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Boston 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 bedpartners 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.

OSA

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 associated with various comorbidities. 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 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. Females often suffer from more nuanced symptoms, leading to untreated treatment, misdiagnosis of depression, or perception as nuts. However, these patients are not nuts; rather, they and everyone around them are N.U.T.S., which can help identify symptoms and causes of sleep apnea. —Not Understanding the Symptoms.

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

Has your CPAP machine failed you?
CPAP is currently the preferred treatment for mild sleep apnea and more severe cases. However, after a single year, 50% of CPAP patients can no longer tolerate their machine. Your bed partner may have looked into a sleep apnea test to diagnose it.  Your bed partner may have tried using an anti-snoring pillow or an over-the-counter snoring mouth guard, but without success.  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 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. It 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 can often be linked to sleep apnea, which increases in severity over time.

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 a 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?

At our sleep center, we recommend the following strategies to improve your sleep hygiene:

  • Positional sleeping (sleeping on your side)
  • Avoid alcohol within 3 hours of bedtime to reduce the risk factor for sleep apnea.
  • Avoid caffeine after 1 in the afternoon
  • Drink plenty of hydrating fluids
  • Get regular exercise
  • Maintain a healthy weight to lower the risk factor for sleep apnea.
  • 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 they significantly reduce their effectiveness with moderate sleep apnea and more severe cases. Studies have also demonstrated the benefits of vitamin supplementation. 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 cost 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.

Patient Testoimonial

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 works 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 specializes in diagnosing sleep apnea and its symptoms and causes. 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.

Your snoring may not require evaluation. Please call to obtain more information before scheduling an appointment.

We are delighted to discuss your condition and your treatment options on a complimentary phone consultation. Please call our office at (617) 536-4620 and mention the phrase “sleep apnea occurs” when discussing symptoms with your doctor. 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. TTA blockage disrupts the breathing pattern and leads to 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.

A person suffering from obstructive sleep apnea will experience breathing pauses lasting 10 seconds or more, occurring at least five times per 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 obstructive sleep apnea experiences pauses in breathing or shallow breaths during sleep. This phenomenon can occur up to 30 times per hour. And it can lead to problems like daytime sleepiness, high blood pressure, and heart disease.

IIf If you If our doctors suspect you may have obstructive sleep apnea, they will inquire about your symptoms and conduct a physical examination to confirm the diagnosis. Occasionally we may also want to test how well you breathe during the day and night.

There are various symptoms of poor-quality sleep. Some people may 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 due to disrupted breathing during sleep?

3- Are you waking up often during the night?

4- Are your dreams vivid and memorable?

Obstructive Sleep apnea is a prevalent condition that impacts approximately 24% of the population. The condition is characterized by breathing pauses and decreased 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, which is a risk factor for central sleep apnea.

There are numerous indicators that can determine whether an individual 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.

A sleep study, which monitors your breathing patterns overnight, is the best way to determine if you have OSA.

Obstructive sleep apnea may not sound serious, but it is. In fact, it has the potential to 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.

True-or-False Quiz: Understanding Sleep Apnea

1. Sleep apnea is a common sleep problem that only affects adults who snore.
➡ False
Explanation: While snoring and obstructive sleep apnea often occur together, sleep apnea is a potentially serious sleep disorder that affects both adults and children; not everyone with sleep apnea snores.

2. Obstructive sleep apnea occurs when the airway collapses or becomes blocked during sleep.
➡ True
Explanation: Obstructive sleep apnea occurs when the muscles in the throat relax repeatedly during sleep, causing the airway to become blocked and resulting in pauses in breathing during sleep.

3. Central sleep apnea happens because your brain fails to send the proper signals to control breathing.
➡ True
Explanation: Unlike obstructive types, central sleep apnea occurs when the brain doesn’t send the correct signals to the muscles that control breathing. Apnea occurs because the brain fails to activate the respiratory muscles.

4. There is no connection between a family history of sleep apnea and your own risk.
➡ False
Explanation: A family history of sleep apnea can increase your risk of obstructive sleep apnea, especially if combined with other factors like obesity or age.

5. Untreated sleep apnea may lead to serious health conditions such as high blood pressure, heart disease, or stroke.
➡ True
Explanation: Sleep apnea is associated with several serious health conditions. Untreated sleep apnea significantly increases your risk for cardiovascular problems and other chronic illnesses.

6. Mild to moderate obstructive sleep apnea usually doesn’t need any form of treatment.
➡ False
Explanation: Even mild obstructive sleep apnea can disrupt restorative sleep and may lead to daytime fatigue or more serious complications. There are many options for the treatment of sleep apnea at all severity levels.

7. People with central sleep apnea often experience symptoms similar to obstructive sleep apnea.
➡ True
Explanation: People with central sleep apnea may also experience daytime sleepiness, fatigue, and poor sleep quality. While the causes differ, obstructive and central sleep apnea can share similar symptoms.

8. Complex sleep apnea syndrome refers to having both obstructive and central sleep apnea.
➡ True
Explanation: Complex sleep apnea (also known as treatment-emergent central sleep apnea) is a condition where patients treated for obstructive sleep apnea develop central sleep apnea symptoms during therapy.

9. You can only diagnose sleep apnea through overnight hospital testing.
➡ False
Explanation: While in-lab sleep studies are useful, many patients can now use a home sleep test to help diagnose and treat sleep apnea under the guidance of a sleep specialist.

10. Adults with sleep apnea are less likely to experience mood changes or daytime fatigue.
➡ False
Explanation: Adults with sleep apnea often suffer from mood swings, irritability, and excessive daytime sleepiness. These are common signs of sleep apnea caused by poor-quality, interrupted sleep.

11. People with sleep apnea might stop breathing hundreds of times in a single night.
➡ True
Explanation: In severe obstructive sleep apnea, patients may stop breathing repeatedly during sleep, significantly lowering oxygen levels while you sleep and affecting heart health.

12. The best treatment for obstructive sleep apnea is the same for everyone.
➡ False
Explanation: Treatment for sleep apnea depends on the severity, cause, and the patient’s specific needs. Options include oral appliances, CPAP machines, or lifestyle changes, and the treatment of obstructive sleep apnea is individualized.

13. If you have a high BMI and snore loudly, you may be more likely to have sleep apnea.
➡ True
Explanation: A higher BMI, loud snoring, and pauses in breathing during sleep are all common indicators that a person is likely to have sleep apnea—especially obstructive sleep apnea in adults.

14. The goal of treatment is to cure sleep apnea completely.
➡ False
Explanation: While some treatments may significantly reduce symptoms, the primary goal is to manage obstructive sleep apnea, improve restorative sleep, and ease your symptoms, not necessarily cure it entirely.

15. People with sleep apnea often have severe disruptions in their sleep cycle.
➡ True
Explanation: Sleep apnea often results in frequent awakenings, even if you’re not aware of them. This leads to a lack of restorative sleep, which affects overall health and energy levels.

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