Treatment of sleep apnoea and snoring with an orthodontic appliance
Sleep apnoea is a condition during sleep in which the muscles of the pharynx on the side and back of the neck relax. This complete relaxation can occur to such an extent that it causes our breathing to stop for a few seconds. As sleep apnoea occurs, the brain perceives a lack of oxygen in the blood, so the brain wakes up to stimulate the muscles and regain the ability to breathe. This process can be repeated several times during sleep without us realizing it.
How can sleep apnoea affect us?
Sleep is a vital habit that a person has, and a quality sleep can improve everyday life. The quality of sleep has the ability to affect even certain medical indicators that affect our health in general. In many cases, it is in fact necessary to use an orthodontic appliance, although we may not consider it necessary ourselves. We may not recognize the importance of the fact that sleep apnoea can have a negative impact on the levels of fatigue one feels during the day. It can also affect even vital indicators; for example, these may include oxygen saturation, but also general health indicators. Quite often, sleep apnoea is accompanied by what is referred to as “snoring”. As a result, it also affects one’s desire to be with their partner, either at the end of the day, or before or during sleep.
The development of sleep apnoea and snoring is due to the instantaneous airway obstruction. It is mainly related to the anatomy of the area, burdened to a large extent by high body weight, but also by various other parameters. Daily habits that affect sleep apnoea may include late dinner, consumption of large amounts of alcohol, smoking, lack of physical activity, and a history of diabetes.
Are there any orthodontic appliances to help treat sleep apnoea?
In most cases, an extraoral CPAP device may be used to treat sleep apnoea. This orthodontic appliance helps to provide a continuous positive air flow, preventing the momentary airway obstruction.
Although the CPAP orthodontic appliance is particularly effective in preventing sleep apnoea, it can adversely affect the patient’s psychology due to aesthetic reasons. The patient needs to wear this device at all times. It should be clear to the patient that in order not to burden their vital signs and at the same time for them to be able to sleep comfortably with their partner, the CPAP orthodontic device is considered necessary.
For this reason, in the last 15-20 years, intraoral orthodontic devices (IST type) have been used to advance the mandible. These help to treat mild to moderate cases of sleep apnoea, and snoring.
The experience of one of our patients suffering from sleep apnoea:
It was a great pleasure for us to receive a thank you message from one of our patients. He came to the doctor’s office about a month ago in order to have an intraoral IST device created to replace the extraoral CPAP. The reason for replacing the device was due to aesthetic and psychological reasons, as mentioned earlier.
After taking specialized measurements in a sleep laboratory, reductions in the phenomenon of apnoea were observed, which was reduced from 39.6 (without device) to 9.4 (with IST) per hour. The duration of snoring also decreased from 59.5% (without device) to 2% (with IST). Finally, the drop in oxygen saturation levels improved from 27.2 (without any device) to 9.5 (with IST) per hour.
The intraoral mandibular advancement device (Intraoral Snoring Therapy or IST) is an alternative method of treating sleep apnoea. It is used instead of an extraoral CPAP in mild to moderate obstructive sleep apnoea and snoring. In order to select the appropriate treatment, and prior to the manufacturing process of any device, it is important for the treating physician / internist / pulmonologist to monitor the patient. Cases where orthodontic appliances were manufactured without the necessary the necessary investigation of medical data and indicators from a specialized sleep study laboratory, are considered dangerous. Frequent monitoring of the course for the treatment of sleep apnoea by a specialist orthodontist is also considered necessary. The reason is that there is a possibility of adverse effects of the device on the occlusion of the teeth.