Sleep Apnea

Although orthodontics may not be thought of as a treatment for sleep apnea there are two effective options within this specialty. Sleep apnea is a disturbance in the breathing pattern during sleep that disrupts quality sleep, decreases oxygen levels and can lead to a multitude of health problems from fatigue to heart disease. Sleep apnea is classified as either central or obstructive or a combination of the two. In central sleep apnea there is a nervous system component. Obstructive sleep involves a collapse of the soft tissue into the airway during sleep which obstructs the flow or air. A sleep study is performed to diagnose the problem and then a hierarchy of solutions can be tried from conservative to more invasive. A conservative approach may involve a change in sleep posture, losing weight, or ceasing smoking or alcohol consumption. If lifestyle changes are ineffective then other modalities may be considered. Continuous positive airway pressure (CPAP) machines force air through a face mask worn nightly. These are uncomfortable and difficult to adapt to, so compliance suffers. Orthodontics can provide an equally effective solution for mild to moderate sleep apnea. A mandibular advancement splint holds the lower jaw forward during sleep much like an orthodontic functional appliance. The tongue is attached to the anterior mandible so positioning the lower jaw forward pulls the base of the tongue away from the airway opening it for respiration. The second orthodontic option involves orthognathic surgery so it is on the invasive end of the spectrum of treatment choices but it has a high success rate. Rather than holding the lower jaw forward it is surgically repositioned forward which pulls the tongue with it. This is a great choice when the lower jaw is deficient and would benefit from orthognathic surgery to produce a better occlusion and facial profile. If the teeth already fit well then the upper jaw would need to be repositioned forward as well.


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