Sleep Apnoea

What is sleep apnoea?

Obstructive Sleep Apnoea (OSA) is a condition that occurs during sleep and affects 4% of Australians. The airway is often obstructed by relaxed muscles in the jaw, tongue and neck which then completely blocks the flow of air which interferes with normal breathing habits. Due to this airway obstruction the body’s oxygen levels decrease and carbon dioxide levels peak. Receptors in the body sense this unnatural change which results in an abrupt arousal from a deep sleep where the sleeper usually gasps for air or chokes.

What are the signs of sleep apnoea?

Signs and symptoms of Obstructive Sleep Apnoea are varied, may be related to other lifestyle choices and differs from person to person. The most common signs found in OSA sufferers include:

  • Loud and continuous snoring – which may mostly affect a significant other
  • Tossing and turning during the duration of the evening
  • Frequently waking up during the night
  • Gasping and choking for air during sleep
  • Daytime tiredness (hypersomnia)
  • High blood pressure (hypertension)
  • Difficulty getting to sleep (insomnia)
  • Multiple episodes of breathing cessation

How sleep apnoea is officially diagnosed

Sleep apnoea is often first noticed by a partner as the OSA sufferer may never awake to a conscious level during their OSA episodes and are best placed to know the number of episodes there are and know how loud their partner’s snoring is. When attending the first OSA dentist appointment or consultation it is a good idea to bring your partner along as they may provide invaluable information.

If it is suspected you have OSA, your dentist will then perform a physical examination of your mouth, nose and throat, who often looks for issues with the tonsils or soft palate as they are the usual suspects of OSA related airway blockages.

Finally, it may be recommended that you undergo a sleep study before the final diagnosis is made. The sleep study is usually carried out externally at a specialised sleeping clinic but a take-home version of the kit is also readily available.

How is sleep apnoea treated

Sleep apnoea can be treated in a number of ways, depending on the severity of the condition. An oral appliance, also known as a mandibular advancement splint (MAS) or mandibular advancement device (MAD), is one of the most common methods used to treat sleep apnoea.

After a sleep study is taken, you can be assessed for suitability. If you are suitable for an oral appliance, your dentist will take data from your sleep study to construct an oral appliance custom-made for your mouth.

This appliance is specifically constructed to a clinically determined bite position. This is the position for which your lower jaw is at rest, while your muscles are completely relaxed.

Once constructed, your dentist will ask you to trial the oral appliance for a few weeks. After this time, a second sleep study can be conducted to monitor any changes since the last study. Your oral appliance may then be adjusted according to the results, based n objective data. The objective is to reduce or stop the snoring completely.

The Panthera Anti-Snoring Device

This device is custom-made and includes two retainers to be inserted on the upper and lower arches. The retainers are manufactured using a laser sintering process.

The connector system consists of two triangles attached to the lower retainer and of retaining rods. These rods are connected to the upper retainer and to the triangles of the lower retainer in order to maintain the jaw in a forward position.

Benefits of treatment utIlizing a mandibular advancement device (MAD)

panthera instructions for patients

  • Non-invasive, reversible, and long-term treatment
  • Excellent patient compliance because of its effectiveness, its comfort and the absence of side effects
  • Minimizes bulk in the mouth when sleeping thanks to its small size and comfort
  • Easy adjustment, titration, insertion, and removal both for the dental practitioner and the patient

The action mechanism

  • Mandibular advancement with retention
  • Interchangeable rods to control the advancement
  • No pressure on incisors
  • Articulation parallel to the occlusal plane
  • Made in type 12 organic polyamide
  • Homogeneous material
  • Easy insertion and removal

Custom Made Oral Appliance

The device is designed according to the characteristics of each patient, thus offering a better fit to minimize discomfort and increase stability.

Advantages of the Connector System

This innovative system transfers forces in the horizontal plane. It reduces muscle pain and stress on the temporomandibular joints (TMJ). Since the retaining rods and the pivot points located on the triangles of the lower retainer and on the anchor points of the upper retainer are elevated, vertical forces are suppressed. The fact that there are no vertical forces limits the retention of the retainers to strong teeth, which increases comfort and, consequently, improves patient compliance to the treatment. The device works in the same direction than the muscles and the design minimizes the size and the retention force of the retainers to provide an improved comfort and protect the teeth.
The traction mechanism allows the closing of the mouth while reducing tension in the joints. The closing of the mouth contributes to nasal breathing, which reduces vibrations resulting in snoring, as well as collapsing causing episodes of apnea.

The Panthera device facilitates lateral and vertical movements during sleep. Consequently, it is also possible to breathe through mouth. Wearing the device does not stop the patient from drinking, yawning or talking. The components of the plastic connector system are safe and metal free. There is no risk of swallowing or inhaling the components.

By changing the retaining rods, it is possible to move the jaw forward gradually, one millimetre at a time, in accordance with medical recommendations. 

Instructions on wearing the sleep appliance

Wearing any appliances in the mouth takes a little time to get used to. It is wise to initially wear the appliance for 1-2 hours during the day before the night wear. This will give some time for the mouth to adjust and when you feel more comfortable with the appliance in the mouth, then you are ready to sleep with it at night time.

Because the bite has been altered, jaw pain may be experienced by the patient in the initial stages, this should improve with time as the muscles adapt to the new position.Gradual advancements of the lower jaw may be required in accordance with clinical observations and sleep study results. In certain cases, up to 8 changes of the rods are necessary to achieve the optimal results.

Hard bristled brushes are to be avoided for cleaning purposes. Daily rinsing of the appliance with liquid hand soap is sufficient to keep the appliance clean and always store in water.

To learn more about how Robina Town Dental can help you with sleep quality, get in touch with us or make an appointment.

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