Sleep ENT Doctors and Sleep Dentist Often Work Together to Treat Snoring and Sleep Apnea


What is the difference between snoring and Sleep Apnea

First off, let’s define snoring and sleep apnea. Snoring is resistance to airflow through the upper airway creating vibration and noise production. Sleep apnea is the same condition except for the resistance to airflow is intermittently severe enough to create cessation of airflow (apnea).  The obstructive sleep apnea (OSA) is defined as mild, moderate or severe depending on the frequency per hour the cessation occurs.

The Most Common Cause of Snoring – Nasal Congestion at night

As it turns out, the most common cause of snoring and OSA is nasal congestion at night when the patient is sleeping. The patient may not even be aware they are having nasal congestion at night because their sensation of breathing is “normal” for them. They will however upon questioning report mouth breathing at night time. These patients may have undiagnosed and untreated conditions in their nose such as a deviated septum, allergic swelling of the nasal lining, chronic sinus infection, and nasal polyps.

As seen in this video, the nasal congestion creates rapid and turbulent airflow in the collapsible portion of the airway resulting in the vibration of the soft palate and the uvula with noise production. It also creates a negative pressure that pulls the base of the tongue into the airway creating loud tongue-based snoring and tongue-based OSA.

The Second most common Cause of Snoring – Enlargement of Tongue

The second most common cause of snoring and sleep apnea is the enlargement of the tongue relative to the space that is available. This may occur for a variety of reasons. The most common cause of a large tongue is mouth breathing. Mouth breathing as a child changes the way our face and jaw develops and this creates too small of a space for the tongue. Mouth breathing as an adult also dehydrates the tongue to which the tongue responds by progressively expanding in size.

As an ENT, who also specializes in the treatment of snoring and sleep apnea, we can correctly diagnose the underlying nasal and sinus issues to enhance the patient’s breathing at nighttime and reduce the forces that vibrate and collapse the airway. With high definition nasal endoscopy and office-based mini CT exam, the right medical and sometimes procedural treatments can be offered. Even when procedural treatment is needed, it is typically just a 15 min office procedure under IV sedation. Patients can usually work the next day.

When is Oral Appliance Recommended?

If nasal correction alone does not completely resolve the snoring and OSA, the large tongue is usually the remaining reason. We work with specialized sleep dentists that can make comfortable custom-fitted oral appliances (OA) that help hold the mouth closed with the jaw slightly forward keeping the tongue base from falling back into the airway. These are not like the poor quality over the counter devices that rarely provide much benefit.

What other factors can cause snoring?

Additional factors such as sleep hygiene, weight loss, bed position, etc are also discussed to optimize the results for our patients.

Schedule a Consultation

If you have snoring and/or OSA and do not know what your cause may be, visit us for a comprehensive evaluation and a plan of action. Contact our office to schedule a consultation.

Daniel Slaughter, MD

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Posted in: Sleep Apnea

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