Is snoring keeping you from getting enough shut-eye?
We can treat snoring and mild forms of sleep apnea with the Silent Nite® Slide-Link dentist-prescribed oral appliance.
It is estimated that more than 90 million North Americans snore. Taking into account the snorer’s spouse and children, as many as 160 million people are negatively affected by snoring. Snoring doesn’t merely interrupt your sleep cycle, the struggle for breath can result in soaring blood pressure, which can damage the walls of the carotid arteries and increase the risk of stroke.
At certain levels of severity, complete blockage of the airway space by the soft tissues and the tongue can occur. If this period of asphyxiation lasts longer than 10 seconds, it is called Obstructive Sleep Apnea (OSA), a medical condition with serious long-term effects.
During sleep, muscles and soft tissues in the throat and mouth relax, shrinking the airway. This increases the velocity of airflow during breathing. As the velocity of required air is increased, soft tissues like the soft palate and uvula vibrate. The vibrations of these tissues result in “noisy breathing” or snoring.
For the majority of snorers, however, the most affordable, noninvasive, comfortable and effective snoring solution remains a dentist-prescribed snore prevention device, such as Silent Nite sl, a custom-fabricated dental device that moves the lower jaw into a forward position, increasing space in the airway tube and reducing air velocity and soft tissue vibration. Special Slide-Link connectors are attached to transparent flexible upper and lower trays with a soft inner layer with a hard outer layer that is durable and BPA-free. The trays are custom laminated with heat and pressure to the dentist’s digital model of the mouth. The fit is excellent, comfortable, permits small movements of the jaw (TMJ) and allows uninhibited oral breathing.
This intraoral appliance is indicated for patients with a minimum of 8 teeth per jaw and a body mass index (BMI) of 30 or less.
- Young T, Palta M, Dempsey J, et al. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328(17):1230-5.
- 2. Friedlander AH, Yueh R, Littner MR. The prevalence of calcified carotid artery atheromas in patients with obstructive sleep apnea syndrome. J Oral Maxillofac Surg. 1998;56(8):950-4.
- American Academy of Sleep Medicine. International Classification of Sleep Disorders (ICSD), Rochester, Minn., 1990.
- Isono S, Remmers J. Anatomy and physiology of upper airway obstruction. Kryger MH, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine, 2nd ed. WB Saunders and Co. 1994:642-56.
- Kopp HP. Snore Device Specifications. ERKODENT Erich Kopp GmbH, Siemen-strasse 3, D-72285 Pfalzgrafenweiler, Germany.
Snore Score Quiz:
What Is Your Snore ScoreTM?
Your answers to this quiz will help you decide whether you may suffer from sleep apnea.
- Are you a loud and/or regular snorer? Yes No
- Have you ever been observed to gasp or stop breathing during sleep? Yes No
- Do you feel tired or groggy upon awakening, or do you awaken with a headache? Yes No
- Are you often tired or fatigued during waking hours? Yes No
- Do you fall asleep sitting, reading, watching TV or driving? Yes No
- Do you often have problems with memory or concentration? Yes No
If you have one or more of these symptoms, you are at higher risk for having obstructive sleep apnea. If you are also overweight, have a large neck and/or have high blood pressure the risk increases even further. If you or someone close to you answers “yes” to any of the above questions, you should discuss your symptoms with your dentist, physician or a sleep specialist.
Different treatment options exist; the appropriate treatment choice for you depends upon the severity of your apnea and other aspects of the disorder. Talk to your doctor about choices. Untreated, obstructive sleep apnea can be extremely serious and cannot be ignored.
Epworth Sleepiness Scale:
Your age (Yrs): _______________ Your sex (Male = M, Female = F): ________
How likely are you to doze off or fall asleep in the following situations, in contrast to feeling just tired? This refers to your usual way of life in recent times. Even if you haven’t done some of these things recently try to work out how they would have affected you. Use the following scale to choose the most appropriate number for each situation:
0 = would never doze
1 = slight chance of dozing
2= moderate chance of dozing
3 = high chance of dozing It is important that you answer each question as best you can.
Situation Chance of Dozing (0-3)
Sitting and reading
Watching TV
Sitting, inactive in a public place (e.g. a theatre or a meeting)
As a passenger in a car for an hour without a break
Lying down to rest in the afternoon when circumstances permit
Sitting and talking to someone
Sitting quietly after a lunch without alcohol
In a car, while stopped for a few minutes in the traffic
Berlin Questionnaire© Sleep Apnea
Height (m) ______ Weight (kg) ______ Age ______ Male / Female
Please choose the correct response to each question.
Category 1
1. Do you snore?
□ a. Yes
□ b. No
□ c. Don’t know
□ d. 1-2 times per month
If you answered ‘yes’:
□ c. Louder than talking
□ d. 1-2 times per month
□ e. Rarely or never
□ a. Almost every day
□ b. 3-4 times per week
□ c. 1-2 times per week
□ d. 1-2 times per month
□ e. Rarely or never
□ b. 3-4 times per weekIf you answered ‘yes’:4. Has your snoring ever bothered other people?
□ a. Yes
□ b. No
□ c. Don’t know5. Has anyone noticed that you stop breathing during your sleep?
□ a. Almost every day
□ b. 3-4 times per week
□ c. 1-2 times per week
□ d. 1-2 times per month
□ e. Rarely or never
Category 2
6. How often do you feel tired or fatigued after your sleep?
□ a. Almost every day
□ b. 3-4 times per week□ c. 1-2 times per week
□ d. 1-2 times per month
□ e. Rarely or never
7. During your waking time, do you feel tired, fatigued or not up to par?
□ a. Almost every day
□ b. 3-4 times per week
□ c. 1-2 times per week
□ d. 1-2 times per month
□ e. Rarely or never
8. Have you ever nodded off or fallen asleep while driving a vehicle?
□ a. Almost every day
□ b. No
9. How often does this occur?
□ a. Almost every day
□ b. 3-4 times per week
□ c. 1-2 times per week
□ d. 1-2 times per month
□ e. Rarely or never
Category 3
10. Do you have high blood pressure?
□ Yes
□ No
□ Don’t know
Scoring Berlin Questionnaire:
The questionnaire consists of 3 categories related to the risk of having sleep apnea. Patients can be classified into High Risk or Low Risk based on their responses to the individual items and their overall scores in the symptom categories.
Categories and Scoring:
Category 1
Category 1: items 1, 2, 3, 4, and 5;
Item 1: if ‘Yes’, assign 1 point
Item 2: if ‘c’ or ‘d’ is the response, assign 1 point
Item 3: if ‘a’ or ‘b’ is the response, assign 1 point
Item 4: if ‘a’ is the response, assign 1 point
Item 5: if ‘a’ or ‘b’ is the response, assign 2 points
Add points. Category 1 is positive if the total score is 2 or more points.
Category 2: items 6, 7, 8 (item 9 should be noted separately).
Item 6: if ‘a’ or ‘b’ is the response, assign 1 point
Item 7: if ‘a’ or ‘b’ is the response, assign 1 point
Item 8: if ‘a’ is the response, assign 1 point
Add points. Category 2 is positive if the total score is 2 or more points.
Category 3 is positive if the answer to item 10 is ‘Yes’ or if the BMI of the patient is greater than 30kg/m2.
(BMI is defined as weight (kg) divided by height (m) squared, i.e.., kg/m2).
High Risk: if there are 2 or more categories where the score is positive.
Low Risk: if there is only 1 or no categories where the score is positive.
Additional Question: item 9 should be noted separately.