Snoring & Sleep Apnea Treatment | Alexandria VA
As a member of TMJ & Sleep Therapy Centres International, TMJ dentist, Dr. Singer was hand-picked and personally trained by Dr. Stephen Olmos, a world renowned speaker / lecturer and leader in the field of sleep disordered breathing and TMJ disorders. Thus, Dr. Singer has advanced training necessary to evaluate risk and treat snoring and mild, moderate and severe sleep apnea. Along with a complete medical and dental history, the in-office exam by our office may also include a simple screening using:
- Motor reflex testing system developed by renowned orthopedic surgeon John Beck
- A computerized 3D scan to evaluate skeletal and soft tissue structures for relative risk for obstructive sleep apnea
- Computerized Pharyngometer to measure the throat airway space
- Computerized Rhinometer to measure the nasal airway
- An intra-oral habit assessment
- Checking of gag reflex
- Evaluating periodontal health, diagnostic models
- Evaluation of the mouth, teeth an oral soft tissues
- Whole body structure and gait
- TMJ disorder and craniofacial pain occlusal exam with specialized x-rays to assess whether you are a sleep appliance candidate
If sleep apnea is suspected, Dr. Singer will prescribe a sleep study by a sleep physician to confirm the suspected diagnosis.
Our treatment plans focus on the airways. We have safe 3-dimensional technology, Cone Beam Computed Tomography or CBCT that allows us to quickly and easily look at and measure the airways. (see below and in the technology page for more info. on the Cone Beam.)
Our sleep apnea treatment is holistic and unlike the CPAP, it will not interfere with some of your enjoyable nightly routine activities such as falling asleep with a good book. We usually refer our patients to a sleep clinic for an overnight sleep study (called a polysomnogram) or a take home test is available. Dr. Singer consults with the Sleep Physician to determine whether an airway oral appliance will be an effective treatment for you! He has the special training necessary to treat sleep disorders and he works together with sleep physicians and other specialists: ENTs, internists, pediatricians, chiropractors, and physicians in integrative medicine, etc., to achieve the best possible results. Many times, a sleep orthotic/appliance is the only treatment needed. Other times, a sleep orthotic can be used in combination with CPAP (continuous positive air pressure). Oral appliance therapy (OAT) gives patients, who have been diagnosed with obstructive sleep apnea (OSA), an alternative treatment to CPAP to help manage their serious disorder.
Can’t wear CPAP? In some studies CPAP failure is estimated as high as 60% or greater. In order for a patient to be officially diagnosed for insurance coverage with obstructive sleep apnea, a patient must undergo an overnight sleep study called a polysomnogram (PSG) at a sleep lab or with an at home test. Once the diagnosis and the severity – mild, moderate or severe – have been determined, the sleep physician will usually recommend the patient wear a CPAP to manage their disorder. However, there are often better options and many patients who are intolerant to CPAP therapy and choose not to wear their CPAP to bed. Dr. Singer can help these patients. Oral appliance therapy has been shown equally or more effective as CPAP in managing, mild to moderate obstructive sleep apnea. An appliance can also be effective in some cases in managing severe obstructive sleep apnea. Furthermore, oral appliance therapy has the added benefit that it can reduce the noise of snoring and in most patients, Dr. Singer can virtually eliminate their snoring. Snoring is oftentimes tied to social dilemmas that may keep you from traveling and staying overnight with friends and family.
It is good to know that oral airway appliances are non-invasive, reversible, painless and all are FDA medical devices approved to be worn at night. There are many kinds of oral appliances we can provide (some shown below). Dr. Singer will work to determine which one is best for your specific problem.
If you snore or your spouse snores or stops breathing periodically during the night, the answer may be closer than you think! With the dentist’s knowledge and diagnostic skills our sleep apnea centre is able provide assistance for the snoring or sleep apnea patient.
Here are a few of the many custom made sleep appliances available.
Dr. Lawrence Singer has attended a comprehensive residency in OSA/TMJ postgraduate education on the topic of oral appliance therapy for the treatment of TMJ disorders, craniofacial pain, and apnea. At your initial visit, the doctor will perform an examination of your teeth, muscles of mastication (muscles involved in moving the jaw) and joints. He will also examine your airway utilizing computerized 3-D images. This will allow him to determine if you are a good candidate for oral appliance therapy. After your custom-made oral appliance has been fabricated and delivered, he may monitor your progress with a home sleep evaluation testing device.
- The Rhinometer uses sound echoes to measure the geometry of the nasal cavity, not unlike a ship’s sonar. This test is done by placing the Rhinometer over each nostril for a few seconds. With this test, our office is able to determine if the nasal airway is blocked by mucosal tissue or structural damage.
- The Pharyngometer also uses sound echoes to measure the throat’s diameter, collapsibility and problem spots. It maps the points of obstruction, as well as how the airway responds to different breathing positions. Finding the optimal breathing position is key in determining the type of oral appliance therapy best suited for each patient.
Dr. Singer is trained, qualified and experienced in treating snoring and sleep apnea. He is Director of the TMJ & Sleep Therapy Centre of the Greater Washington, DC Area, an affiliate sister center of 25+ centers worldwide. TMJ & Sleep Therapy Centres International use a uniform carefully designed and constructed system to gather and compile data. This data is compiled and used in studies that have been published in prestigious medical journals such as the New England Journal of Medicine and Sleep and Breathing. Call with any questions. We’re here to help! 703 299 4614.
Why There Is An Important Difference Between Breathing Through Our Noses and Breathing Through Our Mouths
Breathing through our noses is imperative and it is important to understand why it is so. When we breathe through our noses we increase circulation, oxygen in the blood and carbon dioxide levels among other things. All good things that our bodies need to stay healthy and fight of viruses and infections. The air we take in through our noses travels through our nostrils to the nasal cavity and then travels down our trachea before depositing into our lungs by way of the windpipe.
There are many benefits of breathing through our noses. The air we breathe in must be properly prepared before taken into our bodies. Our noses are the ONLY organ that can do this preparation. Our noses filter, warm and humidify the air before it travels to our delicate lungs. Without this treatment of air, tiny unwanted particles would reach our delicate lungs, our airways would be dry all of the time, and our lungs would not receive air that is our body’s temperature. All through out the airways, dust, bacteria and other pollutants are caught by sticky mucus that line them. Within the turbinates in our noses lay an impressive amount of blood vessels that warm and humidify the air. Without the work of the blood vessels warming the air, cold air would tighten up the airways making it difficult to breathe. If the blood vessels aren’t humidifying the air, then the mucus thickens making it hard for it to pick up the germs it is supposed to filter away.
The nose is for breathing, the mouth is for eating.~Proverb
On the other hand, there are many unfavorable effects of breathing through our mouths. Mouth breathing can lead to chronic hyperventilation, low carbon dioxide levels, entry and build up of pollutants that make us sick, reduced blood circulation and narrowed airways. Our blood pressure is elevated as well as heart rate and conditions such as asthma and allergies become more serious. Our brains and other vital organs are deprived of the levels of oxygenation that we need to be our healthiest. Sleep apnea can be the result of breathing through our mouths while we sleep. We snore when we mouth breathe.