Sleep Apnea Treatment


Obstructive sleep apnea is an ongoing condition that disrupts sleep.


Sleep apnea is a disorder in which a patient experiences one or more pauses in breathing or shallow breaths during sleep. The sleep disruption caused by sleep apnea can negatively impact your quality of sleep, leaving you tired and irritable.

Mild sleep apnea can often be treated with lifestyle changes such as losing weight, positional therapy or with the addition of an oral appliance to help maintain an open airway while you sleep.


Woman having trouble sleeping

Could Sleep Apnea be disrupting your sleep?


  • Do you wake up with a dry mouth?
  • Do you wake up gasping for air?
  • Do you suffer from excessive sleepiness during the day?
  • Are you irritable?
  • Do you have frequent morning headaches?
  • Does your partner tell you that you snore loudly?
  • Does your partner report that you stop breathing while you sleep?


TRUE OR FALSE

Sleep Apnea treatment can improve your overall health and wellbeing.

TRUE

Treatments such as oral appliance therapy can significantly improve the quality of your sleep, which then improves your mood and overall health.


What are some examples of Sleep Apnea Solutions?


  • ¬†Oral Appliances¬†are custom made devices designed to adjust the position of the lower jaw and tongue. These appliances help maintain an open, unobstructed airway when worn while sleeping. Please be sure to bring your oral appliance in to your appointments to make sure it is fitting properly.
  • Anterior Growth Guidance Appliance, or AGGA can be used to permanently expand your jaw or correct other orthodontic concerns that may be obstructing an open airway. This means that you can simply balance the bones of the face and teeth to help breathe better and sleep better. In addition, the AGGA develops bone through a biological process that creates bone for a more developed, balanced, and beautiful face. With the use of this painless orthodontic appliance, Dr. Coats can monitor the growth of your jaw to help with sleep apnea and also with¬†straightening your teeth and improving facial aesthetics.

    Learn More about AGGA
  • Continuous Positive Airway Pressure, or CPAP, can also be an effective treatment option. A CPAP machine uses a mask that fits over your mouth and/or nose and gently blows air into your throat. This constant air pressure helps keep your airway open while you sleep.
  • Surgery to treat Sleep Apnea usually involves the removal of excess tissue that might be restricting your airway. Surgery can also be used to strengthen the airway walls by adding small pieces of plastic. If you answered yes, you may be experiencing sleep apnea.


Garrett: Relief of Sleep Apnea with Oral Appliance


Sleep Apnea FAQS


  • Can Sleep Apnea distort the face?

    Sleep Apnea can contribute to changes in your face as your muscles become disorganized, with some working too much  while other muscles atrophy. The natural aesthetic of the face can be altered if your teeth shift, causing a change in chin, lip support, or lines. If bone loss occurs around teeth or teeth are missing, the muscles can be less supported on the width of the face and lips, causing a wrinkled, sunken, or distorted face. Breathing through the mouth is caused by a tongue posture that is low in the mouth, preventing it from resting naturally in the roof of the mouth. Over time, this dysfunction may cause the development of the bones of the face and mouth to narrow, causing a long face, dry lips and even a sunken appearance under the eyes.When the dental bite and jaws develop more towards the direction of your ear, you may notice changes in your chin or in the angle of your neck to your throat. The solution to avoiding any facial distortion is to seek early treatment for children who breathe through their mouths or have other issues mentioned above. The goal of early treatment would be to achieve the following changes: the lips closed at rest, an absence of tongue habits, and the development of the dental arch and midface bones to help with healthier breathing, speech issues, and even to enhance facial aesthetics. 

  • What happens if you only breathe through your mouth?

    Breathing through the mouth should only become necessary if you have nasal congestion due to allergies or a cold. In children, mouth breathing can cause crooked teeth, facial deformities, or poor growth  and can inhibit your growth potential. In children, mouth breathers often do not sleep well, and thus can have poor growth, poor academic  performance, sleep disorders, and the inability to concentrate. In adults, chronic mouth breathing can cause bad breath, gum disease, snoring, chapped lips, dark circles under the eyes, lack of nitric oxide and increased risk of body inflammation. It can also worsen symptoms of other illnesses such as asthma, sleep apnea, inflammation, blood pressure, heart failure, lung infections, ear and throat infections.

  • Does mouth breathing change your face?

    Mouth breathing may result from an upper airway obstruction or from habit wherein air flows through the mouth. Causes of obstruction can be from a tongue tie, a tonsil or adenoid tissue enlargement, or low posturing tongue. According to the literature, this form of breathing may change the growth pattern of the face and lead to morphological and functional alterations in shape.  The changes noted can appear as possible long narrow faces,  narrow mouth, gummy smiles, poor posture dental overbite, crowded teeth and open mouth posture. 

  • Can imbalance of the spine affect the muscles of the temporomandibular joint?

    The¬† muscles in the jaw work together in tandem with many of the muscles in the neck, meaning that imbalance in the jaw joint can ultimately lead to imbalance in the neck. This dysfunction may cause you to hold your head unevenly, though you may not notice it yourself. You might think you always have a head tilt in your selfie pictures. Did you ever wonder why?¬†Look at your shoulder height for imbalance. If your shoulders are off, you could have a spine and neck imbalance which may be related to your temporomandibular joint and dental bite possibly being offset as well. It’s amazing how the teeth bite, TMJ, neck, and spine muscles are all related. All aspects must be evaluated prior to your¬†TMJ disorder diagnosis. Correcting imbalance in the jaw will lead the forces of the teeth, bite, muscles, and TMJ to properly rebalance. The good news is that, with the exception of bone deformities, asymmetry caused by TMJ can be easily treated to restore an attractive, balanced appearance while also treating your pain.

  • Can jaw misalignment cause facial asymmetry?

    TMJ  disorders can cause facial asymmetry with or without pain. Most often, issues resulting from uneven jaws can be treated without surgery. These issues and many more can contribute to facial asymmetry and pain. Pain can present in a variety of ways such as jaw joint pain, muscle aches and tightness, headaches, neck aches, or even ear pain. 


    TMJ disorder is often caused by an imbalance within the components of your jaw. Although this imbalance may begin as an entirely internal event, it usually doesn’t stay that way, and as your TMJ disc and joint develops, you may experience facial asymmetry that is visible to others as well as yourself when you look in the mirror. This asymmetry may be due to tooth problems, joint displacement, bony deformities, muscle development and function, or spinal misalignments. 

  • Can jaw position influence ADHD?

    Lots of studies show that a narrow and retruded dental bite might influence ADHD. The ADHD/jaw position link stems from the role of allergies causing mouth breathing. When you or your child mouth breathes, the tongue is low on the floor of your mouth rather than on the roof of the mouth. When your tongue is not resting on the roof of your mouth either from mouth breathing from allergies or a tongue tie you end up with a high palate and a narrow mouth. You can look at yourself to see if you have open lip posture and a long face. The pressure of the tongue on the palate is so important to influence not just dental arch width but depth of the mouth and the bones of the face. When you have a narrow mouth, enlarged tonsils and adenoids, and tongue habits you can also have less airway space in the back of your throat . This means that the less oxygen you have due to the retruded jaw, tongue tie, enlarged adenoids and underdevelopment of the dental arch or midface bones results in poor sleep , bed wetting, behavior and attention issues. Dental arch shape influences sleep, oxygen, attention/behavior, face shape, headaches, mood and health.

  • How do you fix jaw asymmetry?

    The first step to correcting jaw asymmetry is correct diagnosis.  Many factors should be considered and evaluated such as:

    • Airway and Breathing
    • Tongue posture and position
    • Upper and Lower jaw anatomy
    • Jaw joint position
    • Muscle function of the head and neck
    • Facial asymmetry
    • Postural¬†and spinal components

    When the bones of your face are developing, the proper airway factors affect the shape of both jaws. The lack of tongue pressure on the roof of the mouth can cause a misshapen face with a long, concave facial profile. This is consistent with a less than prominent chin or a long face. A 3D scan will help Dr. Coats identify what changes can be made as well as see where and why there is facial asymmetry. Many times, the way the teeth come together is dysfunctional, causing strain on the facial and neck muscles, facial asymmetry, and poor facial muscle balance.   Other times, the teeth may force the jawbone and muscles to one side, which also causes strain and facial asymmetry which can be corrected non-surgically.

    In these cases, utilization of sophisticated computers can help provide more information as to where to position the jaw and teeth to ensure that the muscles are all stable and balanced as well as the joints. A temporary orthotic is often made to help achieve this position. The orthotic allows the patient to adapt to the new bite as well as allows the muscles and joints to heal and return to balanced symmetry. These orthotics should not be removable so that the patient can learn now to truly eat, chew, and function in this new position. Most cases will see the facial balance return.  From this point, long-term non-surgical options can be applied to complete treatment. This could include TMJ Orthodontics to continue the transformation of the teeth to their new position or even an AGGA, Anterior growth guided appliance. An AGGA develops the bones of the face and jaws to accommodate the new balanced bite. TMJ or controlled arch braces or even some restorative dental care can sometimes achieve these results.

  • Are Sleep Disorders More Common in ADHD children?

    The literature shows that up to 74% of parents report sleep-related problems in children that have been diagnosed with ADHD. Trends in the research data suggest that some sleep disorders may be more common in ADHD. When comparing children with ADHD who are not being treated with medication to children without ADHD, there are a few facts that may prove to be  true.


      Many studies show increased restlessness and periodic limb movements during sleep in the kids with ADHD The percent of time spent in rapid eye movement (REM) sleep may be decreased in kids with ADHD. The occurrence of parasomnias, nightmares, and bedwetting may be increased in kids with ADHD.


    **Source: Noble GS, O’Laughlin L, Brubaker B. Attention deficit hyperactivity disorder and sleep disturbances: consideration of parental influence. Behav Sleep Med. 2011;10(1):41-53. doi:10.1080/15402002.2012.636274

  • Does sleeping with the mouth open cause ADHD?

    Mouth breathing because of nasal obstruction is likely to cause sleep disorders, and by day, it may give rise to symptoms similar to those of attention deficit hyperactivity disorder (ADHD), daytime sleepiness, anxiety, poor focus, behavior issues. . In these ways, it has been suggested that breathing through the mouth instead of the nose can adversely affect brain function.

  • How is mouth breathing treated?

    Dr. Becky Coats might recommend that your child wears an appliance designed to widen the palate, develop the bones of the mouth and face, and to also help open the sinuses and nasal passages. Braces and other orthodontic treatments might also help treat the underlying cause of mouth breathing.


    It is important to evaluate your child for tongue tie or a tongue restriction that could be a contributing factor to mouth breathing. In this case, a frenuloplasty can be a solution to correct the mouth breathing as well as speech issues. Myofunctional therapy for the muscles of the tongue will need to be done in advance of a frenuloplasty. If needed, surgical removal of swollen tonsils and adenoids by an ENT can also help to treat mouth breathing.

    Lip taping can be a solution to help train someone from mouth breathing to keep their lips together until the habit can be corrected. Lip taping techniques need to be used with caution to be done correctly. Lip trainers to help correct tongue and lip habits are a safe and effective way to help kids with tongue sucking and other oral habits to overcome mouth breathing. 

    Medical professionals can prescribe medications that can treat nasal congestion due to colds and allergies. These medications include: nasal decongestants, antihistamines, and nasal sprays. Allergy testing can be an excellent diagnostic tool to help determine the cause of mouth breathing.  Adhesive strips, such as Breathe Right, applied to the bridge of the nose can also help breathing. A stiff adhesive strip called a nasal dilator applied across the nostrils helps decrease airflow resistance and helps you breathe more easily through your nose.

    If you have obstructive sleep apnea, your physician will likely have you wear a face mask appliance at night called continuous positive air pressure therapy (CPAP). A CPAP appliance delivers air to your nose and mouth through a mask. The pressure of the air in the CPAP keeps your airways from collapsing and becoming blocked.