Is Snoring Keeping You Awake at Nights?
from the library of Robert L. Talley, DDS

Snoring is to obstructive sleep apnea as thunder is to lightning. They may, but not always, appear together. One may be just an annoyance, but the other may be serious trouble.

Obstructive Sleep Apnea

With obstructive sleep apnea, muscles of the soft palate at the base of the tongue and the uvula (the small, conical, fleshy tissue hanging from the soft palate) relax and sag, obstructing the airway, making breathing labored and noisy. Collapse of the airway walls blocks breathing entirely. When breathing periodically stops, a listener hears the snoring broken by pauses. As pressure to breathe builds, muscles of the diaphragm work harder. Sleep is then temporarily interrupted, sometimes for only seconds. This, in turn, activates throat muscles and "un-corks" the airway. The effort is akin to slurping a drink through a straw that is stuck in a lump of ice cream. A listener hears deep gasping as breathing starts. With each gasp, the sleeper awakens, but so briefly and incompletely, that he does not remember doing so in the morning. Someone with obstructive sleep apnea may stop breathing for ten seconds or longer-dozens, even hundreds of times each night.

Each time breathing stops, oxygen in the blood stream falls and the heart must work harder to circulate blood. Blood pressure rises and, over time, may stay elevated after breathing restarts. The heart sometimes beats irregularly and may even pause for several seconds. This may account for some deaths during sleep of people who went to bed in apparent good health.

• 98.5% of snorers exhibit some apnic tendencies
• 24% of males and 18% of females suffer from snoring
• 60% of males and 40% of females over the age of 60 snore (female snoring increases after menopause)
• loudness of snoring may reach as high as 90db (worker's compensation requires ear protection in workplace at 90db)
• hypertension is present during wakefulness in approximately 50% of people with sleep apnea
• over long periods, sleep apnea results in intellectual and memory deterioration

The following is a Sleep Quiz to help you rate the quality of your sleep patterns.  

• I've been told that I snore.
• I've been told that I stop breathing while I sleep, although I don't remember.
• I feel tired and irritable in the morning, even though I slept through the night.
• I am having trouble controlling my weight.
• I sweat excessively during the night.
• I have noticed my heart pounding or beating irregularly during the night.
• I get morning headaches.
• I have trouble sleeping when I have a cold.
• I have jolted awake gasping for breath during the night.
• I am overweight.
• I seem to be losing my sex drive.

What treatment offers

Most people with sleep apnea benefit from both general measures and specific treatments.

• lose excess weight
• get regular exercise
• avoid alcohol, heavy meals and medications that make you drowsy

When symptoms are more severe, and these measures don't solve the problem, other treatment options include:

• Nasal CPAP (continuous, positive airway pressure). Pressure from an air compressor forces air through nasal passages and into the airway under gentle pressure, keeping it open and allowing the person to sleep and breathe normally.
• Surgery may be able to correct physical abnormalities that cause sleep apnea. However, there is no easy surgical solution.

Considering the invasiveness of surgical solution, a failure can be devastating to the patient. Surgery success ranges between 50%-70%.

• Dental appliance therapy. An effective way of treating snoring and obstructive sleep apnea for many patients.

The Silencer:  Dental Appliance Therapy

A dental appliance is a small plastic device, similar to an orthodontic retainer, or an athletic mouthguard. It is worn in the mouth during sleep to prevent the soft throat tissues from collapsing and obstructing the airway. Dentists with training in dental appliance therapy can design, construct and fit these special appliances to meet their patient's individual situations and conditions.

In recent clinical studies, physicians and dentists have found that, in the majority of patients, as well made, well fitted dental appliance will effectively reduce or eliminate snoring.

Dental appliances work by bringing the lower jaw forward, by holding the tongue forward, and by lifting the drooping soft palate.

The success of dental appliance therapy is an important development in sleep disturbance. However, such therapy should never be undertaken in the absence of a joint working relationship between a physician and a dentist.

The Silencer is an articulated elastomeric mandibular advancement appliance. This dental device is designed to allow the advancement of the mandible through a controlled range of forward movement while, at the same time, allowing for a limited amount of vertical and lateral movement of the mandible. This appliance has proven extremely effective in treating snoring and sleep apnea.

There are three component materials in the Silencer. The body of the appliance is constructed of elastomer, a pliable material which offers the patient a much greater degree of comfort than harder acrylic materials. For additional support to the dentition, as well as the temporomandibular joint, hard acrylic "bite pads" are placed in the molar regions. A commercially pure titanium articulating component grants the appliance the many adjustment characteristics that make the Silencer unique - kind to the tissues, the teeth and the temporomandibular joint (TMJ).

The Silencer