Resumo
If you snore and wake up tired even after plenty of sleep, there is an explanation and it has a name. Snoring is the sound of air squeezing through while you sleep, and people who snore often wake dozens of times a night without knowing it. That is why eight hours in bed do not turn into rest. This piece shows how to recognise it, what to do and in what order.
You sleep eight hours and wake as though you had slept three.
Someone has complained about your snoring, or has moved to another room because of it. In the afternoon the sleepiness hits and you cover it with coffee. And you have got used to it, because it has always been this way.
It does not have to be.
If three of these sound like you, read on
- Someone complains about your snoringOr has already moved rooms because of it
- You wake tired even after plenty of sleepEight hours in bed and the feeling of not having rested
- Sleepiness in the middle of the dayNodding off at the television, in meetings, at a red light
- You wake with a dry mouth or a sore throatYou breathed through your mouth all night
- Headache right on wakingThe kind that fades an hour after you get up
- You get up several times to go to the bathroomFar more connected to sleep than people imagine
- You grind your teeth or wake with a locked jawSnoring and bruxism often appear together
- Someone has seen you stop breathing in your sleepThat one alone is enough to seek help
What happens while you sleep
When we sleep, the muscles relax. The tongue and the tissues of the throat fall back a little, and the passage of air narrows. Air squeezes through and vibrates whatever is in the way. That sound is snoring.
So far it may be only noise. The problem is when the passage closes so far that air stops getting through for a few seconds. The body registers the missing oxygen and wakes you just slightly, enough for you to breathe again and remember nothing the next day.
This can happen dozens of times a night. You spent eight hours in bed, but you did not get eight hours of sleep. That is what is called obstructive sleep apnoea, and that is the explanation for the tiredness that never lifts.
Sao Paulo Epidemiologic Sleep Study, 2010
Not every snore is apnoea. There is snoring that really is just snoring. But one in three is too many people for you to assume yours is only noise.
If you recognised yourself in the list above, it is worth finding out what is happening in your nights.
Quer avaliar o seu caso?
A consulta com a Dra. Debora Ayala dura uma hora e meia e começa por ouvir o que você observou.
Alameda Lorena, 1.304 · Jardim Paulista, São Paulo
Why the jaw comes into this
Your jaw holds up your tongue. When it falls back during sleep, the tongue goes with it and the airway closes further. That is why many people snore more on their back: gravity helps it close.
This is where dentistry comes in. There is an appliance, worn only for sleeping, that holds the jaw slightly forward and keeps the airway open. It is made to fit your mouth and adjusted gradually, millimetre by millimetre, until it finds the position that works without hurting the joint.
Worth knowing before you buy anything
Those ready-made devices sold online make no such adjustment and do not respect your bite. And an appliance that repositions the jaw every night can move your teeth over time. That is not a reason to avoid treatment, it is a reason to have it done by someone who follows it up.
The right order
This part is short and it matters, because many people do it out of order and lose time.
- First, a sleep assessment with a physician. It is the study that says whether your case is simple snoring or whether apnoea is involved, and how severe. Nobody works that out by looking at you, myself included.
- With the result in hand, the treatment is decided. It may be CPAP, the air mask, which is the first option when apnoea is more severe. It may be the custom appliance, which is the way out for people who cannot get on with the mask or prefer another route. That is a great many people.
- If it is the appliance, that part is mine. I assess your bite and your jaw joint, plan it, make it and follow it up.
Do not put this off if
Someone has seen you stop breathing in your sleep. You wake up choking. You feel sleepy enough to nod off at the wheel. You have high blood pressure that is hard to control.
In those cases a sleep assessment is not optional. If you do not know where to start, write to me and I will point you.
How the appointment works here
The appointment is with me, and it lasts an hour and a half. Not with an assistant. In it I assess your bite, the jaw joint and the muscles, and we talk through what you have been feeling in your nights.
If you have not had a sleep study yet, come anyway. We will guide you on that step. If you have had one, bring the result.
What to bring
The list from the start of this piece, with what you recognised · your sleep study, if you have had one · a list of your medicines · any appliance or night guard you already wear, even an old one.
Treatment is private. We do not work with insurance plans.
An hour and a half, with me, to understand your nights from the start. You can book on WhatsApp.
Frequently asked questions
Why do I wake up tired even after plenty of sleep?
Because people who snore can have their breathing interrupted during the night. Each time, the body wakes you slightly so you breathe again, and you do not remember it the next day. You spent eight hours in bed, but you did not get eight hours of sleep.
Does everyone who snores have sleep apnoea?
No. There is snoring that is just snoring. But it is common: in the largest study carried out in Sao Paulo, with full overnight testing, 32.8% of the city’s adults had obstructive sleep apnoea. Only a sleep study tells one case from the other.
How do I find out whether my case is serious?
With a sleep assessment carried out by a physician. It is the study that shows whether apnoea is present and how severe it is. Nobody works that out by looking at you.
What does a dentist have to do with snoring?
The jaw holds up the tongue. When it falls back during sleep, the airway closes further. There is an appliance worn only for sleeping that holds the jaw forward and keeps that passage open. It is custom-made, adjusted gradually and followed up by the dentist.
Do those devices sold online work?
They do not make the gradual adjustment the treatment requires and they do not respect your bite. An appliance that repositions the jaw every night can move your teeth over time, which is exactly why follow-up exists.
Does the clinic take insurance?
No. Treatment is private.
Uma hora e meia, com a própria dentista
- Avaliação funcional completa da mordida e da articulação
- Scanner digital e exames de imagem quando indicados
- Um plano explicado antes de qualquer coisa começar
Alameda Lorena, 1.304 · Jardim Paulista, São Paulo
References
- Tufik S., Santos-Silva R., Taddei J. A., Bittencourt L. R. A. Obstructive Sleep Apnea Syndrome in the Sao Paulo Epidemiologic Sleep Study. Sleep Medicine, 2010; 11(5):441-446. pubmed.ncbi.nlm.nih.gov/20362502
- Ramar K., Dort L. C., Katz S. G. et al. Clinical Practice Guideline for the Treatment of Obstructive Sleep Apnea and Snoring with Oral Appliance Therapy: An Update for 2015. Journal of Clinical Sleep Medicine, 2015; 11(7):773-827. pmc.ncbi.nlm.nih.gov/articles/PMC4481062
