Often it's the partner who brings it up. "He snores like a freight train, and sometimes he just stops breathing for a few seconds." Plenty of people snore and are perfectly fine. But loud snoring with pauses, gasps or constant daytime exhaustion can be obstructive sleep apnea, and that's worth taking seriously because it affects far more than sleep.
What causes snoring
When you fall asleep, the muscles in your throat relax. If the airway narrows, air moving through it makes the soft tissues vibrate, and that is the sound of snoring. Alcohol, nasal congestion, sleeping on your back and extra weight can all make it worse.
What is different about sleep apnea
In obstructive sleep apnea, the airway doesn't just narrow; it partly or fully collapses. Breathing slows or stops for several seconds, oxygen levels drop, and the brain briefly wakes you to reopen the airway. This can happen many times an hour without you remembering it.
Warning signs
Snoring is more likely to be sleep apnea when it comes with:
- Pauses in breathing, gasping or choking, often noticed by a partner
- Waking up tired even after a full night in bed
- Falling asleep easily during the day, while reading, watching TV or driving
- Morning headaches or a dry mouth
- Waking up often to use the bathroom
- Trouble concentrating, irritability or low mood
- High blood pressure that is hard to control
Two or three of these together? Bring it up with your doctor.
How sleep apnea is diagnosed
Sleep apnea is diagnosed by a physician with a sleep study. Many people can now do this at home with a small monitor worn overnight; others need a study in a sleep lab. The results show how many breathing events happen per hour and how low oxygen levels drop, which determines whether apnea is mild, moderate or severe.
A dentist can't diagnose sleep apnea, but dentists often notice clues first: a large tongue, a narrow airway at the back of the mouth, a recessed lower jaw, or teeth worn down by nighttime grinding.
Treatment options
- CPAP is the standard treatment, especially for moderate to severe apnea. A machine gently pushes air through a mask to keep the airway open.
- Oral appliance therapy uses a custom device, similar to a mouthguard, that holds the lower jaw slightly forward during sleep. It is often used for mild to moderate obstructive sleep apnea and for people who can't tolerate CPAP, and it can reduce snoring.
- Lifestyle changes such as weight loss, avoiding alcohol before bed and sleeping on your side can help some people.
Where the dentist comes in
Once a physician has diagnosed sleep apnea and an oral appliance is a suitable option, a dentist takes impressions, makes the appliance and adjusts it over several visits. The physician usually confirms with a follow-up test that it is working. Read about sleep apnea oral appliances at our office, and our earlier guide on sleep apnea without CPAP.
What about snoring without apnea?
If a sleep study shows simple snoring without apnea, an oral appliance can still reduce it for many people. Store-bought anti-snoring devices exist, but they should not be used to self-treat suspected sleep apnea, because they can quiet the snoring while the breathing problem continues.
Next steps
Start with your doctor and a sleep study; that's the only way to know. If you already have a diagnosis and CPAP isn't working for you, or you'd like to know whether an oral appliance is an option, call us at (747) 339-7016 and we'll set up a consultation.
