Boston Sleep Apnea

Obstructive Sleep Apnea

What is Obstructive Sleep Apnea?

Snoring can be a sign of a serious medical condition called obstructive sleep apnea.

Every night 1 in 4 Americans snores while sleeping, making it a widespread problem that affects sleep and quality of life for millions of snorers and their bed partners alike.

Our Boston Center for Oral Health diplomate of AADSM Dr. Carmine Morreale is dedicated to serving the needs of patients with sleep disorders that can be treated with custom-made oral appliances and snoring mouthpieces. A graduate of the Dental Sleep Medicine residency at Tufts University School of Dental Medicine, Dr. Morreale is also an Associate Professor of Prosthodontics at Tufts School of Dental Medicine. He is committed to helping his patients sleep better and live better lives by treating the underlying causes of snoring and sleep apnea.


Obstructive Sleep Apnea is the blockage of your airway by the soft tissues in your mouth/throat. It often results in poor sleep health. This blockage disrupts restful sleep, drops your average oxygen saturation levels, causes you to wake up feeling unrefreshed and tired, and can have you snore away. This medical condition is highly associated with many co-morbidities. Approximately 18 million American adults suffer from obstructive sleep apnea – with an untold number of undiagnosed cases. Sleep apnea symptoms in men tend to display more ‘classic’ signs of OSA such as heavy snoring and excessive daytime sleepiness, whereas sleep apnea symptoms in women more often show as insomnia, anxiety, and headaches/TMJ related pain (this often results in fewer sleep testing recommendations from family physicians for females).   Because males tend to suffer from the more “classic” symptoms of OSA, they are more likely to be encouraged to seek testing by their bed partner. Due to the more nuanced symptoms suffered by females, they are often left untreated, or even misdiagnosed with depression or thought to be nuts. However, these patients aren’t nuts, instead, they and everyone around them are N.U.T.S. – Not Understanding the Symptoms. 

 There are several different types of sleep apnea devices that one can turn to in order to lead to no more snoring and to improve your sleep health.

Has your CPAP Machine failed you?
The current gold standard for mild sleep apnea, and more severe cases, is CPAP. However, after a single year, 50% of CPAP patients can no longer tolerate their machine. Your bed partner may have looked into an anti snoring pillow or an over-the-counter snoring mouth guard, but to no avail. Even if the snoring pillow, sleep apnea mask or snore guard stops the snoring, it may only be masking the underlying issue. A sleep apnea treatment without CPAP – a new sleep apnea treatment is a custom made sleep apnea appliance. 


How do you know if you have poor sleep, obstructive sleep, or sleep apnea?

The signs and symptoms of sleep apnea are succinctly explained in Breathe Well, Sleep Well, Live Well by Dr. Carmine Morreale. 

The signs and symptoms of obstructive sleep and sleep apnea are like stars in a constellation. Once you start identifying the stars, you can see the whole constellation.

Adults with sleep-disordered breathing will often have some of the following symptoms or ‘stars’ :

  • Waking up tired and unrefreshed, no matter how many hours of sleep you get, excessive daytime sleepiness or fatigue
  • Insomnia. Seems strange, but your body is actually trying to keep you awake so you don’t stop breathing while asleep.
  • Waking up frequently during the night to go to the bathroom.
  • While asleep, gasping for breath or pauses in breathing
  • Waking up gasping or choking
  • Heartburn or waking up with stomach acid in your mouth.
  • Frequent napping.
  • Loss of interest in life, hobbies and intimacy.
  • High blood pressure (adults)
  • Hyperactivity/Attention Deficit Disorder (children)
  • Snoring loudly
  • Morning headaches
  • Trouble concentrating
  • Depression & Anxiety
  • Sleep difficulties

The American Dental Association directed all dentists to screen patients for sleep-disordered breathing in 2017—just like dentists have been asked for years to screen every patient for oral cancer. The best way to find out would be a systematic review by a sleep physician or sleep test/sleep study.


Can Sleep Apnea be Cured?

In some cases, yes, through exercise, weight loss, positional sleeping on your side, good sleep hygiene and sleep health, and neck surgery. However, in most cases, sleep apnea can only be managed, not cured. Some examples of sleep apnea management are:
  • CPAP (snoring machine)
  • Oral Appliance Therapy (i.e. a sleep apnea mouthpiece
  • Sleep apnea pillow (the MyPillow® guy)

What are some Home Remedies for Sleep Apnea?

What we recommend at our sleep center to improve your sleep hygiene includes:

  • Positional sleeping (sleeping on your side)
  • Avoid alcohol within 3 hours of bedtime
  • Avoid caffeine after 1 in the afternoon
  • Drink plenty of hydrating fluids
  • Get regular exercise
  • Maintain a healthy weight
  • Eat a balanced diet
  • Keep a consistent sleep schedule
  • Keep the room you sleep in dark and cool
  • Avoid electronics and screen time at least 2 hours before you go to bed

Nasal dilators like Mute, Nozovent, and snoring strips can help by keeping the nasal passages open, therefore enhancing airflow. There is also an over the counter snoring mouthpiece available at several pharmacies. Many of these treatments can greatly improve your obstructive sleep, but greatly reduce their effectiveness with moderate sleep apnea, and more severe cases. Vitamin supplementation has shown to be beneficial as well. For instance, low levels of vitamin D are associated with poor sleep quality and sleep quantity. Additionally, several studies demonstrate a lack of vitamin D may also affect the severity of sleep apnea, with lower D levels linked to more severe cases of OSA. 

What is the Total Cost?

The total fee for Obstructive Sleep Apnea Oral Appliance therapy all depends on each patient, their individual case, their treatment plan, and their insurance plans. The out of pocket for a patient is anywhere from $0 to $4700. The best way to find out what your coinsurance amount is would be by calling your insurance company directly.https://youtu.be/10QTvZPY0X8

Oral Appliance Therapy Benefits

The benefits of Oral Appliance Therapy are:

  • Small and transportable – unlike a CPAP, an oral appliance can fit into your pocket and go wherever you go.
  • Easy to use – there is no setup required, you simply put it in your mouth before falling asleep.
  • Extremely effective when used in conjunction with CPAP – when used together, successful treatment from both devices work hand-in-hand to keep your oxygen levels up at night.

Our Boston Center for Oral Health Diplomate of AADSM Dr. Carmine Morreale and AADSM Associate, Dr. Megan Huyett are dedicated to serving the needs of patients with obstructive sleep disorders that can be treated with custom-made oral appliances at our sleep center. A graduate of the Dental Sleep Medicine residency at Tufts University School of Dental Medicine, Dr. Morreale is also an Associate Professor of Prosthodontics at Tufts School of Dental Medicine. Through his systematic review, he is committed to helping his patients sleep and live better lives by treating the underlying causes of snoring and sleep apnea with dental sleep medicine.

Not sure if your snoring needs to be evaluated? Call to get more information before you come in for an appointment.

We are happy to discuss your condition and your treatment options on a complimentary phone consultation. Just call our office at (617) 536-4620 and mention the phrase “snoring phone consultation.” 

Frequently Asked Questions

Obstructive sleep apnea is a sleep disorder that occurs when a person’s airway becomes blocked during their sleep. This blockage interrupts the breathing pattern and causes snoring. The obstruction can be due to enlarged tonsils or adenoids, excess tissue in the mouth, throat or nose, or a smaller than normal airway.

The person with obstructive sleep apnea will have pauses in breathing for 10 seconds or more at least 5 times an hour. If no one is there to wake the person up from their deep sleep, they will stop breathing for long periods of time and this can lead to serious health problems such as heart attacks, strokes and high blood pressure.

A person with sleep apnea has pauses in breathing or shallow breaths while sleeping. This can happen 30 times or more an hour. And it can lead to problems like daytime sleepiness, high blood pressure, and heart disease.

If you think you might have obstructive sleep apnea, our doctors will ask about your symptoms and do a physical exam to find out if you have the disorder. Sometimes we may also want to test how well you breathe during the day and night.

There are many different symptoms of poor quality sleep. Some people might experience daytime sleepiness, fatigue, or irritability. Others might have trouble concentrating, remembering things, or making decisions.

The first step to figuring out if you have poor quality sleep is to look at your habits and see if you can identify any of the following 4 patterns.

1- Do you often feel tired in the morning?

2- Do you need a lot of coffee in the morning to stay awake?

3- Are you waking up often during the night?

4- Are your dreams vivid and memorable?

Obstructive sleep apnea is a common condition that affects about 24% of the population. It is characterized by pauses in breathing and reduced airflow during sleep. These pauses can last anywhere from a few seconds to minutes, and they usually occur when the person is sleeping on their back.

There are many signs that can indicate whether or not someone has obstructive sleep apnea. The most common sign of obstructive sleep apnea is snoring, but there are many other symptoms as well, such as fatigue during the day, morning headaches, difficulty concentrating or remembering things, depression and anxiety.

Obstructive sleep apnea (OSA) is a common disorder that affects adults. It occurs when the airway becomes blocked or narrowed during sleep.

Treatment for OSA can include lifestyle changes, oral appliances, surgery, or a combination of these treatments.

The best way to find out if you have OSA is to undergo a sleep study in which your breathing patterns are monitored overnight.

The phrase obstructive sleep apnea may not sound serious, but it is. In fact, it can lead to serious health problems such as heart attacks. The condition is characterized by pauses in breathing and decreased oxygen levels during sleep. Other symptoms include the occurrence of loud snoring and choking sounds during sleep, which may be either a symptom of apnea or simply not getting enough air.

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