By Inna Gellerman
How well you sleep at night has a big effect on how you feel during waking hours.
Despite myths to the contrary, older adults do need as much sleep as other adults. However, sleep is often more difficult for aging individuals. Insomnia and anxiety are problems for many, while others find sleep is made difficult by medications that they take. Sleep apnea and restless leg syndrome, along with needing to visit the bathroom frequently during the night, are also unfortunately common experiences for older adults.
The problem with CPAP
The first step in dealing with sleep disorders is to have a complete medical checkup. There may be other issues contributing to sleeping disruptions, such as a heart problem interfering with proper breathing.
A diagnosis of sleep apnea often results in a doctor prescribing the use of a CPAP, or Continuous Positive Airway Pressure, machine. This is a machine with a face mask that is used to deliver a steady stream of air during the night. Originally developed to assist newborn infants who were having difficulty breathing, in recent years, the CPAP machine has become a common treatment for sleep apnea.
Unfortunately, for many people, CPAP devices present more problems than solutions. Some find wearing the mask and being hooked up to a hose extremely uncomfortable and cannot sleep while using the device. For others, spouses are unable to sleep because of the steady hum caused by the machine.
A simple solution
Older adults can find relief from sleep apnea through the use of a simple device, called a mandibular oral appliance, worn in the mouth during the night. These devices can be prescribed by an orthodontist or a primary care physician, who may refer an individual with sleep apnea to an orthodontist.
It's not necessary to undergo a sleep study to receive a mandibular oral appliance, as these devices are not as intrusive as the CPAP system. These appliances are available from orthodontists with advanced training in sleep apnea therapy.
The mandibular oral appliance looks a little like a mouthguard, and is custom-fitted to an individual's mouth to ensure that it will be effective and comfortable. It fits over the upper and lower dental arches and, through the use of a hinge, opens the upper and lower jaw very slightly, which positions the jaw and allows the muscles in the face and the neck to relax.
This slight opening allows the air passage ways to remain open during the night, and makes night time breathing easier.
A similar device allows the doctor to set a specific size opening for the patient's mouth. Any sleep apnea device must be made to measure, based on the exact size and shape of the patient's jaws and oral cavity.
There are two potentially negative factors to consider when thinking about a mandibular oral appliance. First, these dental devices will require the patient to bring them in, periodically, so that the orthodontist can ensure that the appliance has not changed in shape or size through use. Second, the use of a mandibular oral appliance may cause an older adult to experience dry mouth or dry lips because their mouths are being held open throughout the night. However, the benefits of improved oxygen flow during a sound sleep often outweigh these inconveniences.
Dr. Inna Gellerman of Inna Gellerman, DDS is a board certified orthodontist and a diplomat of the American Board of Orthodontics. She uses innovative techniques to bring personalized care to each of her patients in the Huntington area.