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Find out how low blood oxygen levels affect your body during Sleep Apnea


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Sleep Disordered Breathing

IT’S TIME FOR CHANGE! Take the first step toward getting the sleep you deserve with Oral Appliance Therapy.  


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Obstructive Sleep Apnea (OSA)

Occurs when the muscles and tissues in the airway collapse and block off the airway, preventing airflow. When the oxygen in the brain becomes low enough, the sleeper partially awakens, the obstruction in the throat clears and the flow of …


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TRANSFORMING YOUR SLEEP, REDEFINING YOUR HEALTH

The Raphaelson Dental Sleep Center is very proud to be one of the few dental practices on Long Island to help the medical community treat Sleep Apnea. “We are excited to screen our patients for Sleep Apnea, knowing that we are improving their health and potentially saving their lives”. We believe it is our moral responsibility to the health of our patients to screen them for Sleep Apnea. Our sleep specialists are here to help, “Transform Your Sleep, Redefine Your Health”.

Dr. Todd Raphaelson

Obstructive Sleep Apnea

More than 50 million Americans suffer from sleep disorders. Despite this growing statistic, unfortunately over 90% remain undiagnosed. Although there are over 80 classifications of sleep disorders, they are broken down in four major areas: Sleep Apnea, Insomnia, Narcolepsy, and Restless Leg Syndrome. Sleep apnea is the most common sleep disorder affecting over 18 million Americans.

Obstructive Sleep Apnea is the most common type of Sleep Apnea. Obstructive Sleep Apnea causes interruptions or cessations in your breathing due to an obstruction of the airway. During an apnea episode your diaphragm and chest muscles work harder to open the obstructed airway and pull air into the lungs. Your breathing eventually resumes with a loud gasp or a snort for air, as you are temporarily woken up from a deep sleep.

The consequences of untreated Sleep Apnea can range from mild to severe, including high blood pressure, heart disease, stroke, brain damage, diabetes, depression, obesity, and impotencey. Sleep apnea and related sleep disorders should not be taken lightly and can lead to serious health related issues. Many people with Sleep Apnea wake up in the morning feeling tired even though they have had a full night of sleep. During the day they experience difficulty concentrating or may even unintentionally fall asleep, placing them at a higher risk for accidents. This is a result of your body waking up numerous times throughout the night, even though you may not be conscious of it.

At Raphaelson Dental Sleep Center, our patients with Sleep Apnea are treated with an Oral Appliance. It is an alternative for patients who are unable to tolerate C-PAP Therapy and is considered the first line treatment for patients diagnosed with Obstructive Sleep Apnea according to American Academy of Sleep Medicine. Oral appliances are custom and comfortable, they fit like a sports mouth guard or an orthodontic retainer. The oral appliance holds the lower jaw forward keeping the airway open, preventing the tongue and muscles in the upper airway from collapsing and obstructing the airway.

Raphaelson Dental Sleep Center works with hundreds of medical insurance companies for Sleep Apnea treatment. In most cases, Raphaelson Dental Sleep Center does not require a physician referral. Some insurers require referrals, or may have additional requirements for certain medical care. Our sleep coordinators will contact your insurance company to verify medical coverage and to obtain any needed authorization prior to your treatment.



Nox T-3 Portable Home Sleep Study

Obstructive Sleep Apnea

Obstructive Sleep Apnea (OSA) is a sleep breathing disorder in which a person stops breathing during sleep. The tissues in the throat collapse, cutting off the airway despite efforts to breathe. Apnea is defined as “a cessation of airflow for 10 seconds or more.” This can occur dozens and sometimes even hundreds of times an hour, depending on the severity. These apnea episodes will wake you up from a deep sleep into light sleep stage, never allowing you to get the restful sleep that you need. As airflow stops during an episode, the oxygen level in your blood drops and there is an arousal from deep sleep. The low oxygen levels during sleep can make you feel very tired in the morning and will contribute to more restless sleep. These sudden drops in blood oxygen levels during sleep apnea episodes increase blood pressure and overwork the cardiovascular system and other major organs. If you have Obstructive Sleep Apnea you have a higher risk of developing High Blood Pressure, having a Heart Attack, experiencing abnormal Heartbeats, and even a Stroke. If you already suffer from any Heart disease, you should be aware that multiple episodes of low blood oxygen (hypoxia or hypoxemia) can lead to sudden death from an irregular heartbeat. Obstructive Sleep Apnea is classified as mild, moderate or severe:

Mild OSA- The sufferer experiences 5-14 episodes of interruptions in breathing in an hour.

Moderate OSA- The sufferer experiences 15-30 episodes of interruptions in breathing in an hour.

Severe OSA- The sufferer experiences 30 or more interruptions in breathing in an hour.

Central Sleep Apnea

Unlike Obstructive Sleep Apnea breathing is not interrupted because of a physical obstruction; rather, the person does not try to breathe at all because the brain does not send proper signals to the muscles. Central Sleep Apnea is usually related with a serious illness in the lower brainstem. It can also be an indication of Chiari malformation (also known as Arnold–Chiari malformation), which is a malformation of the skull. In some cases, Central Sleep Apnea patients display shallow breathing or under breathing that alternates with deep over-breathing, a condition known as Cheyne-Stokes breathing. In addition, Central Sleep Apnea can occur with Obstructive Sleep Apnea, which is called a Mixed Apnea.

Conditions that may be associated with Central Sleep Apnea include the following:

Congestive heart failure
Hypothyroid Disease
Kidney failure
Neurological diseases, such as Parkinson’s disease, Alzheimer’s disease, and amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease)
Damage to the brainstem caused by encephalitis, stroke, injury, or other factors

The symptoms of Central Sleep Apnea are for the most part similar to those of Obstructive Sleep Apnea. They include chronic fatigue, daytime sleepiness, morning headaches and restless sleep. If CSA is caused by a neurological disease, patients may also experience difficulty swallowing, voice changes, and an overall sense of weakness and numbness.

Oral Appliance Therapy

A custom-fit oral sleep appliance can improve your sleep and restore health. An oral appliance fits like a sports mouth guard or an orthodontic retainer, that is worn at night during sleep. It supports the jaw in a forward position to help maintain an open upper airway. Research shows that oral appliance therapy is a very effective treatment option for snoring and obstructive sleep apnea. It has been named as the first line of treatment for OSA by the American Academy of Sleep Medicine. Oral appliance therapy is covered by many medical insurance plans and our Sleep Coordinators will be happy to check your medical benefits.

Our patients like oral appliance therapy because it is:

Comfortable
Easy to wear
Quiet
Portable
Convenient for travel
Easy to care for

Oral appliances are customized using physical impressions and models of your teeth. These models are sent to a dental lab where the appliance is made. Our oral appliances are very sleek in design, consisting of smooth, durable and comfortable material. Other oral appliances can be heavy, bulky or are even made with metal. Our appliance is so comfortable and flexible that you will be able to fully open and close your mouth while wearing it. Once your oral appliance is ready, you will return to your our office for a fitting. Our sleep specialists will adjust the appliance to insure its comfort and effectiveness. Our sleep technicians will help teach you how to clean the oral appliance and maintain it. After this fitting, your sleep specialist will schedule you for a sleep study to verify treatment success.

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Sleep Apnea Facts and Treatment Options

Who Is At Risk For Sleep Apnea?

Even though Sleep Apnea can affect anyone regardless of age, weight, and gender, there are a few factors that indicate a higher likelihood of having Sleep Apnea. If you experience any of the following, your chances of having sleep apnea are greater: mouth breathing, overweight, increased neck size, family history, use of alcohol or sedatives, smoking, being a male, age, narrowed airway, snoring, excessive daytime fatigue, enlarged tonsils or jaw structure.

Sleep Apnea Statistics

– Doctors estimate that 9.1% of men and 4% of women have sleep apnea.

-18-25 million Americans (1 in every 15) are living with sleep apnea.

– It is estimated that fewer than 10% have been diagnosed, or have taken a sleep study.

– A person afflicted with untreated obstructive sleep apnea is up to 4 times more likely to have a stroke, as well as 3 times more likely to have heart disease.

– Approximately 50% of all patients who have hypertension, or high blood pressure, are also afflicted with obstructive sleep apnea.

– People suffering from OSA are as much as 6 times more likely to be involved in a car crash than those without sleep disorders. This is due to the fact that they are drowsy from lack of sleep.

How is Sleep Apnea Diagnosed?

Our sleep specialists will diagnose Sleep Apnea based on your Home Sleep Study results and other factors such as your medical history, symptoms, and a physical examination. We will evaluate your medical history and symptoms first and after give you an Airway Evaluation to determine whether there are any obstructions in your airway. During your Airway Evaluation, our sleep specialists will check your mouth, nose, and throat for extra or large tissues. We will also look for other obvious signs of OSA such as a tongue with scalloped borders, an enlarged tongue or uvula, a soft palate, a narrow airway, and wear on the teeth (which indicate sleep bruxism). In children one of the more common physical signs we notice are enlarged tonsils. After an Airway Evaluation our patients are given a Home Sleep Study that is self performed and done in the comfort of their home. All of our Sleep Specialists are qualified and have the credentials to diagnose and provide optimal treatment to patients who have Sleep Apnea.

Measuring Sleep Apnea

With today’s technological advancements a polysomnograpy can be performed at home and is called home sleep testing (HST) or a home sleep study.

Sleep apnea is measured by the number of times you stopped or reduced breathing per hour. Together, these events are counted and known as the Apnea-Hypopnea Index (AHI).

A sleep study will measure your AHI as well as the drop in your blood-oxygen levels to help determine the severity of the disease. Oxygen values under 90 percent are considered low and dangerous. If you have Obstructive Sleep Apnea, your sleep study results will indicate mild, moderate or severe.

Our sleep specialist will use the results from your home-based sleep test to help diagnose sleep apnea.

The Benefits of A Sleep Home Study Include:

  1. The typical cost of a home sleep test or a home sleep study is only a fraction of the cost of an in-lab sleep study, and will yield similar results. It is also more accepted as the preferred method of testing patients for sleep apnea by insurance companies.
  2. It’s self administered in the convenience and familiarity of your own home.
  3. Its great for our senior patients who often have a more difficult time leaving their homes due to chronic illness and the need for specialized care.

Sleep Apnea Symptoms

One of the most common symptoms of sleep apnea is snoring. Snoring can be an indication of sleep apnea when it is proceeded with breathing cessation and choking or gasping sounds. However, you may still have Sleep Apnea even if you do not snore. Most people who have Sleep Apnea are not aware they have it and they can go undiagnosed for years. A family member or bed partner will often be first to notice signs of Sleep Apnea.

Common symptoms of sleep apnea include:

– Loud or frequent snoring
– Silent pauses in breathing
– Choking or gasping sounds
– Daytime sleepiness or fatigue
– Unrefreshing sleep
– Insomnia
– Morning headaches
– Difficulty concentrating
– Decreased sexual desire
– Memory problems
– Feeling irritable, depressed, or having mood swings or personality changes
– Waking up frequently to urinate
– Dry mouth or sore throat when you wake up

Symptoms in children may not be as obvious. They may include:

– Bedwetting
– Choking or drooling
– Sweating a lot at night
– Ribcage moves inward when they exhale
– Learning and behavior disorders
– Problems at school
– Sluggishness or sleepiness
– Snoring
– Teeth grinding
– Restlessness in bed
– Pauses or absence of breathing
– Unusual sleeping positions, such as sleeping on the hands and knees, or with the neck hyperextended

Oral Appliances are placed in the mouth and are worn much like an orthodontic appliance or sports mouth protector. Worn during sleep to prevent the collapse of the tongue and soft tissues in the back of the throat, oral appliances promote adequate air intake and help to provide normal sleep in people who snore and have Sleep Apnea.
Oral appliances are the first-line therapy for patients who have been diagnosed Obstructive Sleep Apnea according to the American Academy of Sleep Medicine. They are also a great alternative for patients that cannot tolerate their prescribed CPAP. The oral appliance holds the lower jaw forward keeping the airway open. It prevents the tongue and muscles in the upper airway from collapsing and obstructing the airway. Our oral appliances are very sleek in design, consisting of smooth, durable and comfortable material. It is also one of the strongest appliances currently available, making it an ideal treatment option for all patients, especially those who clench or grind their teeth at night.

CPAP (continuous positive air pressure applied through a nasal mask) is the another common form of treatment of Obstructive Sleep Apnea (OSA). The CPAP machine consists of a face or nasal mask that is connected to a pump, providing a positive flow of air into the nasal passages in order to keep the airway open. This pressure ensures that the airway doesn’t collapse during sleep.

While not considered as the first line of treatment for snoring or sleep apnea, surgery may be an effective option for patients with a deviated nasal septum, enlarged tonsils, or a small lower jaw with an overbite causing the throat to be too narrow.

The most commonly performed types of surgery for Sleep Apnea include:

Nasal surgery: Correction of nasal problems such as a deviated septum.

Uvulopalatopharyngoplasty (UPPP): A procedure that removes soft tissue on the back of the throat and palate, increasing the width of the airway at the opening of throat.

Mandibular maxillary advancement surgery: Surgery to correct certain facial problems or throat obstructions that contribute to sleep apnea.

With many surgical options available, it is up to the surgeon to find where the obstruction and determine what the best solution is.

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WHAT OUR PATIENTS SAY

Welcome to our Sleep Blog

Have a look and see what’s new!

Womens Health: Hypertension and Sleep Disorders

by on June 8, 2017

Raphaelson Dental would like to bring high blood pressure awareness to our patients, especially women and encourage you to get your blood pressure reading. Normal blood pressure is 120/80, whereas prehypertension is defined as 120-139/80-89, with a reading of 140/90 …

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by on April 24, 2017

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by on March 28, 2017

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Smoking A Risk For OSA- Another Reason To Quit

by on March 8, 2017

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by on March 2, 2017

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by on February 21, 2017

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Preventing and Treating Sleep Apnea Naturally

by on February 1, 2017

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Sleep Apnea, a risk for Sudden Cardiac Arrest

by on January 29, 2017

Sudden cardiac arrest kills more than 300,000 Americans each year and often strikes without warning. Recent evidence suggests that there is a link between sudden cardiac arrest and sleep apnea, a common sleep disorder that causes a person’s breathing to pause or …

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Is Sleep Apnea the root cause of Insomnia?

by on January 25, 2017

Insomnia is a common sleep disorder that can make it difficult to fall asleep and stay asleep. Insomnia is also a common symptom of sleep apnea.  Although many may believe that chronic insomnia is a completely separate sleep disorder from …

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Sleep Apnea causes a higher risk for developing Type 2 diabetes

by on December 27, 2016

OSA is a condition in which breathing stops for 10 seconds or more during sleep, sometimes hundreds of times a night. This sleep disorder affects approximately 18 million people in the United States and is linked to type 2 diabetes. …

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