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Treatment Options

Behavior Modification

Changing various habits can reduce local swelling within the airway and reduce the symptoms of snoring and sleep apnea or may improve the quality of the time spent sleeping.

Reduce alcohol consumption

Avoid sedative drug use

Quit smoking

Avoid use of caffeine in later hours of the day

Lose weight

Maintain a regular sleep schedule with an adequate amount of sleep

Alter sleeping posture (ex. sleep on your side with a pillow/tennis ball attached to the back of your pajamas)

Surgery

Surgical alteration of the bones/soft tissues of the mouth or throat may permanently increase the diameter of the airway and reduce or eliminate the symptoms of snoring.

Nasal surgery – reshaping of the bone and soft tissues inside the nasal cavity to widen the airway

Uvulopalatopharyngoplasty– removing soft tissue from the back of the mouth using lasers or traditional surgical techniques to widen the airway

Mandibular advancement surgery – moving the lower jaw bone forward to widen the airway

Palatal pillar implants – inserting small cylinders of polyester into the soft palate to decrease flexibility

CPAP (Continuous Positive Airway Pressure)

Pressurized air is pumped from a machine at the bedside through a hose and mask into the nose and/or mouth to hold the airway open and allow uninterrupted breathing. This is considered the Gold Standard method of treatment for snoring and sleep apnea. It is very successful provided that it is used regularly. There are several designs of masks and nose pads available to maximize comfort and the benefits of treatment.

Oral Appliance Therapy

The Canadian Sleep Society and the American Academy of Sleep Medicine recognize oral appliance therapy as a viable option for people that snore only, or for people with mild to moderate sleep apnea, or for people with severe sleep apnea that cannot tolerate CPAP.

Mandibular Repositioning Splint (MRS): A pair of plastic mouth-guards are worn on the upper and lower teeth. As the teeth close together, the mouth-guards reposition the lower jaw forward, moving the tongue and soft palate away from the back of the airway and increasing its diameter, thereby creating less resistance to breathing.

MRSs and TRDs require custom impressions of the teeth to design the appliances properly and may take a few weeks to fabricate. They also may require several follow-up appointments to adjust the appliances. Follow-up sleep tests will be necessary to determine the effectiveness of the appliances. Yearly examinations are also recommended to ensure maximum comfort and to make sure they are working properly.

Over-the-counter (OTC) appliances: There are several devices available from local pharmacies that are relatively easy to mold to the teeth. These may provide similar benefits to a custom designed oral appliance. However, unlike those made by a professional trained in the fabrication of oral appliances, OTC appliances may not be as durable and may not fit well for some people. In addition, more side effects may occur if the appliance does not contact all of the teeth to enhance maximum stability.

Oral appliances can be used alone or can be combined with other methods of treatment for snoring and sleep apnea.

Custom designed appliances usually last about 3-6 years before needing to be replaced due to normal use. If any dental treatment is done that significantly changes the shape of the teeth, a new appliance may also be necessary. Side effects of oral appliances may include salivation, difficulty swallowing with the appliance in place, sore jaws, sore teeth, jaw joint pain, dry mouth and short-term bite changes. Most of these side effects are minor and resolve quickly on their own or with minor adjustment of the appliance. Long-term complications may include minor permanent bite changes – the result from tooth movement and/or joint repositioning.