment is also used to help find the ideal jaw position to which an oral appliance can be fabricated to maximize your airway. Dr. Lazare has been treating patients for over 20 years, and has special training to help treat patients who have airway problems leading to snoring and sleep apnea.

Screening for Obstructive Sleep Apnea (OSA)

OSA is actually a medical condition that can be life threatening.

Dr. Jordon Lazare’s role in screening for predisposing factors will include:

Questionnaires for daytime sleepiness, obstructive breathing, nighttime breathing, signs and symptoms of TMJ disorder and occlusal exam

A complete dental exam of the teeth, supporting structures and evaluation of the head, neck and facial area

Examination of the upper airway for obstruction, the palate, airway space, size and condition of the tongue and position of the mandible

Obtaining upper and lower impressions

Specialized X-rays, when required

Measuring the throat and nasal airways with a computer, which involves the use of a pharyngometer/rhinometer for evaluation of airflow

It is a simple, painless test that tells Dr. Lazare about the airway and the patient’s mandible (lower jaw)

Determining if a sleep study is indicated, either via an in-lab/clinic polysomnogram, or via a home sleep study that Dr. Lazare can provide (which is subsequently interpreted by a certified sleep doctor)

Determining if the patient is a candidate for oral appliance therapy or if they should be referred to a physician for other tests

OSA – Facts and Figures

30-83% of patients with hypertension (high blood pressure) have sleep apnea

43% of patients with mild OSA and 69% of patients with severe OSA have hypertension

65% of stroke patients have sleep-disordered breathing

People with sleep apnea are at twice the risk of having a traffic accident (with a 15-fold increase in moderate to severe cases)

sleeping man

A mandibular repositioning device (MRD) is a custom made, adjustable oral appliance that maintains the lower jaw in a forward position during sleep. This mechanical protrusion widens the space behind the tongue and reduces the vibration and physical obstruction to breathing and the tendency to snore. Mandibular advancement can increase upper airway capacity by 50-75% with maximum mandibular protrusion.

Treatment with an oral device offers significant improvement of sleep apnea symptoms including sleepiness, quality of life, systolic or diastolic blood pressure, and cognitive performance. Oral devices are equally effective in treating mild to moderate cases of sleep apnea in patients who are not compliant or refuse CPAP therapy. OSA is a chronic condition; Oral devices or CPAP treatment must be used nightly.