Sleep Apnea/Snoring

  Snoring & Sleep Apnea (Airway Obstruction) Respiration is divided into two categories, passive and active. Passive respiration occurs when you are at rest, sleeping, and performing a light exercise such as walking. Active respiration occurs when you increase your muscle activity requiring a greater intake of air in terms of volume.

Passive respiration should be only nasal breathing, while active respiration requires both nasal and oral breathing. Patients who mouth breath during passive respiration are airway obstructed and will suffer from a significate reduction of oxygen in the blood stream. This becomes extremely critical during sleep leading to snoring and episodes of sleep apnea which can be life threatening.

There are five ways the airway can be obstructed. The most common is an underdeveloped maxilla, followed by a trapped skeletal Class II mandible, excessive tonsil and adenoid tissue, a retrognathic maxilla, and nasal turbinates with a deviated septum. Some patients have only one of these obstructions, and some have all five. If the obstruction is confined to the oral pharyngeal area repositioning the mandible forward may clear the airway while the patient sleeps.

This is accomplished using an intraoral appliance that is titrated to find the optimal position of the mandible for maximum opening of the airway. These repositioning appliances are ineffective if the obstruction is somewhere other than the oral pharyngeal area.