Sleep Apnea Could Really Be Stressing You Out!

raised hand saying "need sleep"Inhale, then exhale, but don’t inhale right away. Count out 10 seconds until your next breath.

Take that breath. How do you feel?

Relieved, probably. Maybe you even noticed the tension releasing from your whole body as you inhaled again.

Now imagine experiencing that over and again through your night’s sleep. That’s a bit of what obstructive sleep apnea (OSA) is like. Not getting the oxygen it needs to survive, the body perceives a threat and reacts accordingly. You wake with a gasp, taking in as much air as you can.

Then you go back to sleep only to wake once the airway is again blocked – by excess tissue around the top of the windpipe, for instance, or the tongue or lower jaw slipping backwards.

New research in the Journal of Clinical Endocrinology & Metabolism shows just what an impact this has on the body as it sleeps.

Now, most studies on OSA collect data during the day, when patients are awake. But

“This is one of the first studies to show real-time effects of sleep apnea on metabolism during the night,” says Jonathan Jun, M.D., assistant professor of medicine at the Johns Hopkins University School of Medicine and the paper’s senior author.

Jun and his team collected a range of metabolic data from patients while they slept both with and without CPAP – the usual treatment for OSA symptoms, which uses continuous positive airway pressure to keep the airway open. They measured free fatty acids in the blood, glucose, insulin, and the stress hormone cortisol. They measured brain waves, blood oxygen levels, heart rates, and eye and leg movements.

Jun and colleagues found that CPAP withdrawal caused recurrence of OSA associated with sleep disruption, elevated heart rate and reduced blood oxygen. CPAP withdrawal also increased levels of free fatty acids, glucose, cortisol and blood pressure during sleep. The more severe the OSA, the more these parameters increased. In addition, glucose increased the most in patients with diabetes. Increases in fatty acids, glucose and cortisol have all been linked to diabetes. The Johns Hopkins team also found that blood pressure increased and the arteries showed signs of stiffness in the morning without CPAP. Over time, increased blood pressure and vascular stiffness can contribute to cardiovascular disease.

That’s the very picture of a body under stress. It also suggests that OSA may be more than just a manifestation of obesity and related health issues. It may actually aggravate them.

CPAP is hardly the only solution, though – and it’s a good thing, too. Many people find reasons to quit it. Compliance rates are notoriously low. But there are other effective options for dealing with mild to moderate sleep apnea – from lifestyle changes to oral appliance therapy.

In fact, according to the most recent American College of Physicians guidelines for managing sleep apnea, the first recommendation is to encourage overweight and obese OSA patients to lose weight. Other research suggests that exercise can likewise have a big impact on at least some OSA symptoms.

And these, of course, can be pursued in tandem with oral appliance therapy, in which custom appliances are used to keep the tongue from blocking the airway or gently repositioning the lower jaw to keep the airway free and clear.

One 2016 study found that airflow may be greatly improved by appliance therapy.

Our findings suggest that oral appliance therapy not only improves the upper airway collapsibility but also improves the upper airway compensatory effectiveness. Thus, oral appliances appear to unload the upper airway, thereby enabling patients to exhibit more effective compensatory dilator muscle responses for improved airflow.

OSA is much more common today than just a couple decades ago. According to one study, between 1993 and 2010, OSA diagnoses jumped 14.6-fold! But many more treatment options and tools have been developed during that same period – and continue to be developed – offering options beyond CPAP.

And you just might find some of those options in your dentist’s office.

Image by Dmitry Kugarov

A Look Back at…Nitric Oxide

Originally posted September 29, 2016

nitric oxide moleculeUnlike nitrous oxide, a.k.a. “laughing gas,” nitric oxide it is no laughing matter. Rather, it’s a signaling molecule that our body produces to help the trillions of cells in our body communicate with each other.

Nitric oxide is made by the body’s blood vessel’s lining. When this lining – the endothelium – senses healthy conditions, such as when you exercise, it releases more nitric oxide. Nitric oxide expands the blood vessels, increases blood flow, and decreases plaque and blood clotting.

A healthy release of nitric oxide has been reported to

  • Help memory and behavior.
  • Support the immune system’s fight against pathogenic bacteria and defend against tumors.
  • Regulate blood pressure.
  • Improve sleep quality.
  • Reduce inflammation.
  • Increase endurance and strength.
  • Aid digestion.

We get plenty of nitric oxide when we’re young, but production falls later in life. Production also drops off when the endothelium senses less than healthy factors such as high blood pressure, high cholesterol, smoking, and increased stress levels. Free radical damage, inactivity, and poor dietary choices likewise have a negative effect nitric oxide release.

Happily, there are ways to increase nitric oxide and reap its benefits.

  1. Exercise
    When you exercise your muscles require more oxygen, which is supplied by the blood. As your heart pounds, your arteries release nitic oxide into the blood. This opens and relaxes the vessel walls and allows more blood to pass through.

  2. Diet
    Vegetables such beets, beet juice, celery, and dark leafy greens such as kale chard, arugula, and spinach are high in dietary nitrates and nitrites, both of which stimulate the production of nitric oxide. In addition, eating food with color increases the flavonoids in your diet. Flavonoids protect nitric oxide from free radical damage. Generally, it’s best to avoid a diet either too high in fat or carbohydrate. Both can inhibit nitric oxide production.

  3. Nitric oxide supplements
    Traditionally, supplementing for nitric oxide meant taking supplements containing L-arginine. But current research indicates that, as you age, L-arginine is less likely to prove effective.

    Enter new research out of the University of Texas Health Science Center, which has led to a proprietary, beetroot-based, nitric oxide formula that generates authentic nitric oxide while supporting the enzyme that makes nitric oxide in the body.

    The scientist at the helm of this form of supplementation is Dr. Nathan Bryan who co-authored The Nitric Oxide (NO) Solution based on his research.

Whether you increase nitric oxide via exercise, diet, supplementation, or a combination of all three, tapping into this overlooked molecule’s power may well help you age with strength and vitality.

More Reason to Kick the Sugar Habit (and More Tips on How to Do It)

dropped cupcakeEver notice that when you cave in to sugar cravings, you don’t end up feeling any better – and may, in fact, actually feel worse?

That feeling worse may not just be a short term effect. According to new research in Scientific Reports, depressive symptoms can be directly linked to the intake of sugary foods and drinks.

Food frequency questionnaires were reviewed from over 23,000 British subjects dating back to 1985 and compared with mood responses on validated questionnaires. Men who ate the most sugar were found to have a 23% higher chance of common mental disorder (CMD) after five years – a condition marked by insomnia, fatigue, irritability, forgetfulness, difficulty concentrating, and somatic (physical) complaints.

Both men and women who ate the most sugar were found more likely to experience recurrent depression, as well.

The researchers also tried to find a reverse causation between mood disorder and sugar intake – in other words, whether mood also caused more sugar consumption. The answer to that was “no.”

“Our research,” they wrote, “confirms an adverse effect of sugar intake from sweet food/beverage on long-term psychological health and suggests that lower intake of sugar may be associated with better psychological health.”

With a high prevalence of mood disorders, and sugar intake commonly two to three times the level recommended, our findings indicate that policies promoting the reduction of sugar intake could additionally support primary and secondary prevention of depression.

No, the study isn’t perfect. All data was self-reported and thus prone to bias. Sugar from alcohol wasn’t counted. But its results do jibe with the new understanding of the role chronic inflammation appears to play in depression.

Sugar is one of the main fuels for inflammation. Eating less of it is the first step in any anti-inflammatory diet: You quit adding fuel to the fire.

Here are 7 simple tips for cutting back on added sugars (and keep in mind, when we’re talking sugar, we’re talking about all kinds, including honey, agave nectar, and other “natural” alternatives):

  1. Try a squeeze of fresh lemon into your iced tea instead of a sweetener.

  2. If you eat oatmeal or other grains in the morning, top them with fresh sliced whole fruit instead of pouring sugar on them.

  3. Clean your cupboards to simply remove temptation.

  4. Include more healthy fats such as avocado or coconut and olive oils to help satiety.

  5. Create a schedule with healthy snacks throughout the day to avoid those “hangry” moments that might lead you to binge on a sugary snack.

  6. Consider making your own “pudding” with whole fat coconut milk rather than buying something at the store packed with artificial ingredients and extra sugars. Here’s one way to do it, for example.

  7. Substitute things like bananas and applesauce in your baking. Here’s a simple cookie recipe using bananas, oats, Sunbutter, and raisins (optional).

Previously

Image by mumblyjoe

Sleep Like Your Health Depends on It (Because It Does)

bedA recent article over at CNN offers a good reminder that running a sleep debt can have far greater effects than daytime sleepiness and general grouchiness.

It can mean more accidents due to weakened reflexes and an unfocused mind. It can mean weight gain. It can mean a higher risk of depression, anxiety, diabetes, heart disease – in general, a shorter, unhealthier life span.

Recent research has also supported the suspected link between Alzheimer’s and sleep loss. A study in Brain, for instance, found that when sleep is constantly interrupted – as in cases of obstructive sleep apnea (OSA) – more of the proteins suspected to cause Alzheimer’s build up in the brain. (Normal sleep helps clear them.)

What’s more, research in the Annals of the American Thoracic Society found that those who are genetically susceptible to Alzheimer’s appear to be at greater risk of the cognitive decline that OSA and other forms of sleep disordered breathing can contribute to.

Many don’t realize that dentists are in a unique position to help identify sleep breathing problems and even, in mild to moderate cases, offer solutions that can enhance both oral and systemic health. Many signs of OSA can show up in the mouth, from inflamed tonsils to scalloping along the tongue, from tooth wear from bruxing (grinding the teeth during sleep) to headaches and other TMJ symptoms. If exam findings suggest OSA, a sleep test may be recommended for diagnosis.

Dental options for treating apnea provide welcome alternatives to CPAP. Most often, dental treatment involves appliance therapy – comfortable devices that typically keep the airway open by gently pulling the lower jaw forward. On the whole, research suggests that oral appliance therapy (OAT) can be at least as effective as CPAP, yet much more comfortable and well-tolerated.

We may also recommend diet, activity, and other lifestyle changes to support improved sleep, as well as additional therapies such as acupuncture or chiropractic care. As ever, everything depends on the individual and the specific causes of their symptoms. After all, it’s causes we want to address.

While tending to symptoms can bring short term relief, only attention to causes can bring about good long-term results.

Many people don’t even realize the impacts a little lack of sleep can cause. We all know those who like to brag of only getting four to six hours of sleep a night, almost like it’s a competition. Yet according to a 2003 paper in Sleep, such folks are likely unaware of what they’re losing in the course of gaining those extra waking hours.

Since chronic restriction of sleep to 6 h or less per night produced cognitive performance deficits equivalent to up to 2 nights of total sleep deprivation, it appears that even relatively moderate sleep restriction can seriously impair waking neurobehavioral functions in healthy adults. Sleepiness ratings suggest that subjects were largely unaware of these increasing cognitive deficits, which may explain why the impact of chronic sleep restriction on waking cognitive functions is often assumed to be benign.

For the sake of your health, happiness, and those around you, it is worth a quick conversation with your dentist to identify warning signs or offer suggestions for improving your sleep. And if dental factors aren’t at the root of your running a sleep debt, here are some great tips from Harvard Medical School on getting a better night’s sleep.


Image by ellas quezada

How Thermography Can Help You Take Charge of Your Health

Most of us are raised with a rather reactive and passive relationship with healthcare. You see your doctor or dentist only once something goes wrong and expect them to fix it.

But functional and biological medicine remind us that by the time you get symptoms, most conditions are fairly well advanced – and often more costly to treat. Fortunately, there are a number of technologies available to help us spot potential problems before they get to that point.

Thermography is one of those technologies – one that we’ve just recently begun making available in our office via the Texas Thermography Clinic.

Thermography is a radiation-free way to scan your body for early signs of dysfunction or imbalance on the cellular level. It’s been used by European integrative doctors for over 30 years and was FDA-cleared for use in the US in 1997.

The technology itself is based on your body’s ability to thermoregulate. This ability to keep a steady temperature is controlled by your autonomic nervous system.

When your internal temperature changes, your hypothalamus is signaled to initiate changes to bring your temp back to its norm. You sweat; your blood vessels widen or contract; your muscles and other organs generate heat – that kind of thing.

So by making a sort of heat map of your body, thermography aims to shed light on this key aspect of your body’s self-regulating abilities.

Alfa thermometryTexas Thermography Clinic uses a particular type of thermography known as thermometry. This technique uses a lightweight, infrared sensor to measure the temperature of your skin. The scanner is somewhat similar to a wand thermometer that a nurse or doctor swipes across your forehead to check for fever. But with thermometry, more than 100 points are checked, including points on the teeth and jaws.

This is followed by a 10 minute period in which you’re exposed to a cold stimulus. Then the thermographer takes readings of those same 100+ points again. Differences in the readings reflect how well your organs and tissues are functioning and how they deal with physiological stress.

Both sets of readings are run through a sophisticated computer program which maps out the temperature patterns of your body. That information can help your doctor identify imbalances that you can address proactively – through follow-up diagnostics and, as appropriate, treatment – before they can become bigger problems.

You can see how this is a perfect fit with our holistic, biological approach. Prevention is the foundation.

What’s All This about Activated Charcoal?

charcoalOf course, oil pulling is just one of a number of natural at-home health practices that more and more folks have been talking about. Another you may be hearing more about these days is activated charcoal. Claims about it range from instant teeth whitening to a good digestive cleanse.

But what do we know about it really?

We’re Not Talking Briquettes

When you hear “charcoal,” your thoughts probably turn to the stuff you might fuel your barbecue grill with. Activated charcoal has been treated with oxygen. This makes it more porous, which makes it more absorbent.

This is why it’s been a go-to treatment for overdose or poisoning. It absorbs toxins so they can’t be absorbed into the stomach.

A classic and frequently cited early demonstration with charcoal was the ingestion of a lethal dose of strychnine mixed with charcoal by Tovery before the 1831 French Academy of Medicine. Tovery suffered no ill effects from the strychnine because of the simultaneous ingestion of charcoal. Similarly, the American physician Hort, by administering oral charcoal, reportedly saved the life of a patient in 1834 who ingested mercury bichloride.

When used for acute poisoning, activated charcoal is given in extremely large doses. But in small doses, it can be used as a supplement.

Activated charcoal comes in a powder, liquid, or pill/capsule form. The powder is typically mixed with water for topical applications on teeth or as a face mask. The liquid and pill forms are typically ingested in small doses (along with large amounts of water) to help with digestion or to remove harmful toxins like mold from the body (yep, mold – in the body).

What’s Charcoal Good For?

A literature review in the Natural Medicine Journal found good or still unclear scientific evidence for activated charcoal’s use in treating conditions ranging from diarrhea to kidney disease. The author also mentions a range of other uses of the supplement based on tradition, hypotheses, or limited research. These include

Aging, asthma, blood disorders, blood purifier, bronchial asthma, deodorant, disease diagnosis, inflammatory skin conditions, irritable bowel syndrome, liver disorders, metabolic disorders, ulcerative colitis.

But it has its uses in dentistry, as well. For instance, mercury-safe dentists may give patients charcoal before and after removing a patient’s amalgam fillings to protect against any mercury that may accidentally be swallowed during the procedures. (Others use chlorella, a single-celled micro-algae that’s also effective for detox.)

It’s also something that some of our patients may be recommended as part of their formal detox regimen, as it binds heavy metals so well.

activated charcoal supplementIncreasingly, we also see people using it at home for teeth whitening – as has been done throughout history. In addition to removing stains, it may also improve oral pH and help keep oral flora in balance (supporting the helpful bacteria, fighting the harmful). Because of this, it’s also said to help tame bad breath, as well.

That said, if you have crowns, veneers, or other tooth-colored dental work, using charcoal can stain such restorations terribly. If you have any, cleaning with charcoal is not for you.

And if you’re thinking about taking activated charcoal as a supplement? Do consult a qualified integrative or naturopathic practitioner before you begin – particularly if you are taking other supplements or medications (including homeopathic ones), or if you are currently being treated for any health conditions. Even supplements can have bad interactions or may trigger troubling side effects.

Vaping is Safer than Smoking, Right? Wrong

hand holding e-cigaretteIn a way, vaping is kind of like mercury amalgam: Despite those who insist that it’s safe, it’s not.

It’s certainly not any safer or healthier than smoking. While many believe it can help a person quit smoking, the evidence suggests that it actually encourages it, especially in teens (who also happen to be much more likely to vape than smoke, by the way).

And like smoking, vaping also does a number on oral and systemic health alike.

Targeting the Youth Market

Let’s look at the marketing. Here in the US, e-cigarettes are currently advertised differently than regular cigarettes and tobacco.

Unlike tobacco products, e-cigarettes can be advertised on both TV and the radio in the United States. In some states, e-cig makers can even sell their products to minors. E-cigarettes don’t contain tobacco, but they usually do deliver hits of nicotine. That’s the chemical in tobacco that makes smoking addictive.

But things are set to change in a couple years. Still, for now, e-cigarettes aren’t included in the FDA’s ban on cigarette and tobacco broadcast ads.

Flavors for these e-cigs (oh look, they have a cool name, too!) include everything from watermelon and mint to Strawberrylicious and Peach Pit. A simple online search results in hundreds flavors that could be commonly mistaken as candy flavors. Not only can this be seen as targeting the youth market, websites commonly refer to them as “juices.”

Unsurprisingly, we’ve seen alarming increases in teen vaping.

From 2011 to 2015, e-cigarette use rose from 1.5 percent to 16 percent among high school students and from 0.6 percent to 5.3 percent among middle school students, making e-cigarettes the most commonly used tobacco product among youth for the second straight year.

What’s the Harm?

Regulations of vaping are still in their infancy. Only last year did the FDA say it would start regulating e-cigs, along with other unconventional tobacco products. But that doesn’t go into effect until 2018.

Until that time, the nearly 500 brands and 7,700 flavors of e-cigarettes will remain on the market – before FDA is able to fully evaluate them.

And the upshot? “We don’t presently know what is in e-cigarettes,” as the American Lung Association puts it, just nicotine and “other chemicals.”

That alone should give reason to pause. But the research to date gives even more reason.

For instance, recent research out of Johns Hopkins adds to the evidence that toxic heavy metals are commonly inhaled along with the vapor.

In an examination of five e-cigarette brands’ first-generation devices, researchers found varying levels of cadmium, chromium, lead, manganese, and nickel in the liquid component that, when heated, delivers ingredients such as nicotine and flavors to the user. Researchers believe the main source of the metals — which can be toxic or carcinogenic when inhaled — is the coil that heats the liquid to create the aerosol, which is commonly (but erroneously) referred to as vapor. [emphasis added]

The “juices,” meantime, typically include propylene glycol and vegetable glycerin, along with nicotine and mystery flavoring. Although the FDA approves of propylene glycol as a food additive, it’s also found in products such as aircraft de-icing fluid and antifreeze.

There’s also evidence that vaping is cytotoxic – that is, poisonous to cells. A study published last year in Oral Oncology found that it also does genetic damage, as well.

E-cigarette vapor, both with and without nicotine, is cytotoxic to epithelial cell lines and is a DNA strand break-inducing agent. Further assessment of the potential carcinogenic effects of e-cigarette vapor is urgently needed.

And just like smoking, vaping can wreck your gums. In fact, recent research suggests e-cigarettes may be even more damaging to the cells in your mouth than regular cigarettes.

Clearly, vaping is no safe alternative. The only safe alternative is to avoid nicotine products all together. And if you’ve already started but are ready to quit, here are some great tips to get you started.

Image by Lindsay Fox

Fluoride in Your Tea

5001227590_1a883e0927_zThough we’ve blogged before on the benefits of green tea for healthy gums and its ability to relieve oral pain, we’ve not looked at the relationship between tea – green or otherwise – and fluoride

A recent entry on the Nourished Kitchen blog, a traditional foods blog, posed the question: Should you be worried about fluoride in your kombucha? If you have never even thought to ask the question, you’re not alone. Most of us don’t know where to look for fluoride.

In answering the question, the blog’s creator Jenny McGruther cites the Big Book of Kombucha:

Kombucha is made from weak tea, rather than strong, so there will be less fluoride in kombucha than a strong tea of the same volume.

On the surface, this answer might seem plausible. But it’s an incomplete answer. The reality is, since we don’t often consider what foods and beverages may contain fluoride; since many of us live with fluoridated municipal water supplies; since many of us use products like toothpaste and mouthwash that contain fluoride, we have no real way of knowing what our daily intake is.

The truth is, ingesting a known toxin daily at unknown levels can be problematic.

Though McGruther says she doesn’t “worry about relatively small amounts of fluoride in the modest amounts of kombucha my family drinks,” this might err on the side of simplicity.

If you’re wondering about fluoride in tea products, one of the best sources for scientifically based information is the Fluoride Action Network.

Five informative links to assist  your decision making:

  1. How fluoride ends up in a tea plant?
  1. Which tea contains high levels of fluoride?
  1. What kind of health issues a heavy tea drinker might expect?
  1. How much fluoride is in newer tea commodities, such as: packed teas, bottled tea, canned tea, and instant tea powders?
  1. How to minimize your exposure to fluoride in tea, and other products?

That said, it’s important to remember that drinking tea does have many benefits, some which may offset potential fluoride exposure. A well-researched approach can provide information that allows for balanced decision making.

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Screening for Sleep Apnea – Helpful or Not?

nodding offThere’s a new report on sleep apnea in JAMA, and it has us a little…well, restless. We think it may send the wrong message and prevent people from getting the help they need to get a good night’s sleep.

The report sought to find if screening for obstructive sleep disorder (OSD) or obstructive sleep apnea (OSA) is effective. All in all, it said, there’s not enough evidence to suggest that it is.

“There is uncertainty about the accuracy or clinical utility of all potential screening tools,” wrote the group led by Daniel Jonas, MD, MPH, an associate professor of medicine at the University of North Carolina at Chapel Hill.

It’s estimated that over 18 million people have some form of obstructed sleep disorder, many of whom go undiagnosed. OSA itself has been linked to a number of serious health conditions, including heart disease, type 2 diabetes, and stroke. Hence, the recommendation that dentists and doctors screen their patients.

The current study reviewed 110 studies with more than 46,000 patients. The goal was threefold:

  1. To evaluate primary care-relevant evidence on screening adults for OSA.
  2. To evaluate test accuracy and treatment.
  3. To inform the U.S. Preventive Services Task Force.

While they found that multiple treatments for OSA were able to reduce AHI, Epworth Sleepiness Scale scores and blood pressure, they couldn’t establish if these reduced mortality or improved other health outcomes. But they did find evidence of a modest improvement in sleep-related quality of life.

Results based on insufficient evidence concern Susan Redline, MD, MPH, who noted in an editorial in the same issue of JAMA,

While the USPSTF found insufficient evidence on screening for OSA in asymptomatic adults, high priority should be given to additional studies that generate rigorous evidence that will serve to improve the recognition and treatment of OSA in the population and reduce its attendant morbidity. However, the current recommendations, if misinterpreted, could negatively influence public health if they are used to discourage direct questioning or deployment of short screening questionnaires for identifying patients at high risk for OSA. Encouraging patient and clinician discussion of relevant symptoms and signs of OSA is one way to help address early recognition.

We agree.

As we noted just a couple weeks ago, we dentists we are in a unique role to not only screen and treat patients with OSD, but we see the positive results in our patients. And we believe that even the “modest” improvements noted by the study are beneficial to overall health and well-being.

Image by andy wagstaffe

Help for Sleep Apnea from Your Dentist? Yes!

sleep apnea diagramMost people with obstructive sleep apnea (OSA) probably don’t know it. In fact, it’s often a sleeping partner who first notices the common signs. After all, the snoring’s not keeping you awake.

But there’s another person who can tell you if you may have OSA: your dentist.

According to a study published last year in the Saudi Medical Journal, dentists have a unique advantage to hone in on the signs of sleep apnea. Because they see into patients mouths more often than physicians do, they have more opportunities to notice indications of airway obstruction – specifically, enlarged tonsils and scalloping along the sides of the tongue.

Other research has suggested even more dental signs of possible OSA, including worn teeth, morning headaches, gum problems, and TMJ pain.

Of the more than 18 million adults in the US affected by sleep apnea, those who are obese are 10 times more likely to report symptoms than their slender counterparts. According to the National Sleep Foundation, many of those 18 million go undiagnosed. Without diagnosis and treatment, the sleep apnea issues compound. OSA has been linked to heart disease, diabetes, depression, memory loss, and more.

Once sleep apnea is diagnosed through a sleep test, dentists can play a role in effective treatment, as well.

Whether you have a history of OSA and use a CPAP device or are searching for help with a recent diagnosis, you may be interested to learn about how less invasive oral appliance therapy can treat mild to moderate cases of sleep apnea. Appliance therapy tends to be more comfortable than CPAP, while also effective in keeping the airway open.

In fact, oral appliance therapy is now the recommended treatment of the American Academy of Sleep Medicine and the American Academy of Dental Sleep Medicine for adults who are CPAP intolerant or prefer an alternative.

“This evidence-based guideline reinforces the fact that effective treatment options are available for obstructive sleep apnea, a chronic disease that afflicts at least 25 million adults in the U.S.,” said AASM President Dr. Nathaniel Watson. “Although CPAP therapy is still the first-line option for treating OSA, oral appliance therapy is an effective alternative that is preferred by some patients. Sleep medicine physicians and dentists can promote high quality, patient-centered care by working together to identify the optimal treatment for each patient who has sleep apnea.”

Most appliances work by supporting the lower jaw in a slightly forward position. This forward position keeps the tongue from dropping back toward the throat. Over time, this helps tone the tissues that line the throat. Wearing an appliance can sometimes double and even triple the size of the airway opening.

These appliances are not “one-size-fits-all” devices. There are dozens of options available. Only a dentist well-versed in breathing disorders such as OSA can help determine the best choice for your unique situation and help get you on the path to better sleep – and better overall health for the long haul.