Sleep Apnea

Did you know that your dentist can play a role in diagnosing and treating your sleep apnea?  Dr. Nelson will work with your physician to help you achieve the restful sleep you’ve been seeking.  To find out more about sleep apnea, the importance of treatment, and how your dentist help, keep reading!

Due to the overwhelming demand for appointments, and the amount of time Dr. Nelson dedicates to working with patients, we are not currently scheduling new patients for sleep apnea appliances.  We aim to re-open the schedule for sleep apnea appliances in the Fall.  

What is sleep apnea?

Sleep apnea is a disorder where breathing pauses periodically during sleep.  This cessation in breathing causes a drop in your body’s oxygen level.  When your brain detects that your oxygen levels are decreasing, it signals your body to wake-up to resume regular breathing.  Though these wake-ups are brief and usually not remembered, they interrupt the sleep cycle and decrease sleep quality, leading to daytime drowsiness. 

Types of sleep apnea

Healthy Person without Sleep Apnea

There are three main forms of sleep apnea: obstructive sleep apnea, central sleep apnea, and complex sleep apnea syndrome. 


What is obstructive sleep apnea?

Obstructive sleep apnea (OSA) is a form of sleep apnea caused by the soft tissues of the throat (soft palate, uvula, tonsils, tongue, etc) relaxing and narrowing the airway during sleep.  Obstructive sleep apnea is the most common form of sleep apnea and can be managed, with the recommendation of your physician, with a dental sleep apnea appliance.

OSA is often, but not always, found in patients with increased body mass index (BMI), enlarged tonsils, small chin, nasal congestion, and patients with medical histories that include high blood pressure, heart failure, and type 2 diabetes. 


What is central sleep apnea?

Central sleep apnea is a form of sleep apnea where the brain does not appropriately signal the body to breathe normally during sleep, causing temporary cessation in breathing throughout the evening.

Patients who are older, male, or have a history of heart failure or stroke are at a greater risk of central sleep apnea. 


What is complex sleep apnea syndrome?

Complex sleep apnea syndrome is a combination of obstructive sleep apnea and central sleep apnea. 

What are the signs and symptoms of sleep apnea?

Sleep apnea signs and symptoms that you may experience

  • Feeling tired, even after a full night’s sleep
  • Difficulty staying awake during the day
  • Irritability
  • Fatigue
  • Dry mouth upon waking
  • Morning headaches
  • Tooth grinding

Sleep apnea signs and symptoms that your bed partner may notice while you sleep

  • Snoring
  • Pausing in breathing
  • Gasping for breath

Sleep apnea signs that your dentist may observe Dental Signs of Sleep Apnea

Did you know that your dentist may recognize signs of sleep apnea during your routine dental exam?  Because sleep apnea is often associated with tooth grinding and enlarged oral soft tissue structures, your dentist may discuss whether you are experiencing other signs and symptoms of sleep apnea and refer you to your physician.  

  • Tooth wear (shortening of teeth)
  • Tooth fractures or cracks
  • Enlarged tonsils, soft palate, tongue, or uvula
  • Smaller lower jaw

What should I do if l think I have sleep apnea?

If you think that you have sleep apnea, speak to your doctor.  Sleep apnea can only be diagnosed by a physician, not by your dentist.  Your doctor will screen you for sleep apnea by reviewing your medical history and sleep history.  If the screening indicates that you are at risk for sleep apnea, your will be referred to a sleep medicine specialist.

The sleep specialist will likely recommend a sleep study to determine whether you have sleep apnea.  The sleep study can be performed at home or at a sleep center where the patient wears monitors overnight to study oxygen levels and waking frequency.  Based on the study’s findings, you may be diagnosed with mild, moderate, or severe sleep apnea

How is mild sleep apnea diagnosed?

Mild sleep apnea is diagnosed from a sleep study where the person has 5-14 apnea events (where breathing pauses) per hour during sleep.

How is moderate sleep apnea diagnosed?

Moderate sleep apnea is diagnosed from a sleep study where the person has 15-29 apnea events per hour during sleep.

How is severe sleep apnea diagnosed?

Severe sleep apnea is diagnosed from a sleep study where the person has 30 or more apnea events per hour during sleep.

Why is it important to treat sleep apnea?

Sleep apnea is associated with reduction in sleep quality and leads to daytime drowsiness, fatigue, and irritability.  More importantly, sleep apnea can significantly impact your health and is associated with:

  • Heart problems (such as heart attack and stroke)
  • Increased blood pressure
  • Liver problems
  • Types 2 diabetes
  • Complications during general anesthesia

What are the different treatment options to help my sleep apnea?Winston Salem Snore Guard or Sleep Apnea Oral Appliance

After a person is diagnosed with sleep apnea, there are multiple ways to approach treatment depending on the cause.  Treatment options can include:

  • Healthy lifestyle changes including diet and exercise
  • Dental sleep apnea appliance
  • CPAP (continuous positive airway pressure) breathing device

How can my dentist help with my sleep apnea?

If you have been diagnosed with obstructive sleep apnea, you could benefit from a dental sleep apnea device, sometimes referred to as a snore guard.  If your physician determines that you are a candidate, Dr. Nelson can fabricate the appliance for you to wear at night.  Many patients prefer dental sleep apnea devices over CPAP breathing devices as they are smaller, more discrete, and silent.  There are two main types of dental sleep apnea devices: mandibular repositioning devices and tongue retaining devices. 

Mandibular repositioning sleep apnea device 

A mandibular repositioning device is a type of dental appliance worn during sleep that positions the lower jaw forward to help keep the airway open.  Dr. Nelson prefers mandibular repositioning devices for treating obstructive sleep apnea. 

Tongue retaining devices

A tongue retaining device is also a type of dental sleep appliance that holds the tongue forward to facilitate breathing. 

How are dental sleep appliances made?

After your physician recommends a dental sleep appliance, Dr. Nelson will fabricate the appliance so it is custom-fit to your jaw.  This is typically completed over two visits.  In the first visit, Dr. Nelson will complete an oral examination and take impressions of your jaws.  In the second visit, Dr. Nelson will try-in the dental sleep appliance and make any necessary adjustments to ensure the appliance fits well.  After your appliance is made, you will need to follow-up with your sleep doctor to ensure it is working appropriately.