It is not necessary for sleep-related breathing disorders to have medical ramifications for them to be disruptive to people’s lives.  Featured Patient #109 came to us for help with her troublesome snoring which was preventing her husband from sleeping in the same room with her.

Snoring can cause significant relationship problems and has let to many a divorce.  The snorer is almost always unaware of their snoring unless told by a bed partner.  Bed partners can loose significant amounts of sleep as they suffer from “second hand snoring”.  When bed partners chose to sleep in a separate bedroom rather than deal with the snoring, feelings can be hurt.

Oral appliance therapy allowed Featured Patient #109 to sleep quietly.  We were pleased for her when she told us, “My husband and I can now sleep in the same bedroom!”

Women in the third trimester of pregnancy are particularly susceptible to sleep-related breathing disorders.  Studies show that during this time there is considerable upper airway narrowing due to the weight gain and edema that can accompany a pregnancy.  

Studies show that approximately 17% of non-pregnant women snore while as many as 28% of women in the third trimester of pregnancy report snoring.  Interestingly, 75% of women with pre-eclampsia report snoring!

Featured patient #108 came to our office for her regular dental examination during her third trimester.  When asked how she was sleeping, she replied that she was sleeping badly, snoring horribly and awakening in the morning feeling tired, groggy and in a bad mood.

An oral appliance was made to help open her airway during sleep.  The first morning after wearing her appliance, she left the following message on our answering machine, “This is wonderful!  I woke up in a great mood and not groggy at all!  By the way, my husband is very happy!”

 
Oral appliance therapy is normally a process.  In other words, when starting oral appliance therapy a very gentle mandibular advancement position is chosen in order for the patient to easily accommodate the appliance.  This is one of the things that makes oral appliance therapy so successful!  It is a very comfortable device to wear during sleep.  Usually, after the patient has had a week or so to get used to sleeping with the appliance, the appliance is adjusted to bring the mandible further forward.  However, some patients get a major amount of relief with the beginning position.  Patient #111 is such an example.  With only the starting position, she had in incredible amount of benefit in improved night-time oxygen levels.

As shown in the chart, her night time oxygen levels were dramatically and immediately improved.  Without the oral appliance, she spent 54 minutes with her oxygen levels below 90%.  With the oral appliance, she spent only 7 minutes with low oxygen levels.  We expect further improvements in her night time oxygen levels as her treatment progresses.

While everyone suffering from a sleep-related breathing disorder has some physical consequence to the repetitive interruption in the flow of life-giving oxygen, sometimes the effects have larger social consequences than others.  This patient, who could not tolerate CPAP experienced very significant daytime sleepiness from her disorder.  So why is this such a big deal?  She happens to be a school bus driver!  The level of daytime sleepiness she experienced placed her at the same risk of having a traffic accident as a drunk driver.

Oral appliance therapy completely resolved her daytime sleepiness and reduced it from a dangerously high of 16 on the Epworth Sleepiness Scale to a very normal 6.

To hear the interview, click here.