Many patients often rely on dental sleep apnea appliances to control common sleep apnea symptoms such as snoring, poor sleep quality, daytime sleepiness or morning headaches. This often leads to patients feeling more rested and alert throughout the day.
After some time, patients may feel like their devices are no longer working as well as they did in the past. Let’s go over some reasons why an oral sleep appliance becomes less effective.
But first, let’s make a few assumptions. Let’s assume…
- You have been diagnosed with snoring and obstructive sleep apnea
- You had worked with medical professionals trained in dental sleep medicine therapies
- You have had prior symptoms such as snoring, excessive daytime sleepiness, or poor sleep quality
- With the help of your oral appliance, your symptoms were reduced or eliminated
If the above describes your care plan, then let’s chat about the common reasons why your oral appliance is no longer working as well as it had been in the past.
Oral Appliance doesn’t fit correctly
In some way, the device’s working position or fit has been changed.
Over time oral appliances can become loose. This may lead to the jaw not being maintained in the correct position to stop the apnea.
In other situations, the device’s tested position may have changed. Sometimes the screw mechanism can “un-rewind,” or straps may loosen over time.
Newer dental work can also jeopardize the fit of the device.
In these situations, the device may no longer hold the jaw where it needs to be most effective.
Weight gain is another possible reason your oral sleep apnea mouthguard may not be working as it did in the past.
Sometimes it just takes three to four pounds of increased weight to make a difference in your airway anatomy. And the current position might not be enough anymore to give you the optimal results.
A suggestion would be to see if your weight has changed from when you first received your device.
If you find your weight is creeping up, it is important to maintain your weight, especially since your jaw can only be advanced so far before discomfort occurs. In this case, oral appliance therapy may no longer be effective, and CPAP therapy may need to be considered. Incorporating healthier habits that lead to weight loss could often help improve the results of your sleep apnea device.
Age can cause changes too!
As we age, things don’t always work the way they once did.
During the aging process, our tissues are continuously changing. The tissue changes externally and internally, and it is normal to have to advance your device a little bit with age to compensate for these changes.
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Other medical issues can cause snoring
Allergies, medications and other diseases can increase the volume of soft tissue surrounding the airway resulting in the return of apnea and snoring. Please see your primary care physician to help rule out other causes.
Steps to take if your device is no longer working well
First of all, the fit of the device needs to be confirmed. This may require a visit with your dental sleep apnea dentist.
Usually, once the fit has been confirmed, you would likely be instructed to advance your device’s position.
Depending on the type of device you have, this means either a few more turns or changing the strap to the next level, or whatever the next step in advancement is particular to your type of device.
If you need a refresher on how to advance your device, check out the My Sleep Device’s Resource Page. There several different types of devices to help you remember how to advance your device.
If you have discomfort after advancing your oral appliance
Never advance your oral sleep appliance to the point of discomfort that does not get improved, or it takes too long for your bite to get back to normal in the morning or any kind of unusual pain in your head and neck area is noticed.
You might even need to reverse it back to find the most advanced comfortable position.
If you cannot advance the sleep device any further
Sometimes if it’s been a while since you advanced your device, accumulated debris on the mechanism may make it difficult to turn. If this happens, it’s definitely time to visit with your sleep apnea dentist. Professional cleaning fluid and a high grade ultrasonic may help remove debris and allow for easier mechanism advancements.
Every device has a maximum limit it can be advanced to. If your device can’t move forward or your device is on the last strap, you may have reached that point. If this happens, it definitely means you need to visit your dental sleep medicine provider.
Usually, the dentist will help with this limitation. It does not mean a new device needs to be made, but the device may need to go back to the dental laboratory for a specialized adjustment, or added parts may need to be ordered.
A Note on Nasal Snoring
Oral sleep apnea appliances treat throat snoring. But if the source of your snoring is coming from your nasal area and not your throat, other treatments may need to be considered.
To reduce nasal snoring, some people use nasal dilation products while wearing their oral appliance device. You can find a list of these on the My Sleep Device’s patient resource page.
Also, an ear, nose and throat physician may suggest minor surgical procedures that may improve nasal airflow and eliminate nasal snoring.
Improvement in nasal breathing can often improve apnea treatment results, whether it be CPAP therapy or oral appliance therapy.
Is it time to consider alternative treatments for your oral appliance therapy?
If you find that your oral appliance is no longer helping control your apnea symptoms, it is best to visit your dental sleep apnea provider to help troubleshoot causes. Ideally, yearly oral appliance wellness checks with your sleep apnea dentist can help catch things early and help you improve treatment results.
Some patients may also choose to try other sleep apnea treatments, such as CPAP (continuous positive airway pressure) device, sleep position management or surgery. A visit with your sleep specialist can help guide you back to peaceful and restful sleep.
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