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Sleep Better Tonight



Snoring just isn't attractive leaving the snorer not only irritable but his/her/their bed partner cranky as well. Additionally, snoring may lead to sleep deprivation and sleep interruptions making it extremely difficult to achieve a restful night sleep resulting in daily fatigue. The irritating sounds of snoring not only disrupt your sleep but can also be a sign of a more serious issue – obstructive sleep apnea (OSA). As an orofacial pain specialist, I specialize in treating both snoring and obstructive sleep apnea to help you achieve the peaceful sleep you deserve.

Unmasking Snoring: What You Need to Know
Snoring is the sound of the uvula and soft palate vibrating against the back of the pharynx or base of the tongue. The muscles of the throat relax during sleep, and as the air moves through the constricted air passage, compounded with the vibrating soft tissues, snoring sounds are produced that are within the same frequency range of normal human conversation.
The Significance of Snoring: Could It Be Sleep Apnea?

Snoring might be more than just a nightly annoyance; it could be an indicator of obstructive sleep apnea.  This potentially serious medical condition, if it remains untreated, occurs when relaxed muscles during sleep allow soft tissues to collapse and block the airway, leading to repeated pauses in breathing. It is often recommended that individuals who snore undergo overnight sleep studies to provide a definitive diagnosis. 

The Significance of Snoring: Could It Be Sleep Apnea?

The Two Faces of Sleep Apnea: Obstructive and Central
Obstructive sleep apnea

Obstructive sleep apnea occurs when your muscles relax during sleep, allowing the soft tissue to collapse and block the airway. As a result, sleep apnea causes you to stop breathing up to hundreds of times a night for anywhere from a few seconds to more than a minute. Individuals suffering from OSA often do not know that they are gasping for air at night as this choking episode does not wake them up. Snoring, excessive daytime sleepiness, memory problems, irritability, morning headaches, fatigue, and insomnia are all signs that you could be losing shut-eye to sleep apnea. If left untreated, sleep apnea can be a potentially life-threatening condition. It can increase the risk for other serious health problems such as high blood pressure, stroke, heart disease, diabetes, obesity, depression, and impotence. Obstructive sleep apnea is estimated to affect 20% of the population according to the National Sleep Foundation, and 85% of those with sleep apnea don’t even know they have it.

Central sleep apnea

In contrast, central sleep apnea is marked by a failure of the brain to signal the muscles to breathe. Unlike OSA, there is no physical obstruction in the airway. Central sleep apnea can result from various medical conditions affecting the respiratory control center in the brain.


Understanding the differences between obstructive sleep apnea and central sleep apnea
  • Mechanism:

    • Obstructive Sleep Apnea: Physical blockage of the airway due to relaxed throat muscles.

    • Central Sleep Apnea: Lack of respiratory effort initiated by the brain, causing a temporary cessation of breathing.

  • Airway Blockage:

    • Obstructive Sleep Apnea:  Soft tissues collapse, obstructing the airflow.

    • Central Sleep Apnea:  No physical obstruction; the brain fails to send signals for breathing.

  • Common Symptoms:

    • Both obstructive and central sleep apnea have similar symptoms including: snoring, morning headaches, daytime sleepiness, memory issues, irritability, fatigue, difficulty staying asleep, insomnia, and sudden awakenings with shortness of breath.

Treating sleep apnea

How is obstructive sleep apnea treated?

Treatment modalities for sleep apnea are dictated by the extent and severity of the syndrome. For example, lifestyle changes, such as losing weight, and lifestyle habits, such as sleeping on your side rather than your back, may help reduce some of the symptoms of sleep apnea. Additionally, abstaining from consuming alcohol, especially before bed, may also aid in treating sleep apnea symptoms. Often, a Nasal Continuous Positive Airway Pressure (CPAP) machine is recommended and indicated. The CPAP consists of wearing a face mask connected to a machine that directly pumps air on a nightly basis. Although this machine is extremely effective, patients often find it uncomfortable to wear and extremely noisy resulting in poor compliance and thus leaving these patients at risk of the detrimental effects associated with sleep apnea. Additionally, CPAP machines are often difficult to transport. Thus, patients often seek alternative treatments, such as oral appliances (mandibular advancement devices). These oral appliances are essentially mouth guards that protrude the lower jaw (mandible) and tongue thus keeping the airway clear. What's also great about these appliances is that they can even be worn with a CPAP device. 


Lauren Levi, D.M.D. M.S. individually fits and curtails these oral night guards to treat your needs. She works closely with your physicians to help manage your sleep apnea. 

How is central sleep apnea treated?

Central sleep apnea may be linked to various underlying medical conditions and thus treating and managing those conditions is an important part of treatment. CPAP is a common treatment modality that maintains a stable breathing pattern by delivering a gentle flow of air, assisting respiratory efforts and preventing interruptions during sleep. If CPAP is not effective or unable to be tolerated, there are other treatments that your physician may explore with you such as phrenic nerve stimulation and adaptive servo ventilation (ASV). ASV devices adjust airflow in real-time, providing the necessary support when your respiratory system needs it most.

Your Path to Restful Sleep Begins Here

We understand the impact of sleep apnea on your quality of life. Our mission is to guide you toward restful nights by offering personalized, evidence-based treatments that address the unique challenges posed by sleep apnea. Take the first step towards better sleep and overall well-being—contact us today to embark on your journey to a more rejuvenating night's rest.

For more information on sleep apnea oral appliance therapy, check out Dr. Levi's posts on Warning Signs You are Losing Shut-eye to Sleep Apnea and The Link Between Melanoma and Obstructive Sleep Apnea


Are you getting the most out of sleep? 


The STOP-BANG questionnaire screens for obstructive sleep apnea (OSA) and is one of the most widely accepted screening tools for OSA. It was developed in n 2008 (Chung et al. 2008) to screen for undiagnosed obstructive sleep apnea in patients before undergoing anesthesia. The questionnaire has been modified over time and evaluated in multiple populations revealing a sensitivity of 90%-96% sensitivity (Nagappa et al. 2015).


It uses four equally weighted historical questions (STOP) and four equally weighted objective findings (BANG) to create an overall score. Scores less than or equal to 3 predict a low likelihood of OSA whereas scores ≥ 3 predict a higher likelihood of OSA. If you scored higher than 3 (answered YES to 3 or more questions), there is a chance you have sleep apnea. Please consult with your PCP or a sleep physician. Once you have been diagnosed with sleep apnea CALL OUR OFFICE at 914-862-7313 to discover how oral appliance therapy can help you.

Are you at risk for sleep apnea?
Do you snore loudly?
Do you often feel tired, fatigued, or sleepy during the daytime?
Has anyone observed you stop breathing during sleep?
Do you have (or are you being treated for) high blood pressure?
Neck circumference

If you scored higher than 3 (answered YES to 3 or more questions), there is a chance you have sleep apnea. Please consult with your PCP or a sleep physician. Once you have been diagnosed with sleep apnea CALL OUR OFFICE at 914-862-7313 to discover how oral appliance therapy can help you.

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