Sleep Apnea and Snoring

Apnea is a frequent and insidious heterogeneous disorder that gradually creates difficulties in the daily life of patients. Depending on the level of respiratory effort that prevails, three different forms of sleep apnea can occur: obstructive, central or mixed. Some forms of apnea can be diagnosed and treated by the dentist, and more difficult cases are referred to an otolaryngologist.

Snoring is the hoarse or rough sound that occurs when air passes through the soft tissues in your mouth. Sleep apnea is a condition where the upper airway passages close, stopping your breathing and depriving you of oxygen until you wake up and start breathing again.

What is the pathogenesis of sleep apnea?

Anatomical defect – collapsing upper airway, which is the main determinant of obstructive apnea

Respiratory control or loop gain, which if abnormally high (too sensitive to small changes in CO2), can cause central apneas and contribute to cyclic breathing in obstructive sleep apnea, but if too low, can cause sleep hypoventilation.

Tendency to arousal from sleep (arousal threshold)

Muscle function and dilation of the upper airways during sleep.

It is noted that patients with obesity hypoventilation syndrome often have severe apnea.


To diagnose your condition your doctor will perform a physical examination of your temporomandibular joint and study your symptoms and medical history. In diagnostic contexts the dentist will ask relevant questions such as when and how you snore to help you assess the severity of the problem. Accordingly, if your child snores, you will be asked about the severity of your child’s snoring.


The doctor may order an imaging test, such as an X-ray, CT scan, or MRI. These tests check the structure of your airway for problems, such as a deviated septum.

Sleep study

Depending on the severity of your snoring and other symptoms, your doctor may perform a sleep study. Sleep studies can sometimes be done at home.

However, depending on your other medical problems and other sleep symptoms, you may need to stay overnight at a sleep center to undergo an in-depth analysis of your breathing during sleep by a study called polysomnography.

In a polysomnography, you are connected to multiple sensors and monitored throughout the night. During the sleep study, the following information is recorded:

Brain waves
Blood oxygen level
Heart beat
Breathing rate
Sleep stages
Eye and leg movements

Symptoms of sleep apnea:

Retention of breath during sleep
Interrupted sleep
Excessive sweating during sleep
Morning headaches
Dry mouth
Excessive fatigue during the day
Forgetfulness or difficulty concentrating during the day
Decreased sex drive or impotence
Can you have sleep apnea without snoring?

You may snore loudly and not have sleep apnea, or you may have apnea without snoring. The two are closely related, but it doesn’t mean that if you snore, you also have sleep apnea.

How do you know if you have sleep apnea?

If you are experiencing any of the sleep apnea symptoms described above, it is very important to seek treatment.
Undiagnosed and untreated sleep apnea is directly linked to increased risk for your cardiovascular and metabolic health.

Can I start breathing normally?

Science in this field has advanced and the quality of life for patients is improving. In cooperation between the dentist and the otolaryngologist, the possible solutions to the problem are examined and, depending on the severity of the incident, either the dentist creates an intraoral device, or surgery is performed by the otolaryngologist.

How will the dentist help me?

This treatment is carried out by taking impressions of the patient’s mouth, and then, in collaboration with a special orthodontic laboratory, a personalized brace is created, which is placed during sleep in the patient’s mouth.

How many hours a day should I wear the splint?

The personalized splint is placed clean in the mouth during sleep, like the armpits of the bleaching and gurgling. Its purpose is, on the one hand, to create a passage for air to pass through the airways and to facilitate the patient’s breathing during sleep, and on the other hand, it keeps the position of the lower jaw in a specific sliding position, so that the jaw gradually ‘gets used’ to her. Thus over time the patient improves the quality of his sleep, and therefore by limiting the symptoms, thus improving his daily life.