59 “M y family complains that they can’t sleep because of my snoring.” “I don’t feel refreshed after a night’s sleep and feel exhausted all day.” “I cannot work properly because of daytime drowsiness, although I feel I sleep enough.” Snoring is known to cause sleep deprivation for both snor - ers and the people around them, more a bad sleeping habit than anything else. More recently, however, experts have pointed to snoring as the culprit for such issues as chronic headaches, hypertension, stroke and arrhythmia, making it a condition requiring active treatment. Snoring and obstructive sleep apnea The familiar, intermittent sounds of snoring are caused by the vibration of respiratory structures due to ob- structed air movement through the nose while sleeping. Heavy snorers may have excessively relaxed muscles surrounding their airways, or their airways may become temporarily blocked. Some snorers suffer from a condition known as ob- structive sleep apnea, which occurs when snorers stop breathing for more than 10 seconds and five times per hour during sleep. Post-menopausal women and men above their 40s are at an increased risk for this condition, especially those who are obese or who sleep after drinking. The brains of those who have obstructive sleep apnea will be woken up often due to lack of oxygen supply during sleep. This leads to the most common symptom, exces - sive daytime drowsiness, though prolonged stretches of sleep apnea may cause strains on one’s heart and lungs and lead to serious complications such as hypertension, strokes, cardiac failure and even sudden death during sleep. Diagnosis of snoring and obstructive sleep apnea Snoring and obstructive sleep apnea show a higher prev- alence among people who are obese, or have receding chins, large tongues or enlarged tonsils, though the in- cidence rate increases with age. A questionnaire is used to check the severity of a patient’s sleep apnea, and a polysomnography is performed to confirm the diagnosis. Treatment of snoring and obstructive sleep apnea Light snoring and sleep apnea are treatable by shift - ing one’s daily habits such as sleeping sideways, losing weight, ceasing al- cohol consumption or smoking, and exercising regularly. In severe cases, a continuous positive airway pressure ma- chine, oral appliance or surgery are thwe main treatment options. Among these, the CPAP machine is known to be the most effective, but is reported by some to require an adjustment period before sleeping becomes comfortable again. Oral appliances show a similar level of effectiveness as a CPAP machine and are easier to use, have fewer complica- tions and are thus recommended as a treatment of choice. Oral appliance therapy for snoring and obstructive sleep apnea A mandibular advancement device is the most frequently used oral appliance, advancing the lower jaw up to 50-70 percent of its maximum protrusion and thereby indirectly pulling the tongue forward. This widens the area behind the tongue and stabilizes pharyngeal space, thus prevent - ing airway obstruction. Prior to treatment, a patient’s sleeping habits should be monitored using polysomnography and a physical exam - ination should be performed to ensure the feasibility of oral appliance therapy. Regular follow-ups should be car- ried out afterward to address any existing symptoms while wearing oral appliances would aid in effective therapy. oral appliance therapy for snoring and obstructive sleep apnea Talking about causes and exploring treatment options For more information or reservations, call Ms. Kelly Soe, the English coordinator at Yonsei University Dental Hospital. +82 2 2228 8998 +82 2 363 0396 idc@yuhs.ac 50-1 Yonsei-ro, Seodaemun-gu, Seoul www.yuhs.or.kr/ en/hospitals/dent_ hospital/Conserv_ dentist/Intro COLuMN • YonsEi UniVERsiTY DEnTal HospiTal Hyung Joon Ahn, DDS, Ph.D. Dept. of Orofacial Pain & Oral Medicine Yonsei University College of Dentistry