Sleep Apnea Silver Spring & Beltsville MD
OSA occurs when there are repeated episodes of complete or partial blockage of the upper airway during sleep.
What is SLEEP-DISORDERED BREATHING (SDB)?
- SDB is breathing difficulties occurring during sleep ranging from frequent loud snoring to obstructive sleep apnea (OSA)
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There are two main types of sleep disorders under SDB
- Obstructive sleep apnea (OSA)
- Central sleep apnea (CSA)
WHAT IS OBSTRUCTIVE SLEEP APNEA (OSA)?
- The Most common form of SDB is Obstructive Sleep Apnea. OSA occurs when there are repeated episodes of complete or partial blockage of the upper airway during sleep
- Apnea is a cessation of airflow for ≥10 seconds, a reduction of airflow greater than 90% of baseline
- Hypopnea: a decrease in airflow lasting ≥10 seconds with a 30% oxygen reduction in airflow and with at least a 4% oxygen desaturation from baseline
Obstructive Sleep Apnea can be Mild, Moderate, or Severe.
- AHI (Apnea–Hypopnea Index) is the numerical value assigned for how many times a person pauses their breathing per given time.
- AHI = 0-4 Normal range
- AHI = 5-14 Mild sleep apnea
- AHI = 15-30 Moderate sleep apnea
- AHI > 30 Severe sleep apnea
Signs and symptoms of Sleep Apnea
- LACK OF ENERGY
- MORNING HEADACHES
- FREQUENT NOCTURNAL URINATION
- LARGE NECK SIZE
- EXCESSIVE DAYTIME SLEEPINESS (EDS)
- NIGHTTIME GASPING, CHOKING OR COUGHING
- GASTROESOPHAGEAL REFLUX (GE REFLUX)
- IRREGULAR BREATHING DURING SLEEP (IE, SNORING)
WHAT IS CENTRAL SLEEP APNEA
- Central sleep apnea is the less common type of sleep apnea and occurs when the area of the brain that controls breathing does not send the correct signals to the breathing muscles. Can occur with OSA or alone.
- Approximately 42 million American adults have SDB, 1 in 5 adults has mild OSA
- 1 in 15 has moderate to severe OSA
- 9% of middle-aged women and 25% of middle-aged men suffer from OSA
- 75% of severe SDB cases remain undiagnosed
Increased Risk Factors For Sleep Apnea
- Male gender
- Obesity (BMI >30)
- Excessive use of alcohol or sedatives
- Upper airway or facial abnormalities
- Family history of OSA
- Neck circumference of (>17” men; >16” women)
- Endocrine and metabolic disorders
CARDIOVASCULAR CONNECTION TO OSA
- According to Americal Heart Association, 5.7 million people in the US have heart failure
- Approximately 76% of congestive heart failure patients have SDB
- 49% of atrial fibrillation patients and 30% of cardiovascular patients have SBD
- OSA presents in 70% of heart attack patients with AHI ≥5, and 52% of heart attack patients with AHI greater than or equal to 10
TYPE 2 DIABETES CONNECTION TO OSA
- OSA is associated with insulin resistance diabetes independent of obesity
- 48% of type 2 diabetes sufferers have sleep apnea. May have a casual role in the development of type 2 diabetes
- 86% of obese type 2 diabetic patients suffer from sleep apnea
STROKE CONNECTION TO OSA
- 65% of stroke patients have SDB
- Up to 70% of patients in rehabilitation therapy following stroke have significant SDB ,AHI >10
TRAFFIC ACCIDENTS CONNECTION TO OSA
- There is up to 15 fold increase of being involved in vehicular accidents in people with moderate to severe sleep apnea,and a fatality of 980 lives every year in the us.
Oral Appliances for Sleep Apnea | Snoring Mouth Guards Silver Spring & Beltsville
Treatment of OSA with oral appliance & How Does It Work?
Oral appliances are indicated for the treatment of snoring and mild to moderate sleep apnea. Oral appliances also offer alternative for patients with severe OSA who cannot or will not tolerate positive airway pressure therapy or CPAP. Oral appliances for OSA must be prescribed by a physician and fitted by a dentist. The mechanical holding of the mandible forward in relation to the maxilla, and the prevention of the tongue from collapsing into the airway during sleep provides mechanisms that decrease the collapsibility and an increase in the dimensions of the upper airway. This simple and viable option in the treatment of sleep-related breathing disorders reduces the potential for obstruction.
Oral Appliances Types
The two main types of appliances for SBD are those that advance the mandible in relation to the maxilla, and those that hold the tongue in the protruded position. The custom made nocturnal mandibular advancement device is the most commonly used device, and is farther divided into adjustable and non adjustable. The adjustable device allows for adjustments for titration. Oral appliances are easy and comfortable to wear and most people adjust to the appliance with in couple of weeks.The small and convenient size makes it easy to carry it when traveling. Makes for a non-invasive reversible treatment.
The tongue retaining device is least popular because it lacks the ability to adjust for titration, can dislodge because of lack of suction and therefore has low compliance because of comfort issues. Mandibular advancement appliances are the most commonly used.
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Sleep Apnea Treatment Reviews
Elsabet H. Tekle, DDS
Patient Review by Gina S
Doctor: extremely thoughtful and meticulous about explaining process, procedures/and to add polite and gentle Facility: Warm, loved the ambiance and music Front Desk staff: thoroughly organized and polite
- Gina S
Patient Review by Gail J
I experienced a very professional, caring, and honest assessment of my situation.
- Gail J
Patient Review by Paula H
I'm not sure the word "enjoy" is correct in regard to dental work, however, I do enjoy my visits and the courtesy I am shown.
- Paula H
Patient Review by Dora Elaine T
I was deciding between a hard or soft nightguard for my teeth. Dr. Tekle took her time to explain all of the questions I needed to ask to make an informed decision. She also gave me some websites where I could get information. And, maybe most importantly, she showed me a hard nightguard so that I could touch it and know exactly what it would be like. I already wear a soft nightguard and know what it is like. Really seeing and touching was very helpful.
- Dora Elaine T
Patient Review by Atim G
Please note I answered no to the item Was your pain minimized? I did not have any pain.
- Atim G
Patient Review by Tanneil Gayle G
I was good and everyone was kind to me and gentle to me
- Tanneil Gayle G
Patient Review by Joyce R
Dr Tekle never makes me feel that she is rushing or that I am part of a money making assembly line.
- Joyce R
Patient Review by Patricia C
I was very pleased with my office visit. From scheduling to the end of my appointment was time well spent. Very nice decor and office atmosphere.
- Patricia C
Patient Review by David P
I have sleep apnea, and I really like my CPAP machine. But it's a pain in the patootie when I travel. It's bulky and at my age dragging it and luggage around is more trouble than I need. So I asked my ENT about an oral appliance and he recommended Dr. Tekle. Getting fitted took a couple three hours over two visits measuring breathing and trying various means of keeping my air way open. Dr. Tekle was very careful to make sure she got it right. Then after another sleep test has come more adjustments. I'll have three more visits to make sure everything is right.
- David P
Patient Review by Carlton D
I was referred to Dr. Tekle by a co-woker, this was one of the best thing that happened to me. I was suffering from sleep apnea and refused to use the cpap machine. I was averaging about 3-4 hours of sleep a night. I was falling asleep in meetings, at my desk, and watching television on the couch was a joke. My co-workers would joke on how long it would take me to fall asleep. I made an appointment with Dr. Tekle and my life has totally changed and everyone around me has noticed. Dr. Tekle fitted me for an Oral Sleep Appliance. OMG...I can't really put into words the difference this appliance has improved my sleeping, I sleep on average about 6-8 hours a night now. I'm no longer falling asleep in meetings, at my desk, and I can actually watch an entire show without falling asleep. If you have sleep apnea issues I HIGHLY recommend Dr. Tekle and her staff and the Oral Sleep Appliance.
- Carlton D
Patient Review by Robert R
I was referred for an oral appliance for my sleep apnea. I did not know what to expect and Dr. Tekle walked me through the process and tested and re-tested my jaw position to make sure it would work for me - it did. Additionally, the staff worked with my referring Dr. and insurance to get approval in a timely manner. Now, I am sleeping better with more energy! Great, friendly practice.
- Robert R
Patient Review by John B
Not only have I received regular dental care from Dr. Tekle, which has been excellent by the way, but recently utilized Dr. Tekle's services for Sleep Apena. The service provided has allowed me to no longer require a CPAP machine thereby providing a less intrusive sleep experience and saves from the cost of maintenance and up keep of the CPAP device.
- John B
Patient Review by Jacque T
Exceptional and professional service!
- Jacque T
Patient Review by Robert
Fitting for new device was simple. Device itself worked miraculously. Snoring reduced 100% per sleep monitor SnoreLab (which is great and free trial and usage; costs only 2.99 to save multiple nights recordings).