Snoring and obstructive sleep apnea are not only disruptive to your bed partner; they may also be the cause of many other illnesses. And as we have seen in the news recently, can result in deadly vehicle accidents. If you have opted to wear an oral appliance at night for snoring and/or sleep apnea (as opposed to using a CPAP machine) you may have noticed that it’s not working as well as it did when it was first fitted by your dentist. So, how do you know if your sleep apnea appliance is working?
John: A Case Study
My patient John is a 45-year old who had chosen to wear a sleep appliance to spare his wife from the disrupted sleep she was experiencing as “he snored like a jackhammer.” However, after a period of time his snoring (and consequently his wife’s nighttime annoyance) had reappeared.
John came to my office and we sat down to talk. He confessed that he had gained a whopping 15 pounds over nine months, so it wasn’t surprising that the appliance was no longer effective. I subsequently corrected the fit of his appliance (basically moving it slightly forward), which took care of his nightly jackhammer snoring (and probably saved his marriage!). But, another problem developed.
John began experiencing morning jaw tension and an awkward bite, which lasted for about an hour. Another visit to the office and a bit more adjustment took care of the issue. Now John is sleeping peacefully and not worried about a TMJ problem. So, if you use an oral appliance to manage sleep apnea/snoring, and your weight varies you should be going back to your dentist to reset the appliance
How To Determine If Your Oral Appliance Is Working
For those snoring without sleep apnea, your bed partner feedback will certainly alert you as to when the appliance is not working, but how do you know if you live alone? If you sleep alone and are wearing an appliance to protect the tissues in the back of your throat from the consequences of snoring over time, monitoring is key.
How To Monitor Snoring and Apnea With Technology
For those with obstructive sleep apnea (with or without a bed partner) the absolute best way to know if your appliance is working properly is to use a pulse oximeter on two consecutive nights. A pulse oximeter will measure your blood oxygen levels while you are sleeping. If there is less than optimal oxygen your blood, then your appliance needs to be adjusted. The pulse oximeter can be purchased online or provided by your dentist.
Even more information can be obtained through using a HST (home sleep test), which is often covered under insurance plans and obtained through a sleep clinic or your dentist.
Important: technologies such as FitBit and JawBone cannot be used for monitoring oral appliances and Basis Peak and Microsoft Band, though sensing body motion and monitoring heart rate, also come up short.
The message is clear…don’t assume that once fitted, your oral appliance will always maintain its effectiveness. It’s necessary to have it monitored at least once, preferably twice, every year.
Dr. Donald Tanenbaum is a specialist with offices in New York City and Long Island, NY. He is uniquely qualified to diagnose and treat problems associated with facial pain, TMJ, headaches and sleep apnea.