Cathy Auguste 

            After a long period of time when I awoke extremely tired every morning, I took a test for sleep apnea and was diagnosed positive. Then a C-Pap (breathing machine) was prescribed for me and I assumed I'd be using that indefinitely.

            During a visit to Dr. Behm's office I learned that my dental bite was off (incorrect) and that properly fitting with a bite correcting mouth appliance, I would see improvements.

            That was quite the understatement. The CT scan showed an increased space in my breathing area immediately upon wearing the rather comfortable appliance. I'm in the process of having my bite corrected further but in the meantime I get a great nights sleep and have no use for the C-Pap machine.

                                      Cathy Auguste

                                      January 11, 2011

Let's take a look at Cathy's story.

What Is Sleep Apnea?

Sleep apnea (AP-ne-ah) is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep.

Breathing pauses can last from a few seconds to minutes. They often occur 5 to 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound.

Sleep apnea is usually a chronic (ongoing) condition that disrupts your sleep. You often move out of deep sleep and into light sleep when your breathing pauses or becomes shallow.

This results in poor sleep quality that makes you tired during the day. Sleep apnea is one of the leading causes of excessive daytime sleepiness.

Types of Sleep Apnea

Obstructive sleep apnea is the most common type of sleep apnea. It occurs when the soft tissue in the back of your throat relaxes during sleep, causing a blockage of the airway (as well as loud snoring).

Central sleep apnea is a much less common type of sleep apnea that involves the central nervous system, rather than an airway obstruction. It occurs when the brain fails to signal the muscles that control breathing. People with central sleep apnea seldom snore.

Complex sleep apnea is a combination of obstructive sleep apnea and central sleep apnea.

What Are the Signs and Symptoms of Sleep Apnea?

Major Signs and Symptoms

One of the most common signs of obstructive sleep apnea is loud and chronic (ongoing) snoring. Pauses may occur in the snoring. Choking or gasping may follow the pauses.

The snoring usually is loudest when you sleep on your back; it may be less noisy when you turn on your side. Snoring may not happen every night. Over time, the snoring may happen more often and get louder.

You're asleep when the snoring or gasping happens. You likely won't know that you're having problems breathing or be able to judge how severe the problem is. Your family members or bed partner often will notice these problems before you do. Not everyone who snores has sleep apnea.

Another common sign of sleep apnea is fighting sleepiness during the day, at work, or while driving. You may find yourself rapidly falling asleep during the quiet moments of the day when you're not active.

Other Signs and Symptoms

Others signs and symptoms of sleep apnea may include:

- Morning headaches

- Memory or learning problems and not being able to concentrate

- Feeling irritable, depressed, or having mood swings or personality changes

- Urination at night

- A dry throat when you wake up

In children, sleep apnea can cause hyperactivity, poor school performance, and angry or hostile behavior. Children who have sleep apnea also may have unusual sleeping positions, bedwetting, and may breathe through their mouths instead of their noses during the day.

CPAP Machine Mask

CPAP means continous positive airway pressure.

Obstructive sleep apnea reduces oxygen in the blood and causes arousal from sleep. The CPAP machine stops this phenomenon by delivering a stream of compressed air that keeps the airway open.

As you can see from this image, the mask is worn while the person sleeps. 

  

Examination, diagnosis and treatment 

 

During the initial examination, study models are made of the patient's teeth and bite, as well as, x-rays and photos.

 

The bite can be further analyzed with the aid of a computer program and CT scans.

 

A computer program is used to determine the ideal position of the jaw and adjust the jaw muscles so that the teeth will bite in that position.

 

In Cathy's case, the correct position was determined and an appliance was made to fit over her teeth. She can wear this appliance when she sleeps or any other time.

 

 

The following image shows an example of a temporary removable appliance fitted over a study model of a patient's lower teeth.

 

 

 

 
The appliance is a further diagnostic tool. The patient has the opportunity to experience the new bite position and see if any adjustments need to be made.

 

The following two images show the difference in the patient's airway and bite position with the appliance and without.

 

 

  

In this image you can see that the teeth and jaw bones (far right) are positioned with lower teeth back behind the uppers and the airway is narrow.

  

 

 

 

This image shows the jaw in the corrected position. The lower jaw is more open and forward and the airway is wider.

 

It is this adjustment to the patient's bite that brings the patient relief.

 

 

Trial Smile

 

The following could be called Phase 2 or a Trial Smile. This is the step where the patient gets to try out the new bit position with temporary teeth.

   

Before the Trial Smile

 

The Trial Smile is a fixed orthotic set of teeth that are fitted over the existing teeth. It is designed to hold the jaw and bite in the ideal position. Choices are made regarding the size and shape of the teeth, the whiteness and how they feel..

 

Trial Smile

 

When this phase is complete, the patient knows exactly how they are going to look and feel before any permenant work is done to their existing teeth.

 

If this story is familiar to you, call Sarah at (727) 446-6747 and make an appointment for an exam. We can help.