Snoring and sleep apnea are sleep disorders which can have very serious health complications and can even be life threatening; therefore, it is imperative that oral appliance therapy commences only after a medical assessment. Following referral from a physician or sleep disorders specialist, patients are examined to determine if they are suitable candidates for oral appliance therapy for snoring and sleep apnea. Not everyone is a good candidate for this treatment. All options should be discussed, including the advantages, limitations, complications and costs.
Once the appliance is fabricated by the laboratory, the appliance is fitted to the patient in the dentist's office. Several weeks may be needed to correctly adjust it to a comfortable and effective position. Annual follow up is recommended during active treatment to ensure a good, comfortable appliance fit and the continued effectiveness of the appliance.
Before you see your physician, you should have answers to the following questions.
- How often do you snore?
- How loud is your snoring?
(Is your snoring loud enough to disturb the sleep of others? A report from your bed partner or hunting and fishing partners may be helpful).
- Are there periods when the snoring and your breathing stop?
- Do you gasp or snort during sleep?
- How many hours do you sleep?
- Do you wake up refreshed?
- Do you feel sleepy during the day?
A tape recording of the sounds you make while sleeping may also be helpful to your physician.
If your physician makes a diagnosis of benign snoring, a recommendation of treatment with an oral appliance may be made. If, on the other hand, a more serious sleep disorder is suspected, additional testing may be necessary. This may involve a complete examination by an ear, nose and throat specialist or a sleep physician who may request a sleep test which is done over night at a sleep disorders center. This test (known as a polysomnogram or PSG) is non invasive and consists of attaching a series of leads like an electro-cardiogram to your head, body, arms and legs. The polysomnogram tells the physician about the quality of your sleep and helps determine the appropriate treatment for you.
It should be noted that some patients have been diagnosed and treated as snorers when, in fact, they had cancers of the nose or pharynx. Therefore full airway examination should be completed by a physician before an appliance is constructed.
No matter which form of treatment is used for obstructive sleep apnea, it is important that a follow-up sleep study be done by a sleep professional to determine success. Regular follow-up appointments with your healthcare professional are also essential because the severity of your apnea may change with age. If your snoring resumes or if you are sleepy during the day, it may mean the apnea has returned, and additional or other treatment may be necessary.