How Sleep Apnea Affects Your Oral Health
Although they seem like different topics, sleep apnea and oral health are closely connected. The first signs of the disorder can often be seen in the mouth, such as tooth wear, swollen gums, or bruxism.
Bruxism can be a body response to the effort to keep the airway open; dry mouth is also observed since many people with apnea sleep with their mouths open due to difficulty breathing through the nose.
Types of Sleep Apnea
Obstructive Sleep Apnea (OSA)
Obstructive sleep apnea is the most common type, it occurs when the throat muscles relax excessively during sleep, causing a partial or complete airway collapse; this blocks airflow despite the person making breathing efforts.
The pauses can last several seconds and are often accompanied by loud snoring or gasping when breathing resumes; it is more common in overweight people, those who sleep on their backs, or those with anatomical problems such as a small jaw or enlarged tonsils.
Central Sleep Apnea (CSA)
Central sleep apnea is less common and has a different cause in this case; the problem isn't a physical obstruction but rather a problem in the communication between the brain and the muscles responsible for breathing. The brain doesn't correctly send signals indicating when to inhale and exhale, resulting in pauses in breathing.
It is often related to neurological conditions, heart failure, or the use of certain medications. People with central apnea may not snore and usually experience frequent awakenings with a feeling of shortness of breath.
Mixed/complex sleep apnea (CompSAS)
Mixed or complex sleep apnea is a combination of obstructive sleep apnea (OSA) and central sleep apnea (CSA) it begins as obstructive apnea, where the airway is physically blocked. After starting treatment—usually with a CPAP machine—central apneas appear, meaning that the brain temporarily stops sending respiratory signals.
Symptoms may include persistent fatigue, morning headaches, irregular breathing patterns, and difficulty adapting to CPAP therapy. Unlike pure obstructive apnea, snoring may be less intense in mixed cases.
Most Common Causes of Sleep Apnea
The most common triggers include obesity, narrowing of the airways, alcohol and tobacco use, and poor sleeping posture. A misaligned jaw can partially obstruct the airways and cause interruptions in breathing. Sleeping on your back can worsen symptoms because gravity increases the likelihood of airway collapse.
Genetic traits also influence the risk of sleep apnea; people with a small jaw, large tongue, or enlarged tonsils may have obstructed airways. In children, inflammation of the tonsils or adenoids is one of the leading causes of obstructive sleep apnea. This condition is often treated by removing the tonsils to restore normal breathing during sleep.
Other Contributing Factors Include:
Aging: As people age, their throat muscles weaken, causing their airways to collapse more easily during sleep. This increases the risk of apnea, which is often overlooked or misdiagnosed in older adults.
Nasal Congestion: Blocked nasal passages from allergies or a deviated septum force you to breathe through your mouth, which increases the risk of airway collapse and disrupts airflow during sleep.
Endocrine Disorders: Hormonal conditions such as hypothyroidism and PCOS can cause weight gain and tissue swelling, both of which increase the risk of obstructive sleep apnea.
Use of Sedatives: Sedatives significantly relax the throat muscles and delay the brain's response to low oxygen levels, which worsens apnea episodes and reduces natural airway protection during sleep.
Understanding the root cause is key to selecting the proper treatment—from lifestyle changes and oral appliances to surgery or CPAP therapy.
How is Sleep Apnea Diagnosed And Symptoms you Shouldn't Ignore
Diagnosis typically starts with a sleep study called polysomnography, conducted in a sleep center; it records breathing, oxygen levels, heart rhythm, and brain waves overnight. At-home sleep tests are an option for some patients, and dentists can also identify physical signs and recommend further medical evaluation if needed.
If you snore loudly, wake up with a headache, or feel fatigued during the day, you could suffer from sleep apnea. Another key sign is dry mouth upon waking, which is directly related to mouth breathing during the night.
Other common symptoms include irritability, difficulty concentrating, and excessive sleepiness in everyday activities such as reading, watching TV, or even driving; these indicators affect your quality of life and your work or school performance.
Long-Term Consequences if Left Untreated
Untreated sleep apnea can seriously damage your health over time, significantly increasing the risk of high blood pressure, as the constant decrease in oxygen forces the heart to work harder and this extra effort can lead to heart attacks, arrhythmias, and strokes. Sleep apnea is also closely related to type 2 diabetes, as lack of sleep affects insulin regulation, which worsens blood sugar control.
The risk of depression, anxiety, and memory loss also increases due to chronic sleep fragmentation and lack of oxygen to the brain. Mouth breathing associated with sleep apnea can lead to dry mouth, which reduces saliva's protective function and increases the risk of cavities, gum disease, and bad breath.
Sleep Apnea Treatment
A standard dental treatment is the occlusal splint or night guard. While occlusal splints are used to manage teeth grinding, specific oral appliances like mandibular advancement devices are used to treat sleep apnea by repositioning the jaw to help maintain an open airway and improve airflow during sleep. These appliances are custom-made by dentists to ensure a comfortable, precise fit and can significantly reduce apnea symptoms in mild to moderate cases.
Unlike CPAP machines, oral appliances are quiet, portable, and easily adapted. Many patients notice less snoring, more restful sleep, and improved daytime energy after consistent use; dentists work closely with sleep specialists to monitor progress and adjust for long-term success.
