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1401 Hospital Drive, Suite 102, Hurricane, WV 25526
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FAQs

How common is sleep-disordered breathing?

According to the Institute of Medicine, 50-70 million Americans suffer from chronic sleep disorders. In fact, sleep-related problems are the third most common complaint heard in the physician's office (behind colds and headaches).

Sleep disorders are the most common in men, especially those who are middle-aged, somewhat overweight and who consume alcohol. The prevalence of sleep-disordered breathing also increases with age. For example, if you are more than 60 years old, you are 2x-4x more likely to develop Obstructive Sleep Apnea (OSA) according to independent research by the National Institutes of Health and the American Academy of Family Practice. Not surprisingly, rates of OSA are also high in patients who have been diagnosed with cardiovascular diseases as demonstrated by this chart:

CARDIOVASCULAR DISEASE LIKELIHOOD OF OSA
Uncontrolled hypertension - 2+ medications 80%
Stroke 60%
Congestive Heart Failure 50%
Myocardial Infarction 40%
Systemic Hypertension 30%

Because quality, recuperative sleep is vitally important, and because the health of women and children may also be affected by sleep-disordered breathing problems, we urge anyone who does not feel refreshed after a full night's sleep to discuss their sleep concerns with Dr. Bailey.

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How many hours of sleep do I need each night?

Sleep is an active state, which is as important to your overall health as diet and exercise. This includes REM (rapid eye movement sleep), which is the stage of sleep associated with the body’s ability to heal, repair and rejuvenate itself.

AGE GROUP RECOMMENDED AMOUNT OF SLEEP NATIONAL AVERAGE
Infants (3-11 months old) 14-15 hours 12.7 hours
Toddlers (12-35 months old) 12-14 hours 11.7 hours
Preschoolers (3-5 years old) 11-13 hours 10.4 hours
School-Aged Children 10-11 hours 9.5 hours
Parents/Caregivers 7-9 hours 6.8 hours

Source: National Sleep Foundation, 2004 Sleep in America poll

Individuals who do not get a sufficient amount sleep each night put themselves at significantly increased risk of hypertension, heart attack, stroke, diabetes, plus workplace accidents and injuries. In fact, the National Highway Traffic Safety Administration (NHTSA) conservatively estimates that 100,000 police-reported crashes are the direct result of driver fatigue each year. This results in an estimated 1,500 deaths, 71,000 injuries and $12.5 billion in monetary losses annually.

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What is sleep apnea?

A sleeping person normally breathes continuously and uninterruptedly throughout the night. However, a person with sleep apnea actually stops breathing for 10 seconds or longer several times per night. This can happen up to 400-500 times, depriving the body of vital oxygen. This interruption of breathing is called "apnea," which is a Greek term meaning “want of breath.”

There are three forms of sleep apnea:

If you think you may be suffering from sleep apnea, share your concerns with Dr. Bailey. She can screen for sleep-disordered breathing and, once diagnosed, provide treatment that will help you to enjoy the benefits of deep, uninterrupted sleep. When you manage your OSA, may find that treatment you may be receiving for OSA-related disorders may be more effective, too.

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Are there any indicators that can predict sleep apnea?

The only way to determine with certainty if you have sleep apnea is to complete an overnight sleep study. In addition to completing our Self-Scoring Sleep Assesment, here is a quick list of indicators that often predict sleep apnea: snoring, overweight/obesity, high-blood pressure, acid reflux, physical abnormalities in your nose (i.e., a deviated septum), throat or upper airway (i.e., enlarged tonsils, adenoids or tongue size), neck size (i.e., <17 inches for men, <16 inches for women) and genetics.

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If I snore, do I have sleep apnea?

Quite possibly, yes. Snoring can disrupt your sleep as well as your partner's sleep. In some cases, the narrowing of the airway causes vibrations of the soft palate that result in snoring is minor – that is, it does not prevent your body from getting adequate amounts of oxygen and, therefore, causes little or no harm. Over time, however, vibrations associated with snoring can change the structure of tissues in your throat and this can lead to sleep apnea. However, not everyone who snores has sleep apnea.

If you've been told that you snore, please be sure to mention this to Dr. Bailey. She can screen you for sleep-disordered breathing and assist you in completing a polysomnogram (i.e., sleep study), which is the only way to obtain a differential diagnosis.

If you do have sleep apnea, we can provide dental sleep medicine therapies – including alternatives or adjuncts to CPAP – that will enable you to enjoy the benefits of recuperative sleep, enhance your quality of life and even increase your life expectancy.

Take note : You can have sleep apnea even if you don’t snore. This condition is called a “silent apneic.” And it is equally important for you to consult with your doctor or a qualified dentist, especially if you are fatigued and/or you do not feel refreshed after a full night’s sleep.

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How can I know for sure if I have sleep apnea?

The only way to determine with certainty if you have sleep apnea is by completing a sleep study, which our office can arrange for you. Once completed, we will also make sure that the results of your sleep study are read, scored and interpreted by a board-certified sleep physician.

The sleep study is one of the first steps in determining a) if you have sleep apnea, and b) whether or not you are a candidate for oral appliance therapy in our office. More often than not, people who have sleep apnea do not know they have it and seek treatment at the urging of their bed partner. They think they sleep well despite fighting for oxygen all night. And they often don’t realize how bad they felt until they experience what it is like to get restful sleep.

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What should I look for when choosing a dentist to help me with my snoring and/or sleep apnea?

Oral appliance therapy is approved by the American Academy of Sleep Medicine as the first line of management of mild to moderate OSA. Since mandibular position is the fundamental principle of airway management, the benefit of seeking treatment from a dentist who has advanced training in both dental sleep medicine and TMJ disorders is significant. In the recently published update of the Practice Parameters for the Treatment of Snoring and Obstructive Sleep Apnea, the American Academy of Sleep Medicine put it this way:

"Oral appliances should be fitted by qualified dental personnel who are trained and experienced in the overall care of oral health, the temporomandibular joint, dental occlusion and associated oral structures. Dental management of patients with OAs should be overseen by practitioners who have undertaken serious training in sleep medicine and/or sleep-related breathing disorders with focused emphasis on the proper protocol for diagnosis, treatment, and follow up."

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Do I need to complete a sleep study before a dentist can provide with me with an oral sleep appliance?

Yes. The Practice Parameters of the American Academy of Sleep Medicine, which outline the standards of practice for the management of sleep disorders, specifically require diagnosis by polysomnography (PSG - the overnight sleep test). In addition, virtually all medical insurance carriers require diagnosis by means of a sleep study, which is read, scored and interpreted by a board-certified physician, in order to consider reimbursement. If you have not completed a sleep study, we will assist you in doing so as part of the services we provide in our office.

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Can a Pulse-Ox text be used to diagnose sleep apnea?

No. Mild to moderate sleep apnea can go unnoticed on a simple pulse-ox test, which was originally intended to serve as one of several screening tools. The only way to diagnose sleep apnea with certainty is to complete a polysomnogram (i.e., sleep study), which must be read, scored and interpreted by a board-certified sleep physician. (A polysomnogram is also necessary for insurers to consider reimbursement of your treatment costs.)

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How does an oral sleep appliance work?

If you suffer from sleep-disordered breathing, an oral sleep appliance that resembles an orthodontic retainer or athletic mouth guard can help you maintain an open and unobstructed airway during sleep. Recommended by the American Academy of Sleep Medicine for treatment of patients who have mild-to-moderate sleep apnea as well as patients who are CPAP intolerant, oral appliance therapy works by: a) bringing the lower jaw open and forward, b) holding your tongue forward, and 3) preventing the soft tissues in your throat from collapsing and obstructing your airway. To be effective, oral sleep appliances must be precision-fit to each patient and properly calibrated. One size does not fit all, which is why we use several different oral sleep appliances in our office.

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Can I use an oral sleep appliance if I have missing teeth, bridgework or a denture?

Oral sleep appliances can be custom designed and very successful for a variety of patients. Even patients missing some or all of their upper teeth can use an oral appliance. Ideally, you should have at least 6-8 teeth to utilize a conventional sleep appliance. If you do not, Dr. Bailey may be able to fit your appliance over implant-retained dentures over edentulous ridges if you have good retention. To determine if you are a candidate for an oral sleep appliance, Dr. Bailey will assess your teeth, gums, and jaw as part of your new patient examination to determine if an oral sleep appliance can provide successful results with minimal, if any, long-term complications.

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Can I use an oral sleep appliance instead of my CPAP machine?

Continuous positive airway pressure (CPAP) is an effective therapy for OSA; however, we know that CPAP compliance remains alarmingly low at rates of only 40-60%. Many patients find it difficult to tolerate and frequently stop using it because of discomfort. In some cases, nasal mask interference may cause pressure sores, persistent air leakage, claustrophobia, nasal congestion or other side effects.

By contrast, oral appliances are effective treatments for patients who have been diagnosed with mild-to-moderate Obstructive Sleep Apnea (OSA) as well as patients who are CPAP intolerant. Some people use an oral appliance in conjunction with their CPAP. This can reduce the amount of CPAP pressure that is required which, in turn, can make using CPAP more tolerable for patients. Other CPAP users rely on oral sleep appliances as a more convenient option for managing their OSA when traveling. Whether an oral appliance will work for you depends on several factors. To find out if an oral appliance is right for you, please contact us to schedule an appointment for a sleep examination.

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Is one oral sleep appliance better than another?

There are more than 50 types of oral sleep appliances. No single appliance is ideal for every situation and one size does not fit all. To determine the oral sleep appliance that is best for you, Dr. Bailey will consider several factors including the cause(s) of your sleep-disorder as well as the size and position of your teeth and jaw. As a patient, you can expect a professionally-made, precision-fit oral sleep appliance that is both effective and comfortable to wear. In addition to enabling you to enjoy the benefits of quality, recuperative sleep, your oral appliance if selected, fit and calibrated properly should not cause long-term jaw and/or muscle pain.

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Will my insurance cover treatment for sleep-disordered breathing in your office?

Most medical insurance policies (not dental insurance) will cover the cost of a sleep appliance. Insurance plans vary greatly, though, so we suggest that you speak with your insurance company directly. If you are considering treatment in our office, and your insurance company requires a predetermination, please let us know. We are happy to assist you.

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Are there any side effects from using an oral sleep appliance?

The majority of people experience few, if any, side effects from use of an oral appliance to manage snoring and/or mild-to-moderate sleep apnea that is properly fit and calibrated. A very small percentage of people have minor side effects such as increased saliva production, jaw tenderness, and bite changes. Most of these side effects are temporary and will disappear after a few simple adjustments to your appliance.

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1401 Hospital Drive, Suite 102, Hurricane, WV 25526 USA
Jeanne K. Bailey, DDS Sleep, TMJ and Craniofacial Pain Treatment Center in West Virginia (304) 757-7428 (304) 757-3535 wvsleepandtmj@frontier.com