When your partner or housemates tell you that you snore at night and you feel tired during the day despite having a night of ample sleep, it’s time you took it seriously. You may be suffering from a severe sleep disorder. As a result, it may be the cause why they are always tired during the day despite having ample sleep at night. Seeking treatment for this sleep disorder will lead to improvement in your general health, an increase in your productivity during the day, and at the same time, spare your partner from your loud snores at night. You will need to consult a doctor who will examine you and develop a treatment plan ideal for your condition.
Your treatment may involve a visit to your dentist or sleep specialist, where you will receive a comprehensive oral evaluation and examination before they can recommend an appropriate appliance or oral therapy. At Washington Dental, we have a competent team of oral specialists to offer you help if you are seeking sleep apnea treatment in Carson, CA.
Overview of Sleep Apnea
Sleep apnea is a severe sleep disorder where your breathing stops and repeatedly starts while you sleep. You may never realize you have sleep apnea, but your bed partner may notice it sooner. If you do not have a bed partner, some of the symptoms will indicate the sleep condition. Sleep apnea covers over 80% of sleep disorders in the United States.
Types of Sleep Apnea
Central Sleep Apnea
This type of sleep apnea occurs when your brain does not send appropriate signals to the muscles that control your breathing.
Complex Sleep Apnea
Complex sleep apnea is a syndrome that takes place when you have both central and obstructive sleep apnea.
Obstructive Sleep Apnea (OSA)
OSA is a sleep disorder whereby you stop breathing as you sleep during the night, and it is brought about by physical obstruction of your upper airways. Your breathing will stop for about ten seconds, and sometimes it can go unnoticed if you sleep alone. This type of sleep apnea occurs when your throat muscles relax, and it is the most common type of sleep apnea. In this type of sleep apnea, your upper airway becomes partially or entirely blocked while you sleep.
During your sleep, your body muscles relax to repair themselves, ensuring your body is healthy. However, sometimes the muscles in your mouth might relax too much, making them collapse on your upper airway, thereby blocking the airway and entirely or partially blocking the airflow into your body.
This blockage causes your chest muscles and diaphragm to work extensively harder to open your airways as the pressure increases. When this happens, your breathing will resume and what your partner will notice is either a body jerk or a loud gasp. If these episodes continue, it could lead to severe health problems like reducing oxygen flow to various vital organs in your body and sometimes even lead to death.
1. Occurrence of Obstructive Sleep Apnea
Obstructive sleep apnea can affect almost everybody, with men being highly influenced. You will realize that 25% of men suffer from OSA (obstructive sleep apnea) while only 10% of women are affected. With OSA, age doesn’t play a critical factor as even children may be affected. However, most people who are over forty and are overweight have a higher chance of being affected by obstructive sleep apnea (OSA). Other physical characteristics that are common in patients suffering from obstructive sleep apnea include:
- Large neck,
- Being excessively overweight,
- The nasal obstruction which reduces the upper airway diameter
- Enlarged tonsils
- A small jaw that leads to an overbite.
2. Main Causes of Obstructive Sleep Apnea
The cause of obstructive sleep apnea is blockages in the upper airway while you sleep; this usually happens when the soft tissues at the rear of your throat collapse. Your throat and upper airways consist of some cartilages and muscles. When these muscles in the upper airways weaken, they fall on themselves or collapse during sleep, blocking the airways.
At other times, you may experience snoring, which is caused by the weakened soft palate (a soft palate is a muscle that ensures that food doesn’t go up in the nose but ends up in the esophagus). When you are sleeping, most muscles relax, including the soft palate, which may lead to variations in airflow if it is incredibly relaxed. Sometimes, your tongue may relax too much and put unwanted pressure on your upper airways, thereby blocking it.
Signs and Symptoms of Sleep Apnea
Both obstructive and central apnea have similar symptoms making it difficult to differentiate the type of apnea you are suffering from. It is effortless to notice signs and symptoms of sleep apnea in adults than it is for children. Some of the most common signs of both obstructive and central sleep apnea to note in adults include:
- Loud snoring while sleeping.
- Shortness of breath as you sleep.
- Gasping for air while sleeping.
- Morning headache.
- Being overly tired during the day.
- Inattention while awake.
- Experiencing insomnia(the ability to stay asleep).
- Waking up with a dry mouth.
- Episodes of not breathing(your bed partner will report this).
- Excessive sleepiness during the day.
- Sexual dysfunction.
- Trouble while concentrating.
- Night sweats.
It can be tricky to realize if your young one is suffering from sleep apnea when it comes to children. Some of the symptoms to look up for include:
- when you notice a decrease in their school performance.
- Night sweats.
- They will develop some behavioral or learning disorders.
- Taking some unusual positions while they sleep, like sleeping on their knees and hands. Sometimes you will notice they have extended their necks extensively.
- When you see their ribcage moving inwards while they inhale.
- Excessive tiredness during the day.
Effects of Obstructive Sleep Apnea
if you do not receive treatment for obstructive sleep apnea on time, it can lead to serious health issues like:
- Heart attack
- Congestive heart failure,
- Arrhythmias, and
Some other effects of OSA may not necessarily be health-related but will affect you nonetheless like:
- You may cause a road or a work-related accident,
- Poor academic achievements in children,
- Job impairment
When you realize you or your partner has sleep apnea, you will need to find out the severity of the disorder to receive the best care that will ease the condition. The severity of sleep apnea is determined by the number of pauses that take place during sleep. For mild apnea, you will have between five and fourteen episodes of breathing interruptions within one hour. In moderate sleep apnea, your breathing will have between 15 to 30 episodes of breathing interruptions within one hour. While in severe sleep apnea, you will experience more than 30 sleep interruptions within one hour.
Treatment for Obstructive Sleep Apnea
Once your doctor diagnoses you with obstructive sleep apnea, they will offer you some treatment options. Some of these treatments will include using a CPAP (continuous positive airway pressure) machine or oral appliance therapy.
Continuous Positive Airway Pressure (CPAP)
In this treatment method, a positive pressure above the atmospheric pressure is applied continuously on the upper part of the respiratory tract of the affected person. This positive pressure will help prevent the upper airway collapse in obstructive sleep apnea or where the patient is suffering from acute heart failure as it reduces breathing work.
CPAP is one of the most effective methods of treating mild to moderate obstructive sleep apnea. The gentle, positive pressure assists in preventing the upper airways from being blocked or collapsing. If used correctly following the doctor’s instructions, CPAP has been proved to be 100% effective in treating obstructive sleep apnea.
How Does a CPAP Machine Operate?
A CPAP machine has a motor designed to utilize room temperature by pressurizing it, then delivering this air at a constant pressure to the patient via a nose mask. The constant pressure prevents the upper airways from blocking or collapsing and keeps them open when breathing in and out.
Situations Where a CPAP Is Not Applicable
There are some instances where CPAP may not be used on a patient even though they are suffering from obstructive sleep apnea like:
- When the person suffering from sleep apnea cannot breathe on their own.
- When the patient is suffering from facial burns or trauma,
- Unstable patient due to a respiratory condition.
- An anxious or uncooperative person.
Sometimes, you may stop using a CPAP to treat your Obstructive sleep apnea if you experience nasal congestion, if your mask is leaking, experience abdominal bloating, and general discomfort. All these may lead you to try oral appliance therapy.
Oral Appliance Therapy
You should consult with your dentist and physician to determine if you can opt for an oral appliance for effective treatment for your obstructive sleep apnea. You can have a custom-made oral appliance fitted by your dentist. You will then place the device in your mouth while sleeping to prevent blockage or collapse of your upper airway during sleep. The appliance usually prevents your tongue and oropharyngeal tissue from blocking your upper airway, enabling you to have a night of uninterrupted sleep.
Currently, various oral appliances will ensure your upper airway doesn’t collapse or have a blockage. These appliances will generally move your mandible, soft palate, and tongue to ensure that you have enough pharyngeal space. Oral appliances operate by stabilizing and repositioning your soft palate, mandible, hyoid bone, and tongue in a forward position. For this stabilizing and repositioning to occur, your dentist will use a custom-made oral appliance on your mouth rather than a non-custom-made device. Your dentist should evaluate you for any adverse effects of the appliance on you over time.
Benefits of Oral Appliance Therapy
- They are easy to use
- Custom-made to suit your mouth
- It is tranquil
- You can use them if you are unable to tolerate PAP
- You can travel with it since it is easy to carry
- It doesn’t require electricity
- Reduce snoring at night and also helps in improving OSA symptoms like fatigue and moodiness.
Risks Associated with Oral Appliance Device Therapy
Though the benefits associated with oral appliance therapy are numerous, several risks come with the device. Before you decide to go for oral appliance therapy, you should go through the risks with your dentist and determine if it is still worth it. Some of the risks include:
- Your bite will change
- Experience TMJ (temporomandibular joint), teeth, and jaw pain
- You may experience excessive drooling,
- Your teeth may loosen
- Experience mouth dryness
- After all is done, you may need to have a dental replacement.
How is Oral Appliance Device Fitted?
Once you’ve weighed the risks and benefits of oral appliance devices and decided to go forward with the therapy, you will need to consult with an experienced dentist and have them perform an evaluation. Your dentist will then determine if you qualify for the treatment and if you do, they will make an impression that resembles your teeth. Once your oral appliance device with your impression is ready, your dentist will call you back to check if it fits.
Your dentist will also give you a repositioner to help with your bite in the morning after removing the appliance. The work of a repositioner is to realign your bite after a night with the oral appliance. You will also receive instructions on using the oral appliance device at night and cleaning the appliance after use in the morning. It is advisable to visit your dentist to have the appliance adjusted to fit optimal care and use.
Types of Oral Appliance Therapy Devices
There are three main types of oral appliance therapy devices, namely:
Mouthguard uses the boil and bite method, where you put the plastic mold in some boiling water for a short time, the plastic softens, and you can then place it on your lower jaw where it molds onto your teeth. This device helps reposition your lower jaw to a lesser degree and protects your upper airway from collapsing or blockages.
If you suffer from either mild or moderate sleep apnea, your dentist can fit a snore guard for you. A snore guard will move your lower jaw, creating an underbite that will help your tongue pull out, making it easier to avoid blocking your airways. When this intentional underbite lasts for some time, it leads to a lasting altered bite. You should ensure to visit your dentists as the process is slow and takes time.
Mandibular Advancement or Repositioning Device
These devices snap over your upper and lower teeth and have metallic screws and hinges which can tighten and push your lower jaw forward while you sleep. A mandibular advancement device is made up of a molded hard plastic. Your dentist can make a mandibular advancement device custom-made to fit in your mouth but ensure to have this done by an experienced dentist.
You can have a tongue retaining device which will hold your tongue out and forward throughout the night. This device is made of a soft plastic material that you place around your tongue. A tongue retaining device can be very uncomfortable and usually leaves your mouth dry.
Medical Insurance Cover on Oral Appliances
Once you and your dentist have come up with a treatment that will suit you, the next thing to tackle is whether your medical coverage will cover the cost of the treatment. You will realize that oral appliance devices are necessary and will reduce your discomfort and save even relationships. Most dentists will offer their services in managing sleep apnea as it helps the patient effectively.
Most medical insurance plans will cover custom-made dental appliances. Therefore, it is crucial to take care of the necessary paperwork when deciding to have an oral appliance device fitted.
Documents that the Insurance Companies Require when Fitting Oral Appliances
You will realize that depending on your insurance provider. Most documents will vary. Still, most of them will require a copy of your sleep questionnaire score, sleep study, your clinical notes, your screening appointment, and your doctor’s prescription for the oral appliance. In addition, some insurance providers require that you provide your signed proof of delivery form.
How to Determine if Your Medical Plan Covers for Oral Appliance
The first step is to call your insurance provider and check if your plan will cover the cost of having an oral appliance fitted. Next, have your sleep study notes to show your provider the severity of your condition. Once the situation has been determined, it will show the importance of having a custom-made oral appliance.
You will realize that most medical insurance providers categorize oral appliances as medical equipment. Like medical equipment, an oral appliance is under the durable medical equipment (DME) category. Your insurance provider should provide the following information while they are carrying out the verification process:
- The deductible amount available on your cover,
- Preauthorization requirements
- Co-payment percentages
- How much yearly deductible that you have met.
The Types of Oral Appliances Covered by the Medical Plan
In the United States, there are over 100 FDA oral appliances approved and are readily available to dentists who make custom-made sleep appliances. Some medical insurance providers insist that your oral appliance should be found published on Medicare’s Product List. Therefore ensure you comply with the terms and conditions set by your medical cover providers.
Your insurance representative should be in a position to tell you if your plan covers an oral appliance, even if not the exact dollar amount, before you have the dental device custom-made. You should also be in a position to know if your deductibles will differ since oral appliances are treated as durable medical equipment. Since most medical equipment will carry a different deductible, it is crucial to know the benefits of your cover.
Will Medical Insurance Cover for Snoring Mouthpieces?
It is crucial to note that while most insurance providers cover oral appliances after you have been diagnosed with sleep apnea, snoring in most cases is not covered. For example, suppose your doctor prescribes a snoring mouthpiece to assist with your Obstructive Sleep Apnea (OSA). In that case, it can be considered a medical necessity to treat either mild or moderate sleep apnea. However, in most cases, oral appliances are covered to treat severe sleep apnea where CPAP is not applicable.
Reimbursements for Sleep Screening Exams
Once you have submitted your sleep management codes and evaluation documents, most insurance providers will reimburse you for the screening exams. Some medical insurance providers will require you to have cross-codes for your dental work and any radiographs you have had taken. When you decide to bill for your exams, ensure to have all your clinical notes ready, showing your medical history and making it easier to use the medical office visit code.
Billing for a Follow-up Visit for Oral Appliance Adjustments
If you are wondering if your insurance provider will cover any follow-up visit to your dentist to adjust to the oral appliance, worry no more as you can bill it using a medical office visit code. Most insurance providers usually put the first 90 days of the appliance adjustment into a code for the custom-made appliance. Your dentist or health provider will assist you in navigating the medical insurance billing process, asking for assistance to ensure you do not make a mess of it.
Contact a Carson Dentist Near Me
When you face some symptoms that indicate you are suffering from sleep apnea, you should contact your local dentist, who will direct you to an experienced sleep specialist. If you do not have a dentist, you can also consult your local health provider, and they will guide you in the right direction.
Remember to ask about all the available treatment options for your condition. Do not shy away from seeking medical attention, as this will not only ease your discomfort but will also guarantee your partner receives their much-needed sleep as well.
If you decide to seek dental services in Carson, you can contact Washington Dental. We will advise you on the necessary treatment to take. We are aware of the strain you are undergoing. We will notify you of the steps required when billing your insurance provider to ensure you receive full benefits from your cover. Contact us at 310-217-1507 and schedule your first free consultation, and start your journey to attaining peaceful sleep at night.