Snoring Stopped But Sleep Apnea Increased

This is about the case of a patient aged 41 who was diagnosed with mild obstructive sleep apnea (OSA) and who had been treated with a mandibular advancement oral device.  OSA is a condition in which there are pauses in breathing during sleep.  In mild OSA, there are 5 to 15 of these pauses per hour of sleep.  Moderate OSA has 15 to 30 events per hour and severe OSA has more than 30 events per hour.  Our office has seen patients who have more that 60 events per hour or once every minute.  No wonder there are such severe health effects when each event is at least 10 seconds!!

This case shows that just eliminating snoring with a device does not mean that there is an improvement in OSA.  A follow-up polysomnography (PSG) in this case showed that snoring was reduced from 14.8% down to 0.4%.  But the index for OSA known as AHI increased from 8.5 of these events per hour to 11.6 events per hour.  Also the lowest oxygen level in the blood fell from 93% to 87%.  This is a dangerous situation!

This case shows the absolute necessity of objective follow-up sleep testing with PSG or home sleep testing (HST) during and after oral appliance therapy (OAT) to evaluate how well the treatment works. This shows the reason one should never use a device purchased online to stop snoring because OSA can kill a patient!  Also, if one is being treated by a dentist for snoring and OSA, be sure that there is real testing to make certain that not only is the snoring gone, but that the OSA is also decreased.  Snoring cannot kill you but OSA can!

Real testing can only be done with PSG or HST.  Sometimes a doctor will use a test for oxygen levels only instead of a PSG or HST since it is so much cheaper, but it does not show anything about the level of OSA.

Make sure that the dentist treating you for OSA and snoring uses an appropriate testing method to monitor how well the oral device is working.  This may take 3, 4, or more tests to determine the adjustments needed to get you to maximum medical improvement with the device.  A cheap device bought online can cause real damage to your health.