No one likes to be told that they snore loudly. It can be a serious inconvenience for your bed partner and a source of embarrassment for you. But did you know that snoring is often a sign that you suffer from sleep apnea? This serious health condition impacts about 12 million people across the country and can place you at risk of other serious disorders if it is not treated properly.
What Is Obstructive Sleep Apnea?
Obstructive sleep apnea is the most common form of sleep apnea. This type of sleep apnea occurs when the muscles in the back of the throat relax. Because they support all of the surrounding tissues, such as the tonsils and side walls of the throat, when these muscles relax these tissues can collapse inward, narrowing the airway or completely blocking it. In some people their tongue can also fall backward a bit, blocking the upper airway. In others, the airway tissues simply aren’t rigid enough and collapse on themselves. When we’re awake, our brains make sure our tongue stays out of the way and it makes sure we keep the muscles involved with our airway rigid. And, of course, we’re not lying down so gravity doesn’t play a part. But when we’re asleep, our brain isn’t paying attention, until it is forced to rouse the person because the airflow has been blocked.
What Happens If Sleep Apnea Is Left Untreated?
Over time, obstructive sleep apnea can place you at a greater risk of developing conditions such as:
- Stroke
- Heart attack
- Cardiac arrhythmia
- Diabetes
- High blood pressure
- Fibromyalgia
- Gastric reflux
- Depression
Diagnosing Sleep Apnea
Dr. Fleschler will evaluate your symptoms and you’ll be asked to provide a sleep history/sleep diary. You’ll need help from a spouse or partner for this.
From there, evaluation will likely include overnight monitoring at a sleep center, or possibly a home sleep test will suffice. These are the two typical tests used to detect sleep apnea:
. Nocturnal Polysomnography
— At a sleep center, you are hooked up to equipment that monitors your heart, lung, and brain activity. It also records breathing patterns, arm and leg movements, and blood oxygen levels while you sleep.
. Home Sleep Tests
— Testing may be able to be done at home by using portable monitoring devices. These devices provide simplified testing, usually of your heart rate, blood oxygen level, airflow, and breathing patterns.
In certain situations, Dr. Fleschler may work with a local sleep center to more accurately diagnose the cause of your condition.
Symptoms Of Sleep Apnea
The most common symptom of sleep apnea is loud snoring. Other warning signs that you may suffer from this condition include:
- Chronic fatigue
- Daytime sleepiness
- Waking up with a choking or gasping sensation
- Reduced sex drive
- Weight gain
- Headaches in the morning
- Short term memory problems
- Difficulty concentrating
- Insomnia
- Sore throat or dry mouth
If you suffer from one or more of these symptoms, Dr. Fleschler can perform a sleep evaluation to determine whether sleep apnea is the cause.
Sleep Apnea Treatment Options
Once we have performed a thorough diagnostic exam, Dr. Fleschler will devise a customized sleep apnea treatment plan based on your unique condition. For mild cases of sleep apnea, you may be able to alleviate the condition by making minor lifestyle adjustments.
However, for more serious cases, Dr. Fleschler may recommend one of the following treatments:
- Oral appliance therapy
- CPAP (continuous positive airway pressure)
- Positional sleep therapy
- Surgery
Oral Appliance Therapy
With oral appliance therapy, you will wear a customized mouthpiece during sleep to maintain an open airway. These FDA-approved devices perform several important functions to prevent your soft tissue from collapsing and blocking your airway:
- Stabilize your tongue and jaw to eliminate any airway obstructions
- Reposition your soft palate, tongue, and lower jaw
- Support your muscles to help prevent a collapse of your airway
Dr. Fleschler typically prefers oral appliance therapy as her sleep apnea treatment method of choice due to the effective results that can be achieved.
CPAP
For decades, CPAP (continuous positive airway pressure) was considered the gold standard for sleep apnea treatment. It is a device that uses a mask worn over your nose and mouth to deliver a constant flow of air pressure while you sleep. This air pressure helps keep your airway open all night.
While CPAP is an effective sleep apnea treatment method, many patients find the device to be rather uncomfortable and as a result, don’t use it as often as necessary to achieve their desired results. For this reason, Dr. Fleschler will often recommend oral appliance therapy before trying CPAP.
Treatment Options For Mild Cases Of Sleep Apnea
If you only suffer from a mild case of sleep apnea, Dr. Fleschler may simply recommend a series of lifestyle adjustments to keep your airway open while you sleep. These often include:
- Cutting back on alcohol consumption
- Quitting smoking
- Losing weight
- Modifying your sleeping position so that you are on your side instead of your back
- Eliminating heavy meals right before bedtime
- Using additional pillows to elevate your head and facilitate breathing while you sleep
In more severe cases of sleep apnea, these lifestyle adjustments may not be effective on their own. In these situations, Dr. Fleschler may explore other treatment options as well.
Surgical Sleep Apnea Treatment
If sleep apnea patients don’t respond to oral appliance therapy, CPAP, or other non-surgical treatments, surgery may be necessary. Surgery is tailored to the area of obstruction in each particular patient. These areas of obstruction can be anywhere in the upper respiratory tract, including the nose, tongue, and throat. Here are the most common surgical approaches, along with brief descriptions:
. Nasal Surgery
— The septum, tubinates, and the nasal valve often contribute to obstruction. Surgery may straighten out the septum and reduce the size of the turbinates. If the nasal valve is weak and tends to collapse, cartilage can be placed to strengthen it.
. Uvulopalatopharyngoplasty
— This procedure is the most common surgery. It removes tissue from the soft palate and the pharynx. It will also remove the tonsils, if they still remain.
. Soft Palate Implants
— Three polyester rods are placed into the soft palate to stiffen it.
. Hyoid Advancement
— This procedure repositions the small hyoid bone to keep the tongue from falling back and obstructing the airway.
. Tongue Advancement
— This procedure involves advancing one of the main tongue muscles forward.
. Tongue Base Reduction
— The base of the tongue can be reduced, either by using repeated treatment with radiofrequency waves or by excision.
. Lower Jaw Advancement
— This complicated procedure achieves enlargement of the entire upper airway through expansion of the skeletal framework that encircles the airway.
Who Is a Good Candidate for Oral Appliance Therapy?
Oral appliance therapy is ideal for people with mild to moderate obstructive sleep apnea or those who can’t tolerate CPAP. It’s also a great option for frequent travelers or anyone who wants a quiet, comfortable, and portable treatment. Candidates should have healthy teeth and gums, since the device fits over the dental arches. After an evaluation, Dr. Fleschler will determine whether this therapy is the right fit for your needs.
How Oral Appliance Therapy Works (Step-by-Step)
Oral appliance therapy involves more than simply wearing a mouthpiece—it is a structured, customized treatment process designed to restore proper airway function during sleep. Here’s what the typical treatment journey looks like:
- Comprehensive Evaluation - Dr. Fleschler reviews your sleep study results, symptoms, and airway anatomy to confirm that oral appliance therapy is suitable for your condition.
- Precise Impressions or Digital Scanning - Detailed measurements are taken to design a custom-fitted appliance that aligns comfortably with your bite and supports your airway effectively.
- Appliance Fabrication - Your personalized device is created in a dental laboratory using high-quality, medical-grade materials.
- Fitting Appointment - Once the appliance arrives, Dr. Fleschler ensures it fits properly, makes any necessary adjustments, and explains how to insert, remove, and care for it.
- Adjustment Period - Over several weeks, minor refinements may be made to optimize comfort and airway support as your body adapts to wearing the device at night.
- Follow-Up Visits - Regular check-ins allow Dr. Fleschler to monitor effectiveness, track symptom improvements, and maintain proper function and fit.
- Confirmatory Sleep Testing - A follow-up sleep test may be recommended to verify that the appliance is successfully reducing apnea events and improving sleep quality.
Sleep Apnea vs. Snoring: What’s the Difference?
While snoring is a common symptom of sleep apnea, the two conditions are not the same. Simple snoring occurs when airflow causes soft tissues in the throat to vibrate. It may be bothersome, but it does not necessarily interrupt breathing.
With obstructive sleep apnea, the airway keeps collapsing throughout the night, causing frequent breathing stoppages. This prevents your body from getting enough oxygen and interrupts the deep, restorative sleep your health depends on.
Key differences include:
- Snoring is a noise; sleep apnea is a medical condition.
- Snoring does not always require treatment; sleep apnea almost always does.
- Sleep apnea causes fragmented sleep, fatigue, and long-term health risks; snoring typically does not.
If snoring is accompanied by gasping, choking, pauses in breathing, or daytime sleepiness, it may be a sign of underlying apnea.
Sleep Apnea FAQs
See What Our Patients Are Saying:
“I love Dr. Fleschler’s work, her office, and employees. I never wait long to be taken back for treatment. When I’m in the back I’m made really comfortable by her hygienist/assistant. I love this place!”
–Thresa P.
Why Choose Dr. Heather F. Fleschler for Sleep Apnea Treatment?
Dr. Heather F. Fleschler provides sleep apnea care backed by advanced training, respected credentials, and deep ties to the Houston community.
A Meyerland and Bellaire native, she earned her B.S. from the University of Texas at Austin and her D.D.S. from the University of Texas, Houston Dental Branch with honors in restorative dentistry, public health, and patient management. She completed a General Practice Residency and has continued extensive post-graduate education throughout her career. Dr. Fleschler is a Fellow of the Academy of General Dentistry, an achievement earned by fewer than 7 percent of dentists nationwide, and a Fellow of the Las Vegas Institute for Advanced Dental Studies.
Her advanced background in airway, neuromuscular, and comprehensive dentistry allows her to deliver effective, evidence-based solutions for patients struggling with sleep apnea.
Schedule A Consultation
Dr. Heather Fleschler understands the serious risks associated with sleep apnea, and she can help you devise a treatment plan that will alleviate the condition, restoring a restful night's sleep. Please call 713-660-6500 today to schedule a consultation. Dr. Fleschler serves patients in the West University, Bellaire, River Oaks, and Meyerland areas of Houston.
