Habitual snoring is often a sign of obstructive sleep apnoea (OSA), a condition where the airway narrows or closes repeatedly during sleep. Around one in three people in Singapore has moderate to severe OSA. A dentist trained in sleep medicine can screen for it and manage it in three ways: Invisalign to widen a narrow jaw and improve the airway, a custom oral appliance that holds the lower jaw forward during sleep, and myofunctional therapy to retrain the muscles so you breathe through the nose.
We all know the importance of a good night’s sleep. It makes us feel recharged and ready to take on the world. But sleep does way more than that. Sleep allows our brains to consolidate our learning and memory so we can perform tasks better the next day.
Many of us, however, don’t feel rested even after our nightly shut-eye. Interestingly, about 61 per cent of Singaporeans say they often wake up feeling tired.
Feeling exhausted even after getting enough “hours” of sleep can be frustrating, but it indicates that you have poor sleep quality.
While figuring out that you’re not getting enough sleep is easy, figuring out why that sleep isn’t restful is more critical, and we are here to help you with that.
Have you been told that you snore? We often mistake snoring for being a sign of sound, peaceful sleep. However, habitual snoring and sleep disturbances are often signs of a condition called Obstructive Sleep Apnoea (OSA).
What is Obstructive Sleep Apnoea (OSA)?
All of the muscles in the body relax during sleep. Typically, the throat muscles relax but do not block the airway. In patients with obstructive sleep apnoea, though, the airway becomes temporarily blocked or narrowed during sleep. This collapse prevents oxygen from passing through the airway and reaching the lungs.
When this happens, there are dips in the body’s oxygen levels, and you wake up briefly throughout the night.
To put it simply, if you have sleep apnoea, your breathing stops and starts several times each night. This action negatively impacts your sleep quality, and you end up feeling sleepy, lethargic and irritable throughout the day.
Not only does sleep apnoea leave you exhausted even after a whole night’s sleep, but if left untreated, it can cause severe and long-term health problems.
When there are pauses in breathing during sleep, blood oxygen levels decrease. This sudden drop in oxygen levels causes increased blood pressure and stress on the cardiovascular system. Over time, it increases the risk of stroke and heart failure.
Poor quality of sleep can also affect your stress levels and brain function.
So, how common is sleep apnoea in Singapore?
According to studies, one in three Singaporeans suffers from moderate to severe sleep apnoea, and one in 10 suffers from severe sleep apnoea.
How Your Dentist Can Tell If You Might Have Obstructive Sleep Apnoea (OSA)
It may come as a surprise, but relief from snoring or sleep apnoea could come from your dentist. As dentists, we are often the earliest diagnosticians of sleep disorders.
In its Policy Statement on the Role of Dentistry in the Treatment of Sleep Related Breathing Disorders, the American Dental Association (ADA) clearly outlines that:
Dentists play an essential role in the multidisciplinary care of patients with specific sleep-related breathing disorders and are well positioned to identify patients at greater risk of SRBD.
Dentists are encouraged to screen patients for SRBD as part of a comprehensive medical and dental history to recognise symptoms such as daytime sleepiness, choking, snoring or witnessed apneas and evaluate risk factors such as obesity, retrognathia, or hypertension.
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How we manage Obstructive Sleep Apnoea (OSA) at DP Dental
At DP Dental, we have dentists trained in sleep medicine. Therefore we can screen and treat adults and children for sleep-related breathing disorders.
So don’t be surprised if we ask you about your sleep. Worn tooth surfaces usually indicate that a patient grinds their teeth (a condition known as bruxism). This is often a sign of obstructive sleep apnoea.
According to Dr Yue Weng Cheu (Clinical Director, DP Dental), at night, while sleeping, when the airway is blocked, and breathing is interrupted due to OSA, the body sends out a stress response to raise heart and respiratory rates to get in more oxygen. Sometimes, this stress response increases muscle activity in the jaw, leading to clenching or grinding during sleep.
To address obstructive sleep apnoea, we aim to get to the root cause of the issue.
There are three approaches we follow to manage sleep apnoea:
1. Invisalign
In cases of poor teeth alignment and narrow jaws, Invisalign can be used to effect structural changes to improve the airway and bites. We can reduce strain, grinding and clenching, and sleep apnoea through jaw expansion and proper teeth alignment.
2. Oral Appliance therapy
Sometimes, the patient is not ready for orthodontic treatment. In such cases, we recommend using Oral Sleep Devices, such as SomnoDent Avant™ and ProSomnus EVO™.
Oral appliance therapy involves wearing a custom-fitted, removable oral device in your mouth when you sleep. These devices (also known as mandibular advancement devices), treat snoring and sleep apnoea by advancing your lower jaw forward and opening your airway at the back of your throat.
A great deal of scientific evidence backs oral appliance therapy. The American Dental Association (ADA) endorses the use of oral sleep devices in managing OSA:
Oral appliance therapy is an appropriate treatment for mild and moderate sleep apnoea and severe sleep apnoea when the patient does not tolerate a CPAP.
The advantages of using oral sleep devices over the conventional CPAP machine are that they are:
- Lightweight and portable – so you don’t have to worry about carrying big bulky machines while travelling.
- Easy to maintain
- Silent
- Able to prevent snoring and teeth grinding
3. Myofunctional Therapy
Apart from using such devices, what makes DP Dental different is that we also analyse your oral habits to see if they have been contributing to sleep apnoea.
Sleep disorders often begin with mouth breathing. The natural position of the tongue is supposed to be at the roof of the mouth.
“Mouth breathers condition their tongues to lay low in the mouth during the day, and when they continue to mouth-breathe at night, they suffer the consequences of airway obstruction or resistance, resulting in snoring and sleep bruxism,” explains Dr Yue Weng Cheu.
Through myofunctional therapy, we can help you retrain your muscles so you can breathe through the nose and sleep better.
To summarise, obstructive sleep apnoea is a condition that needs to be addressed as early as possible to prevent more severe complications.
If you have been suffering from sleep issues, excessive daytime sleepiness or snoring, do contact us at 6219 3082 or WhatsApp at (+65) 8128 6913 for a thorough assessment. Dr Yue Weng Cheu is trained in Sleep Medicine at TUFTS University, Boston. He has excellent experience with muscles training (especially the tongue) and breathing re-training to help with sleep.
