Snoring & Sleep Apnea
Danoff Dental & Associates, LLP in NYC, two dental offices located in Great Neck and the Little Neck dental office serving Queens and surrounding neighborhoods.
Obstructive Sleep Apnea occurs when the tongue is stuck against the back of the throat blocking the upper airway causing air flow to stop. Obstructive Sleep Apnea is a very common chronic disorder that may create respiratory or cardiovascular complications if left untreated.
Signs that you may have Obstructive Sleep Apnea are:
- Snore loudly
- Gasp for air or pause breathing during sleep
- Feel sleepy during the day and sometimes fall asleep at inappropriate times
- Wake up more than 2 times a night to use the bathroom.
- If you are more than 30 pounds over weight with a large neck size.
The Greek word "apnea" literally means "without breath." Obstructive Sleep Apnea (OSA) is very common. Left untreated people with sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times during the night and often for a minute or longer. With each apnea event, the brain briefly arouses people with sleep apnea in order for them to resume breathing, but consequently sleep is extremely fragmented and of poor quality.
Sleep apnea is the stoppage of breathing during the night. Sleep apnea affects 13-17% of adults over 40 years old in the United States. 70% of the time, loud snoring is indicative of OSA; however, unless you are aware of the symptoms of sleep apnea or actually wake yourself during your sleep, you may never know you have a lower level of oxygen intake.
How Serious is Sleep Apnea (OSA)
John's Hopkin's University study of 6,400 men and women over 8 years found that OSA increased the risk of death by 46%.
Did you know that sleep apnea studies have shown that...
- Severe OSA can take 12-15 years off a person's life.
- Type ll Diabetes can take 5-10 years off a person's life.
- Smoking can take 7-10 years off a person's life.
What are the effects of OSA?
- 25 Million Americans Suffer from Sleep Apnea
- 38,000 die each year from complications of sleep apnea (i.e. heart attack, stroke etc.)
- OSA Cost of healthcare in the ER or ICU is in excess of $50,000 per patient - total estimated cost is $1.9 Billion.
- People with untreated sleep apnea face 4 time higher risk of a stoke and are 3 times more likely to have heart disease if left untreated.
- 200,000 each year are involved in Motor Vehicle Accidents because of sleep problems.
- OSA suffers are 6 times more likely to die in a car accident.
- - Of these at least 50,000 are estimated to be directly related to sleep apnea.
- - Insurance cost per accidents is estimated to be over $80,000.
- - Total estimated insurance cost for MVA related to sleep apnea only $4 Billion.
- Productivity ratio is at least 10% less in people who suffer from sleep apnea
- That is estimated to costs the US economy $75 Billion each year Sources: The American Sleep Apnea Association and the National Commission on Sleep Apnea Research.
How much sleep are you and your bedmate losing?
Untreated sleep apnea can result in a significant amount of sleep loss. The snoring, gasping for air, and choking episodes during the night can results in a bedmate losing up to an hour of sleep a per night.
Is Snoring and Restless Sleep costing you years off your life!
Ask your spouse if they have witnessed you holding your breath or breathing too fast or too slow. Many sleep disorder sufferers are not aware of habits they may have. Awareness is the first step to your health improvement.
ASK YOURSELF THESE QUESTIONS:
- Have you been told that you snore?
- Are you still tired when you get up in the morning?
- Do you wake up with a dry or sore throat?
- Are you irritable in the morning or have morning headaches?
- Do you have trouble concentrating?
- Do you doze during the day?
- Do you feel depressed?
- Do you seem to be losing your sex drive?
- Do your legs feel twitchy at night?
Symptoms of Obstructive Sleep Apnea Include:
- Do you feel like your metabolism has slowed down?
- Have you gained so much weight it is hard to lose?
- Neck Circumference:
- Do you have a large neck circumference?
- A neck circumference of 17 inches for men and 15 inches for women is generally associated with OSA due to the added weight compressing the airway when sleeping.
- Are you grinding your teeth?
- When you look into the mirror do your teeth look like someone is filing them down?
- Are your teeth becoming sensitive to hot and cold liquid?
- Are your teeth darker at the gum line?
- Have you noticed visible tooth fractures or even broken a tooth off just by eating?
- Do you sometimes bite your tongue when you eat or talk?
- Do you feel your tongue is too large for your mouth and sometimes restricts your air flow?
- A large tongue and narrow airway opening to the throat is a risk factor.
Obstructive Sleep Apnea can Increase the Risk of Cardiovascular Disease & Stroke
Sleep Apnea is measured in the stoppage of breathing of more than 10 seconds at a time or the drop in blood oxygen of 4% or more. People with sleep apnea can have these events dozens to literally hundreds of time per night. These apnea events lead to drops in blood oxygen levels. If the body is not getting sufficient oxygen it cannot produce enough nitric oxide. Nitric oxide opens blood vessels. Without nitric oxide, susceptible to plaque buildup which leads to heart attack and stroke.
In additional, when a person finally starts breathing (by gasping or coughing) after not breathing for 10 or more seconds there is sympathetic (flight or fight response), which results in a spike in blood pressure and rapid breathing as the body attempts to get the oxygen levels back up to normal. It is easy to see how those "flight or fight" events happening dozens of times or more a night can lead to strain on the heart and cardiovascular system.
Diagnosing Obstructive Sleep Apnea (OSA)
OSA can only be properly diagnosed by a board-certified M.D. in sleep medicine. This is done either through spending a night in a sleep lab connected to wires and monitors or by a home sleep test. In our office, we have home sleep testing monitors which you can wear to bed in your own home. When you bring the testing unit back to our office, we will upload the data stored in the unit to a board-certified sleep physician who will diagnose if you have sleep apnea. The physician will also determine how severe the sleep apnea is and prescribe what treatment options would be appropriate.
There are three common treatment options for Obstructive Sleep Apnea (OSA)
Dental Treatment for Sleep Apnea
We offer an oral appliance therapy to treat OSA. By performing a airway diagnostic measurement and the use of a high technology, non-invasive sonar device (a Pharangometer) we can determine the jaw position which will provide the optimal airway opening. We can fabricate an oral appliance, much like a mouth guard, that will position the lower jaw to keep the airway open. By wearing this appliance each night, we can dramatically decrease sleep apnea and snoring. The oral appliance is covered by many private health insurers. For those insurers who do not cover this treatment, we offer the treatment at an affordable level with convenient payment options so we can provide this life-saving and life-changing care to all who need it.
Medical Treatment for Sleep Apnea
OSA may be treated with a CPAP (continuous positive air pressure) device. It consists of a facial or nasal mask connected by a hose to an air pump next to your bed. The CPAP continually forces air down the airway to keep you breathing. The CPAP works and is considered the standard of care, especially for those patients with severe OSA. Unfortunately, the CPAP has a low level of long term compliance because many stop wearing it over time.
Surgical Treatment for Sleep Apnea
In extreme cases and only when medically warranted, a surgical solution may be suggested to address sleep apnea and snoring disorders. Surgery may be effective in treating snoring and sleep apnea when bones and tissue in your mouth, neck and throat are not aligned properly.
See what some of our patients have to say about sleep apnea treatment by Dr. Scott Danoff and his staff.
See what some of our patients have to say about sleep apnea treatment by Dr. Scott Danoff and his staff.
Snoring is caused when the muscles and soft tissue in the throat and mouth relax making the breathing airway smaller. A relaxed and/or collapsed airway produces soft tissue vibrations during breathing and snoring is the result.
An oral appliance can greatly reduce or stop snoring for most people.
One way to treat people who have sleep apnea is a continuous positive airway pressure (CPAP) device. A CPAP device includes a mask, tubes and a fan. It uses air pressure to push the tongue forward and open the throat thus allowing air to properly flow through. It reduces snoring and prevents apnea disturbances.
You should put your CPAP device on whenever you sleep, even for naps. A CPAP device does not cure sleep apnea; but, when you use the device correctly, your sleep problems should get much better.
A snoring appliance is an oral appliance that resembles an athletic mouthpiece. Small and flexible, it has no moving parts, masks, hoses, or batteries. Generally made from sterile plastic it is easy to clean with a regular toothbrush.
Custom fit by a dentist in one simple, painless visit. Fit to the patient's teeth to keep the upper and lower jaw in position when the jaw and throat muscles relax during sleep. This keeps the airway open providing restful, quiet sleep.
The ProSomnus EVO is the absolutely latest sleep apnea oral device that will be introduced to the market this spring. This appliance is light as a feather, yet one of the strongest and most durable yet. EVO is flexible and easy to deliver, small and comfortable (up to 2.5 less volume than the other standard appliances), precise and effective, hygienic and BPA free, yet durable enough to be the only OAT to pass the US Military Drop test (dropping the appliance from over 4 feet more than 25 times without breaking). The EVO is fabricated digitally and is designed to follow the shape and contours of your teeth to afford the most natural and comfortable fit. Were are proud to have been selected to deliver and fit these new devices months before the actual national launch.
The ProSomnus IA series Sleep Device is easy to customize for each patient’s treatment plan. With the ability to add anterior discluders, airway openings, different dual post angles, splint coverage options, compliance sensor capability, unlimited advancement aches and more, all with the intent of optimizing patient experiences. This is the most versatile of all of the sleep devices available on the market today.
The ProSomnus PH Precision Herbst-style Sleep Device is FDA cleared, Medicare E0486 verified and designed to provide a better experience for all patients. Incorporating the ProSomnus precision OAT platform, ProSomnus [PH] offers all the benefits of ProSomnus [IA] and [CA], using a Herbst-style advancement mechanism providing 7.0mm total titration. ProSomnus [PH] provides greater comfort, durability, smaller overall volume, ease of use and efficiency over predicate Herbst-style devices.
ProSomnus [CA] LP
ProSomnus [CA] LP is the only low profile Continuous Advancement OAT Medical Device for OSA. In addition to the ProSomnus platform advantages such as fewer side effects, biocompatible hygienic material, impression-free digital replacements and device customizations, [CA] LP uniquely offers clinicians precision Continuous Advancement without compromising patient comfort. These devices have an infinite number of settings and a 12mm range of adjustability, where others have mostly a 5mm range. ProSomnus [CA] LP utilizes proprietary technologies to resolve the archform asymmetries, manufacturing variances, bulkiness and other device design limitations of traditional dorsal style Continuous Advancement devices.
Respire Blue+ is a custom mouthpiece that features a dual block design with interlocking wings. It works by keeping the airway open in any sleep position and allows for a wide range of mouth movement. The new Respire Blue+ has a 4 wings design with 2 adjustable and 2 fixed wings. This appliance is not recommended for those with heavy grinding habits.
Respire Blue EF+
The Respire Blue EF+ (Endurance Framework) sleep devices offer enhanced comfort. They are similar to the Standard Blue+ but have an innovative, patented design and are made of alloy, making them significantly thinner yet durable.
Respire Pink AT
The Respire Pink AT features a simplified titration (adjustment) mechanism with a special user-friendly adjustment key. Its ergonomic design with telescopic hardware is ideal for people who experience teeth grinding. It works by allowing lateral and vertical movement, and opens up the airway for better airflow while holding the jaw in a position that prevents it from falling back and collapsing the airway. The new Advanced Titration (AT) mechanism offers simpler yet precise adjustments with measuring scales on arms. A special titration key with a handle for easier grip will provide an overall improved experience.
Respire Pink EF AT
Respire Pink EF AT features a simplified titration mechanism with a special user friendly adjustment key. Its Endurance Framework (EF) is an innovative, patented design made of chrome, significantly thinner yet durable. Respire Pink EF AT is suitable especially for people who have larger tongues and experience bruxism at night.
The Somnomed Herbst Advanced Elite appliance is the only milled, PDAC (Medicare) approved oral appliance with a soft inner liner. It has an 18% greater flexural strength, from precured PMMA and is covered by a three year, no questions asked warranty. This appliance has superior comfort.
The Airway Management TAP appliance gives you more tongue space for greater comfort. It has Cobalt-chromium hardware (even stronger than surgical stainless steel) is nickel-free, 100% allergen-free, and has clinically proven, single-point midline adjustment. It comes with 3 hooks for a greater range of adjustment and can be fabricated out of a variety of custom-formed liners for superior retention. This device is rust and corrosion resistant.
The Panthera D-SAD (Digital-Sleep Apnea Device) is made of type 12 polyamide, a resistant biocompatible nylon. The D-SAD is the smallest device in polyamide, a resistant biocompatible nylon. The D-SAD is the smallest device in the industry and it is the only one that is entirely printed using CAD/CAM technology. From a 3D scan of the stone model or intra-oral scanning, each appliance is designed specifically for you. The unique titration mechanism of the D-SAD uses rods which are made of the same biocompatible polymer as the device. The lengths of the rods vary from 21 mm to 35 mm and can be adjusted in 0.5 mm increments. Each D-SAD appliance comes with three additional sets of rods to allow for additional 3 mm protrusive movements.
Many of our patients are professional car and truck drivers, bus drivers and train engineers. These industries are relying more and more on ways to be sure their drivers and alert and operating their vehicles safely. We rely heavily on sensors to assure these men and women are using their appliances while they sleep. Most of our devices can be designed with Compliance Sensors installed at the time of fabrication. We mostly use the Braebon DentiTrac Micro-Recorder sensors as they are the top of the line device platform. These compliance sensors have a 97.5% service longevity of 5 years. The DentiTrac sensor measures the time the oral appliance is worn while the patient sleeps to aid the Doctor in confirming a successful treatment plan for the patient. The sensor does not change the use, indications or care of the devices.