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Sleep Apnea

logomark Sleep Apnea

Obstructive Sleep Apnea (OSA) occurs during sleep when the tongue and soft palate collapse onto the back of the throat. This blocks the upper airway, causing air flow to stop. When the oxygen level drops low enough, the brain moves out of deep sleep and the individual partially awakens. The airway then contracts and opens, causing the obstruction in the throat to clear. The flow of air starts again, usually with a loud gasp a.k.a. ‘Snoring’. When the air flow starts again, you then move back into a deep sleep. The airway muscles collapse, as you awaken with a gasp. The airway clears once again as the process repeats itself. This snoring scenario may occur many times during the night.

The combination of low oxygen levels and fragmented sleep are the major contributors to most of the ill effects that the sleep apnea patient suffers. In addition to excessive daytime sleepiness, studies show that sleep apnea patients are much more likely to suffer from heart problems (heart attack, congestive heart failure, and hypertension), strokes, and personality changes such as irritability or depression, as well as having a higher incidence of work related and driving related accidents.


Since OSA is a serious medical condition, it must be diagnosed by a physician.

Diagnosis is based on the results of an overnight sleep study.

CPAP is an acronym for Continuous Positive Airway Pressure and is pressurized air generated from a bedside machine.

The air is delivered through a tube, connected to a mask, covering the nose and/or mouth. The CPAP opens the airway like air into a balloon; when air is blown into the balloon, it opens and gets wider. This is exactly how CPAP clears the airway.

CPAP is sometimes effective for sleep apnea and is considered the gold standard for treatment. However, some people just can not adjust to the apparatus or they travel-for-business and it difficult to bring everything along with them. In this case, alternative treatment modalities need to be considered.

Alternate Treatment to Conventional CPAP Machines

SOMNOMED-PRODUCT-IMAGE-CLASSICOral appliances are worn in the mouth to treat snoring and OSA. These devices are similar to orthodontic retainers or sports mouth guards.

These appliance then attempt to maintain an opened, unobstructed airway in the throat.

Oral appliances work in several ways:

  • Repositioning the lower jaw and tongue
  • Stabilizing the lower jaw and tongue
  • Increasing the muscle tone of the tongue

Dr. Tobias has training in Oral Appliance Therapy and is familiar with the various designs of appliances. He will work with your physician as part of the medical team in your diagnosis, treatment, and on-going care. Determination of proper therapy can only be made by joint consultation with your physician and Dr. Tobias.