A new clinic at Touro College of Dental Medicine, led by pioneering expert Dr. Lauren Levi, is helping sufferers find relief.

Here, Dr. Levi answers some commonly asked questions about sleep apnea and explains the connection between the condition and facial pain.

Has sleep apnea become more common than ever over the last 10 years? How many people in America suffer from it?

It hasn’t become more common, but it has definitely become more commonly diagnosed over the last decade. I would attribute this to increased awareness, advancement in diagnostic techniques and the growing prevalence of risk factors such as obesity.

The number of people in the U.S. with sleep apnea is around 30 million, and it is estimated that 70-80% of moderate to severe cases remain undiagnosed.

What are the health risks/dangers of having untreated sleep apnea?

Untreated sleep apnea is associated with a variety of serious health complications, including cardiovascular disease, stroke, depression, diabetes, hypertension and increased risk of accidents due to daytime sleepiness.

What happens to a person’s breathing when he or she has sleep apnea?

When people have sleep apnea, their breathing is repeatedly interrupted during sleep. These pauses in breathing, known as apneas, can last for several seconds to a minute and occur when the airway becomes blocked or when the brain doesn’t send the proper signals to the muscles that control breathing. As a result, the person may experience reduced oxygen levels, frequent awakening, and poor sleep quality. The most common type, obstructive sleep apnea (OSA), happens when the muscles in the throat relax too much and the tongue collapses on the airway, blocking airflow. This leads to loud snoring, gasping or choking during sleep.

What is the connection between sleep apnea and facial pain?

Sleep apnea and facial pain are often interconnected in various ways, especially in the context of orofacial pain and temporomandibular joint (TMJ) disorders. Here’s how they relate:

Bruxism and TMJ: People with sleep apnea often experience sleep bruxism (teeth grinding) which is associated with TMJ. We don’t totally understand why people grind their teeth at night but we believe those with sleep apnea may be doing so to protect their airway. By moving their jaw in different directions, they may be trying to pull their tongue out of the airway. TMJ may cause facial pain, jaw discomfort, headaches and ear pain.

Oxygen Deprivation: Sleep apnea deprives the body of oxygen during sleep, which may trigger headaches and facial pain upon waking. In fact, sleep apnea headache is defined by the international classification of headache disorders as, “Morning headache with a duration of less than fpur hours, caused by sleep apnea. The disorder resolves with successful treatment of the sleep apnea.”

Patients with facial pain often have sleep disorders. In many cases, treating these disorders helps treat their facial pain as well.

Most people use the CPAP machine to treat sleep apnea. You’re recommending a dental device. Can you describe the oral appliance and how it works to treat sleep apnea?

While CPAP (Continuous Positive Airway Pressure) machines are the most commonly prescribed treatment for sleep apnea, oral appliances are an effective alternative for many patients, particularly those with mild to moderate obstructive sleep apnea (OSA). An oral appliance, often called a mandibular advancement device (MAD), is a custom-fitted dental device worn during sleep. The primary function of an oral appliance is to prevent the airway from collapsing during sleep by repositioning the lower jaw. The devices are titratable, meaning that some of them simply prevent the lower jaw from falling back and others posture the lower jaw forward. By repositioning the lower jaw, the device also prevents the tongue from collapsing on the airway. By stabilizing the airway and keeping it open, the oral appliance helps reduce the frequency and severity of apnea episodes, allowing for smoother breathing during sleep.

Many patients find oral appliances more comfortable and easier to use than CPAP machines, especially when traveling. Unlike CPAP machines, oral appliances are silent, which can improve sleep quality for both the user and their bed partner. Additionally, oral appliances are non-invasive and often easier for many patients to adjust to compared to CPAP.

Does this oral appliance work for everyone with sleep apnea or is the CPAP machine ideal for certain types of patients?

Oral appliances work best for individuals with mild to moderate obstructive sleep apnea. They do not work for individuals with central sleep apnea, and they are not as effective for severe obstructive sleep apnea. Sometimes, in individuals with severe obstructive sleep apnea, patients may have combination therapy which means that they use a CPAP and an oral appliance.

What do you offer at the clinic at Touro College of Dental Medicine? How can people reach you?

We provide a multidisciplinary approach to treating sleep-related breathing disorders including snoring and sleep apnea as well as a variety of head and neck pain conditions including facial pain, TMJ pain and primary headache disorders. Regarding sleep, we work with a team to provide individualized treatment plans for each patient and fabricate mandibular advancement devices for the treatment of obstructive sleep apnea.

You can call the Touro Dental Health patient clinic at 914-862-7313 or contact Dr. Lauren Levi at llevi2@touro.edu

They can look to the American Board of Orofacial Pain and the American Academy of Orofacial Pain. The board has a directory of all board-certified orofacial pain specialists, and the American Academy of Orofacial Pain is a different organization but is closely related to the board. It is the sponsoring organization for the specialty of orofacial pain.

Dr. Lauren Levi, is an expert in sleep apnea and facial pain is Director of Orofacial Pain, Headache and Sleep, and Assistant Professor of Dental Medicine at Touro College of Dental Medicine.