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Snoring is a very real problem,

Snoring is a very real problem, potentially implicating on sleeping patterns of the individual and those around them.
Whether as the symptom of a serious condition such as Obstructive Sleep Apnoea (OSA), or not, lack of sleep can lead to problems such as high stress levels and lack of energy.

The British Snoring and Sleep Apnoea Association recognising the following signs and symptoms: www.britishsnoring.co.uk

Important signs:

  • Obesity, especially thick set neck
  • Systemic high blood pressure (hypertension)
  • Nasopharyngeal narrowing
  • Positive questionnaires, i.e. “Epworth Sleepiness scale”

Symptoms:

  • Chronic, loud snoring
  • Gasping or choking episodes during sleep
  • Excessive day time sleepiness (especially drowsiness during driving)
  • Car or work related accidents due to fatigue
  • Personality changes, irritability, cognitive difficulties

As a person goes to sleep, especially while lying on his or her back, the muscles of the tongue and jaw relax and these structures move backward against the posterior wall of the throat.
As the airway becomes partially blacked, snoring occurs. If it progresses to complete airway blockage, sleep apnoea (multiple stoppages of breathing) occurs.

The natural reaction to this is an adrenaline release that wakes the snorer. This pattern may be repeated through the night, which can result in increased blood pressure, headaches and an increased risk of diabetes.

The tongue is attached to the lower jaw. By moving the lower jaw forward with a night time dental appliance, the tongue is moved forward, the airway is opened up and stays opened and snoring stops.
The snoring stays stopped as long as the appliance is worn. Most severe snorers wear their appliances for the rest of their lives. After the first few peaceful nights the sleep partner insists that the snorer wears it faithfully!

For less severe cases of OSA and for snorers there are various types of Mandibular Advancement Device (MAD) that attempt to position the mandible in a slightly protruded position and allows the airway to be maintained.

However, these have generally either been uncomfortable, poorly-retained or ineffective.

A recent development has shown a device called the ‘Sleepwell’ MAD has overcome many of the disadvantages of previous anti-snoring devices. It consists of upper and lower vacuum-formed laminate ‘clutches’ that are comfortably retained on the teeth (providing that there are sufficient satisfactory teeth). There is a small adjustable mechanism on the upper clutch that engages on the lower when the mandible is protruded and maintains it in that position.

An initial consultation determines the suitability of this device for an individual after assessing the degree of sleep apnoea/snoring that they suffer. It is important that if the OSA is considered sufficiently severe a referral is made to a Sleep Clinic physician for assessment.