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Is It FDA Approved or FDA Cleared?

While learning about snoring mouthpieces, you have probably seen advertisements stating that a product is “FDA approved” or “FDA cleared”. Technically speaking, the FDA doesn’t necessarily approve any mouthpieces. While this term is often used loosely by advertisers, “FDA Approved” wording is actually prohibited from being used all together. Most sellers unknowingly use this term in lieu of the correct term which is actually FDA cleared.

However, not just anyone can receive FDA clearance. There’s a certain process that must be followed in order to obtain this badge.

Manufacturers are typically required to register their device and submit a premarket notification 510(k).  Snoring mouthpieces are considered a class II medical device and are typically cleared by the FDA on the basis of being substantially equivalent to a product that is similar and has already received clearance.  Once FDA clearance is obtained, the manufacturer can sell their product and use the term “FDA Cleared” in their marketing.

Why is Being FDA Cleared So Important?

What’s the significance of choosing a product that has been cleared by the FDA? Does it really matter if a mouthpiece is FDA cleared?

The FDA is responsible for protecting public health and safety. Mandibular Advancement Devices, such as the snoring mouthpiece are considered class 2 devices and are regulated by the FDA. There is an application process that must be followed before bringing a product to market. The manufacturer must submit information to the FDA which is carefully examined before a determination is made. If the FDA gives the manufacturer the green light, they are then able to sell their product to the public.

If you purchase a product that has not been cleared by the FDA, you will never know if the mouthpiece that you put inside of your mouth each night is made from a medical grade plastic and it may even contain toxins. You will be spending several hours each night wearing your mouthpiece, so you probably want to ensure that the mouthguard that you are using has been carefully examined by an agency such as the FDA. In countries outside of the US, agencies such as the European Commission and Australian Register of Therapeutic Goods serve a similar purpose as the FDA.

How Do You Ensure That A Mouthpiece Is FDA Cleared?

When shopping for a mouthpiece, you see if the words “FDA Cleared” are written within an ad. Do you stop there and take their word for it? Probably not. Before making a decision it’s a good idea to search the FDA Establishment Registration and Device listing database. First, try searching for the brand. If you are unable to locate a match, try searching the database for the manufacturer’s name.  If you are still not able to locate a product, email the company and ask them to provide their registration number which is typically 10 digits in length.

Before being able to purchase a snoring mouthpiece, you actually must obtain a prescription from a physician. In many cases, getting a prescription is rather simple and can actually be accomplished by answering a few screening questions prior to being able to complete the purchase. If these questions are answered correctly, you can proceed with the transaction. In a case where the questions were not answered to satisfaction, you will not be able to proceed.

With every mouthpiece sold in the US, a prescription must be generated.

One clue as to whether or not a product is a registered device is to look for a questionnaire when checking out. If one does not appear before the final checkout, it’s likely not a US registered product.

Choosing a product that has been cleared by the FDA is one of many items that you should consider before making a buying decision. There are a number of other factors to consider. Take some time reading product reviews in order to familiarize yourself with what’s available.

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Is It FDA Approved or FDA Cleared? While learning about snoring mouthpieces, you have probably seen advertisements stating that a product is “FDA approved” or “FDA cleared”. Technically speaking, the FDA doesn’t necessarily approve any mouthpieces. While this term is often used loosely by advertisers, “FDA Approved” wording is actually prohibited from being used all together. […] Read more

Snoring & Sleep Apnea – How is it Causing my Child to Snore?

Common Reasons Why Children Snore

There are many reasons why infants and children snore.  Most of the time, children snore because of congestion from a cold or infection, however, snoring may be an indicator of a more serious condition such as sleep apnea.  Whatever the case may be, stopping the snoring should be a priority for parents.  The first step should be alerting and visiting your doctor or pediatrician.  Children who snore can experience life-altering side effects from snoring such as growth halts, behavioral issues, and having a weakened immune system.  Let’s get to the bottom of how it all starts.

Enlarged Tonsils

Enlarged tonsils and adenoids are 2 of the most common reasons infants and children snore.  The tonsils are located in the back of your mouth on either side.  They fight infection and filter out microscopic germs.  Many children are repeatedly diagnosed with strep throat in their younger years and strep can cause the tonsils to enlarge, get red, and make an already sore throat even more painful.  When the tonsils enlarge, they block the flow of air down the airway, which creates the soft tissues in the throat to vibrate, since the air is forcing its way through the passageway.  The sound of these fatty tissues vibrating is known as the sound of snoring.  It’s common for children, of all ages, to snore when they are sick, not just because they are congested, but due to inflammation that may be occurring in the tonsils and adenoids.

Enlarged Adenoids

Adenoids are soft tissues located behind the nasal cavity.  They, like the tonsils, act as a filter in the body and catch germs that may be inhaled before they enter the body.  If the adenoids are working overtime to fight off an infection, the adenoids may swell slightly.  If swelling occurs, they may block the flow of air down the throat through the nose.  If there is a blockage in the airway, snoring commonly occurs.

Children Who Are at Risk of Sleep Apnea

If your child does not have an infection or illness, it’s possible that the snoring is coming from a more serious condition called sleep apnea.  Sleep apnea occurs during the night when your body momentarily stops breathing and there is no oxygen entering your body.  Snoring is one of the most common indicators of sleep apnea.  There are several risks of developing sleep apnea in children who are obese, have unusually small jaws, have down syndrome, are between the ages of 2-6.

Obese Children

Children that are obese may snore as a side effect of sleep apnea.  When you are obese, at any age, you can develop extra fatty tissues in the neck and throat.  The extra tissues block the entryway for air to pass into the lungs, thus limiting oxygen into the body and brain.  A study from 2010 suggested that 46% of obese children were diagnosed with obstructive sleep apnea.

Those with small jaws

Small and petite children can often have a smaller frame and bone structures than other children.  If a child’s jaw is very small, the tongue can recede into the back of the throat farther than usual during the night.  If this occurs, it can create a blockage in the airway.  The back of the throat where the tongue relaxes is the most common area of airway blockage with people who have sleep apnea.

Children with Down Syndrome

Children with Down Syndrome are 60% more likely to develop and be diagnosed with sleep apnea.  The reason is simply based on the anatomy of children who have Down Syndrome.  Typically these children lack muscle tone in the mouth and throat, which leaves flabby, fatty tissues lining the throat.  These tissues can create an airway blockage and also produce a loud sounding snore.

Children between the ages of 2 and 6

Children who are between the ages of 2 and 6 are more at risk of snoring.  This is mainly due to the fact that children in this age range typically start daycare or school and are more susceptible to germs and illnesses nearby.  The more they are exposed to germs and viruses, the more likely they are to get sick and experience inflammation in the nose and throat which will cause snoring.

How Sleep Apnea and Snoring Can Effect Children

Raising children can be difficult and problematic enough as it is, but throwing in the side effects of having sleep apnea from your little one can be even more stressful.

Extreme Daytime Drowsiness

Your child may experience extreme tiredness throughout the day, which can lead to an unpleasant day for the parents and child.  When you experience sleep apnea and constant snoring throughout the night, your brain does not receive the correct amount of oxygen that provides a solid night’s sleep.  Instead, you wake up hundreds of times throughout the night, usually completely unaware due to falling immediately back to sleep, and your body does not fully rest.

Snoring

Snoring is the most common side effect of sleep apnea.  When the airway is blocked in the back of your throat, the tissues in your mouth start to vibrate.  When the vibration occurs, the sound of snoring begins.  The more fatty tissues that line your throat and mouth, the louder the sound of snoring.

Behavioral Problems

Behavioral issues can also occur in children who experience sleep apnea.  This can also relate to the child not getting enough sleep and they can be grumpy and difficult to deal with.  More serious behavioral problems can also occur because children need oxygen in order to continue to grow into healthy adolescents and adults.  If oxygen is deprived to the brain constantly and goes unnoticed for months or years, this can impact their ability to learn, act, and associate with peers and adults.

Sleeping in awkward Positions

Many children who snore or have sleep apnea often sleep in very awkward positions.  This may be due to the fact that their body is subconsciously positioning the neck back so that air can flow down their airway.  When a child wakes up in the middle of the night due to sleep apnea and tries to gasp for air, they may toss and turn into a weird sleeping position and then immediately fall back asleep, most of the time not even realizing they woke up.

Wetting the Bed

If your child is potty trained and unexpectedly wets the bed, it may be a sign they have sleep apnea.  Oxygen is cut off from the brain when a child has sleep apnea and lack of oxygen can stop or halt certain neurological impulses that control body functions.  In this case, the impulse that triggers the child that they need to use the restroom could be misfiring, resulting in the child wetting the bed.

Weak Immune System

Snoring and sleep apnea prohibit children and adults from getting a good night’s sleep.  This can be extremely detrimental to the immune system and cause it to weaken.  Children need their sleep in order to stay healthy and if they have sleep apnea or snore on a regular basis, this could lead to a chronic history of infections and viruses.

Halt or Impact Growth

Alongside a weakened immune system, children can also experience a delay in growth if they have sleep apnea.  Oxygen is critical to keep the body healthy and grow during a child’s youth.  Sleep apnea prohibits the child from a steady flow of oxygen during sleep and this can significantly halt growth spurts and physical and mental development.

What to do if my child has sleep apnea?

If your child snores and you are wondering if sleep apnea is the culprit, there are several things you can do.

Go to your doctor

First and foremost, go visit your doctor or pediatrician immediately.  It’s a small price to pay in order to keep your child’s health and development in check.

Consult your ENT doctor

If you think you need a second opinion, consult an ENT doctor.  They can shed more light on the specifics of how and why your child snores.  They can provide details on the anatomy of your child’s throat and if there is any evidence of inflammation or infection that might be blocking the flow of air.  It’s possible that a deviated septum in the nose may also be blocking the intake of air through the nasal cavity.

Ask for a sleep study

It’s not uncommon for children and adults to undergo a sleep study.  In fact, sleep studies can now be performed in the comfort of your own home.  This option may be a better fit for your child because you can administer the study in their crib or bed at home instead of scaring them with an overnight stay at a sleep study center.  These studies have come a long way in recent years and many simply involve wearing a finger clip monitor and a few discrete sensors.

Treatments for children with sleep apnea

There are several ways to treat children with sleep apnea and your child’s physician will suggest the option that is right for you and your child.  The most common treatments for children with sleep apnea include:

  • Tonsillectomy
  • Adenoidectomy
  • Weightloss
  • CPAP treatment

It’s crucial to take action as soon as you witness your child snoring.  The reason may be as simple as them having a cold or respiratory infection which is creating a temporary blockage in their throat.  However, it’s strongly encouraged to consult with your doctor to determine the underlying cause of the snoring, preventative measures to stop it, and an effective treatment plan if it does seem to continue.

 

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Snoring & Sleep Apnea – How is it Causing my Child to Snore? Common Reasons Why Children Snore There are many reasons why infants and children snore.  Most of the time, children snore because of congestion from a cold or infection, however, snoring may be an indicator of a more serious condition such as sleep […] Read more

For over a decade, smartphone apps have changed the way that we go about our daily lives. There is a smartphone app for nearly everything from fitness to communication, travel, and thousands of tools that are designed to make life much easier.

Pop quiz – Name an activity that occurs every night and involves over 90 million Americans? Here’s a hint: it’s an activity that many do not even realize they are doing.  If you guessed snoring, you would be correct. The issue with snoring is that the only way that one can determine if they snore and the intensity in which they snore is to rely on their partner or roommate’s feedback. The other option is to place a sound recorder next to your bed and spend hours listening to the playback. But wait, there is an app for that. Actually, there are several.

How Does A Phone App Help to Stop Snoring?

You may be wondering exactly how an app is going to help with a snoring problem. Such apps are generally used to monitor the frequency and intensity of snoring. They help to establish a baseline in which can be used to determine the effectiveness when corrective action is taken.

For instance, after using an app for several days you may discover that your snoring intensity is high (let’s say an 8 out of 10). Knowing this, you decide to give positional therapy a try and monitor your snoring for the next few nights. The app indicates that your snoring intensity is now rated at 5 out of 10, which is a significant improvement. From there, you can try to further reduce your snoring by experimenting with a number of different methods.

Phone Apps That Help Monitor Snoring

SnoreLab

SnoreLab App

SnoreLab by Reviva Softworks Ltd. is one of the more popular sound recording apps that provides insight into one’s snoring habits. Their claim is that they are the number one snoring app and have over 1 million nightly users.

This app tracks snoring overtime and allows one to see just how intense their snoring is. It generates a spectrogram which gives a visual display of snoring loudness over a specified period of time.

The app assigns what’s called “snore score” which helps to quantify the amount of time spent snoring. It tracks the amount of time that is spent sleeping as well as time spent snoring. The amount of time spent snoring is expressed as a percentage of the total time tracked. The user also has the ability to indicate which type of remedy is being used on a particular night such as a positional therapy or the use of a snoring mouthpiece.  It also allows the user input factors that affect snoring such as alcohol use or blocked nasal passages.

All information collected is stored and analyzed to help paint a picture one’s snoring problem.

The app itself is free, however, there are certain features that are only accessible to paid users. The cost may add up to $2.99-$6.99 per item.

Reviews

Google Play shows that SnoreLab currently has over 6,300 reviews. Of these reviews, 84% are either 4 or 5 star.

Most of the positive reviews mention that the app helps them to realize that their snoring was more than just snoring but rather what was later diagnosed with Obstructive Sleep Apnea. Others describe their experience with the app as “eye-opening”.

As for the negative feedback, the majority of dissatisfied users cited the fact that the unpaid version only allows you to record every other night. Other complaints include that the app will record the sound of your snoring but requires you to upgrade to the premium version in order to review the recording.

The Verdict 

Overall, the SnoreLab seems to be an app worthy of trying. If you have a good experience with the free trial, it seems reasonable that one may update to the “premium” version.

Snore Clock

Snore Clock by Ralph Schiffhauer is another popular snoring app that was awarded app of the month by MIT technology. The features of this product are similar to that of SnoreLab, although Snore Clock does not assign a snore score.

The app will indicate whether or not your or your partner snores, as well as if you talk in your sleep. It also has a feature that will let you know if your sleep is disrupted.

The Snore Clock records up to 11 hours throughout the night and runs quietly in the background of your smartphone.

Visual depictions of snoring are displayed on the screen and recorded sound can be reviewed as well as shared.

While the app is free, an upgraded version of the app can be purchased for $3.99 which offers ad-free use, ability to store sound to an SD card and the ability to set sound or a vibration to be played when snoring is detected.

Reviews

There are currently over 500k installs and over 3400 reviews of this app. 68% of reviews are either four or five star.

While many people praised this app and found it to be useful in identifying snoring, others complain of recordings that stop and it being too ad heavy.

The Verdict

While this app does seem to have its problems, it’s worth giving a try as the developer has made note that the bugs have been worked out. As for purchasing the premium version, this may be of value if you would like to completely avoid ads.

Do I Snore or Grind

Do I Snore or Grind (yes, that’s the name of the app) by Sleep.ai.B.V. combines the ability to detect both teeth grinding and snoring. This app allows you to choose your desired mode – snoring, grinding or both. When activated, it listens throughout the night and uses an algorithm to determine whether the sounds coming from your bedroom are snoring or teeth grinding while filtering all other sound.

Like the other apps, it enables you to specify when a corrective action is taken. This allows you review the data and determine the effect of your action.

The app has a feature that will sound an alarm or vibrate when teeth grinding or snoring is detected.

The developer notes that the app works best with devices that were released after January 2014.

Reviews

There are currently just over 1,100 reviews of this app with over 50k installs.  Of the 1,100, ninety percent of users rated the app at either 4 or 5 star.

Overall, there’s an overwhelming number of users who have a favorable opinion of this app, citing that it works well and has helped them to identify their snoring and make changes to correct it.

There seem to be a few complaints involving bugs that cause the app to crash. It’s possible that these issues may have been resolved by now.

The Verdict

With 90% of users reporting a positive experience, this is one app worth checking out. While it’s the least popular of the three mentioned, it does have the highest percentage of 4 and 5 star reviews.

Using a Snoring App to Determine Effectiveness of a Snoring Mouthpiece

While there are a number of different reasons why someone may use a snoring app, determining the effectiveness of a snoring mouthpiece is perhaps one of the most popular. If you are not familiar with the benefits of a mouthpiece, you can find an abundance of information here. Simply stated, a snoring mouthpiece is placed inside of the mouth prior to falling to sleep. It is designed to hold the jaw and or tongue forward which helps to clear the airway and prevent snoring. Years of clinical research has proven such products to be effective in treating snoring.

Why would you want to determine the effectiveness of a snoring mouthpiece using an app?

Many mouthpiece manufacturers offer their product on a trial basis which allows you to test their product. An app allows you to quantify the results without having to rely on your spouse to make this determination. If the app shows no improvement in snoring, you can always return it and receive a refund.

 

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For over a decade, smartphone apps have changed the way that we go about our daily lives. There is a smartphone app for nearly everything from fitness to communication, travel, and thousands of tools that are designed to make life much easier. Pop quiz – Name an activity that occurs every night and involves over […] Read more

Do Anti Snoring Pillows Work?

One product that is often mentioned is the anti-snoring pillow. In recent years, numerous snoring pillows have entered the market, capturing the attention of millions of snorers from all around.

Until recently, we have only explored snoring mouthpieces which as it turns out, are highly effective. What about the snoring pillows? Is it a viable snoring solution?

How Does a Snoring Pillow Work?

When asleep on your back, gravity has a tendency to allow the jaw and tongue to relax and fall into the airway. As a result, breathing can become restricted and snoring occurs as fast-moving air moves through a narrowed airway. The restriction becomes greater and the snoring becomes louder as we fall into a deep sleep. The use of alcohol and sedatives can further compound this issue.

The effectiveness of the snoring pillow greatly depends on the type of pillow that is being used.

Types of Snoring Pillows

Anti snoring pillows come in many different forms. When describing what they are, it’s easiest to categorize them into one of two categories – Standard Pillows and Smart Pillows.

Standard Snoring Pillows 

Standard snoring pillows come in a variety of different shapes, sizes, and materials. They are designed to help facilitate sleeping on one’s side. How does side sleeping help to prevent snoring?

A surprising number of snorers are considered positional snorers, meaning that they only snore in a certain position, usually while on their back. By remaining on one’s side while asleep, snoring can be reduced or completely eliminated. A standard snoring pillow does just that – it makes side sleeping more comfortable.

The standard snoring pillow is often made from a memory foam material and is shaped in a number of different ways. Some are u-shaped, some are wedge-shaped, others have cutouts that allow your arm to pass through. Some pillows are referred to as a pregnancy pillow because they are designed to keep women on their side during pregnancy.

Then there are other pillows which are designed to allow you to sleep on your back while keeping your neck straight and avoid pinching off the airway.

Examples of such product brands include the Brookstone, Obus Forme, Snore-no-more, Contour, Silentnight, SONA, snoreEzzz, Beautyrest, Celliant sleep, Science of Sleep, Sharper Image, and Tri-Core.

Such pillows can be purchased for well under $100, with the average price being somewhere around $40.

Smart Snoring Pillows

In recent years, we have seen nearly every product transformed into a “smart” version which promises to deliver better results in comparison to its predecessor by making adjustments, collecting information, and storing it on a smartphone app. The snoring pillow is no exception.

How do you go about turning something as simple as a pillow into a smart device?

While the overall design differs from one product to another, they all seem to work in a similar fashion.

Microphones or sound sensors are placed within the pillow or nearby which constantly monitor the sound of snoring. When the sound of snoring is detected, the pillow reacts by moving to either arouse the snorer or reposition their head.

The mechanism used to reposition the head is typically an air bladder which inflates or deflates based how the snorer responds. Some smart pillows only have one air chambers that are used to move the head either up or down while others have multiple chambers which can actually turn the head to the left or right.

Responding to snoring by changing the position of the head is helpful, but how does one understand exactly how effective the smart pillow is? This is where smartphone apps come in handy.

Most smart pillows are offered with a smartphone app. Typically, the smart pillow connects to your phone via Bluetooth connection. When this happens, an abundance of information is stored on your phone which allows you to see the results. Some app software allows you to establish a baseline before use which will allow you to compare the results after being used.

Since this technology is relatively new, there are very few product currently available. The Smart Nora and GoodNite pillow from Nitetronic are two of the only smart pillows currently available, both of which I have tested myself.

As for price, smart snoring pillows are significantly more expensive than standard snoring pillows, due to the complexity of the components contained within the pillow such as the sensors, air chambers, a pump, and computer processor. The average price of a smart pillow is around $300.

Do Anti-Snoring Pillows Really Work?

The idea behind the anti-snoring pillow seems plausible but the question is, do anti-snoring pillows really work?

The general idea behind using a standard snoring pillow is that it helps to make side-sleeping more comfortable. Studies have shown that side sleeping (positional therapy) can be effective in many cases. While using a specialty pillow will make side sleeping more comfortable, the pillow itself generally doesn’t stop the snoring per se, sleeping on one’s side does. The same results can be achieved by using a regular pillow. Special “snoring” pillows do however serve their own purpose of assisting with side sleeping.

A smart pillow on the other hand monitors and makes adjustments to the head and neck using slow movement which can physically interrupt snoring.  With a single air chamber model, the movement of the head is just enough to arouse the airway while not enough to awake the snorer. A multi-chamber pillow actually moves the head which alters the structure of the airway and creates a clear path. As mentioned, I have a couple smart pillows and the results were rather impressive.

While I’m able to see the value in both types of pillows in terms of reducing snoring, the smart snoring pillow seems to add more value in comparison to a standard snoring pillow. Here’s a review of both the Smart Nora and GoodNite pillow if you are interested in reading more.

Should I Buy a Snoring Pillow?

Preventing snoring by swapping out your pillow seems to be an attractive option for most people. It can be inexpensive and effective.  For positional snorers, which accounts for about 50% of those who snore, sleeping on one’s side using a standard snoring pillow can help. Positional snorers, as well as other snorers, can benefit from the use of a smart pillow which tackles the issue from a different angle.

Taking price into account, positional snorers who are willing to sleep on their side may be better off choosing a standard snoring pillow. Those unable to sleep on their side or non-positional snorers may choose a smart pillow instead, although they are considerably more expensive.

How can you tell if you are a positional snorer? Determine this by simply sleeping on your side and asking your partner or a close friend to observe your snoring. If your snoring stops, it’s reasonable to assume that you can correct the issue of snoring by simply sleeping on your side.

While both types of anti-snoring pillows are able to assist with snoring, I still prefer to use a snoring mouthpiece instead. I have been a fan of these mouthguards for several years for a number of reasons, mostly because they work and are fairly inexpensive. You simply insert one into your mouth which holds the jaw forward and tightens the airway to prevent collapse. You can learn more about the different types of mouthpiece available here.

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One product that is often mentioned is the anti-snoring pillow. In recent years, numerous snoring pillows have entered the market, capturing the attention of millions of snorers from all around. Until recently, we have only explored snoring mouthpieces which as it turns out, are highly effective. What about the snoring pillows? Is it a viable […] Read more

One Downside Of Snoring Mouthpieces

Open mouth snoring causes issues for mouthpiece users

There are perhaps thousands of anti-snoring products that are currently on the market, some of which are downright bizarre. Throughout the years, the snoring mouthpiece and chinstrap have remained two of the most popular over the counter snoring solutions, each being sold by a number of different manufacturers.

The snoring mouthpiece stops snoring by holding the jaw forward which clears the airway while a snoring chinstrap holds the jaw closed but does not necessarily exert much pressure to prevent the jaw falling back into the airway which can cause a blockage. While chinstraps are useful in some circumstances, they are not nearly as effective as some of the other stops snoring products that are being sold.

Snoring mouthpieces have been around since the mid-1990’s and have grown in popularity ever since. New mouthpieces enter the market every year, some innovative while others are simply another spin-off of products from the past. In recent years we have seen advancements in mandibular advancement splints. We have even seen a completely new design emerge, classified as a tongue stabilizing device which works by holding the tongue forward instead of the jaw.

While technology has advanced, one common complaint often expressed is the issue of keeping a mouthpiece in throughout the night. In fact, having a mouthpiece fall out during the night is one of the most common complaints that is often expressed. Some mouthguards, such as the SleepTight have made an extra effort to design their product so that it would remain in the mouth throughout the night, however, the majority of devices all seem to share the same flaw.

The solution to address this issue may be easier than you think.

The Solution: A Chinstrap to Hold The Snoring Mouthpiece In

While not exactly it’s intended use, some mouthpiece users have found that a chinstrap can serve as a useful tool when it comes to holding a mouthpiece in.

The reason why snoring mouthpieces tend to fall out is that they often do not fit tightly and as we sleep, the jaw drops. When the jaw drops, this provides the perfect opportunity for a mouthpiece to fall out. The solution is to prevent fallout by holding the jaw closed with the mouthpiece inserted. Exactly how is this accomplished? If you guessed with a chinstrap, you would be correct.

Due to the elastic nature of neoprene material that is used in most chinstraps, these headbands have taken on an entirely new purpose which is to help hold a mouthpiece in. The key is to choose two products that work well together.

When choosing a mouthpiece, it is very important to select one that has holes at the front which will allow for proper breathing. Most of the mouthpieces today offer a breathing hole feature, although not all products are created equally. Some have larger holes while others are smaller which can cause a restricted airflow.  The best rule of thumb is to select a  mouthpiece that has a large breathing hole that will allow for adequate airflow.  You will also want to consider the overall design of the mouthpiece which should fit snugly against the teeth when molded. Other considerations should be whether a product is FDA approved, the material that is made from, and the warranty that comes with it.

Selecting a chin strap is much easier simply because there are not so many considerations. The chin strap should be soft and flexible as well as large enough to comfortably fit around your head. The better-designed chin straps will wrap around your chin and then connect to the back of your head with holes cut out for the ears.

After choosing a chinstrap and mouthpiece combo that’s a good fit for you, give the mouthpiece a try by itself to see how often it falls out while asleep. Afterwards, you can try using the two together. You will likely notice that using the two together works well.

Which Mouthpieces Require a Chinstrap?

Generally speaking, most OTC mouthguards can benefit from the use of a chinstrap. This is especially true for products such as the zQuiet and the VitalSleep. The reason being is that they do not fit very tightly which makes them more likely to fall out while asleep. This is also true for a number of other mouthpieces.  The easiest way to decide is to use the mouthpiece for a few nights. If you are waking up with it next to your pillow, using a chinstrap to keep it in may be a good idea.

If falling out is not an issue, there is, of course, no need to wear a chinstrap.

Will A Chinstrap By Itself Stop Snoring?

You might be wondering if it’s possible to completely forgo the mouthpiece all together and just use a chinstrap. Is this even a possibility?

While there’s certainly no shortage of chinstraps on the market that claims to put an end to your snoring, in my experience, they do not seem to deliver as promised when used as a standalone unit. The reason behind this has to do with the mechanics behind the chinstrap. Simply stated, the positioning along with the elastic nature of the chinstrap actually supports the jaw by holding it up, but it does not help by preventing the jaw from falling back and closing off the airway. This function is best served by a boil and bite style mouthguard which actually keep the jaw forward and in place. Once in place, a chinstrap will help by preventing the mouth from opening while sound asleep.

Chinstrap Use With CPAP

In addition to holding the mouth closed and preventing oral appliances from falling out, a chinstrap can also be used to hold the mouth closed in order to make CPAP nasal pillows more effective. A common complaint among CPAP users is that their mouth opens while using a nasal pillow which can dramatically decrease efficiency and cause dry mouth. The solution is to hold the jaw closed in order to prevent air from escaping. The elastic nature of the chinstrap acts as a giant rubber band that is used secure the jaw closed. The chinstrap can be used with a variety of different equipment, so take a close look at the design to determine if it’s going to work well with the equipment that you currently use. Some chinstraps are specially designed to accommodate CPAP users.

Concluding Thoughts

The combination of a mouthpiece along with a chinstrap is a little-known secret that can be used by anyone who is experiencing difficulty keeping their mouthpiece in at night. If you are considering a mouthpiece and have concerns about it falling out or already own one and could use a little help keeping it in, a chinstrap is an excellent solution.

There’s a large variety of different chinstraps to choose from and they come in many different colors. As for cost, they are fairly inexpensive. One can be purchased on average at a cost of around $20. Philips Respironics makes one that is quite popular. If you haven’t already purchased a mouthpiece, they can be found in combo packs which include both items in one package.

Alternatively, you can search for a mouthguard that fits tightly, which will help to prevent fall out from occurring.

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One Downside Of Snoring Mouthpieces There are perhaps thousands of anti-snoring products that are currently on the market, some of which are downright bizarre. Throughout the years, the snoring mouthpiece and chinstrap have remained two of the most popular over the counter snoring solutions, each being sold by a number of different manufacturers. The snoring […] Read more


4.5 Star Rating

Nitetronic – The Manufacturer of The GoodNite Anti-Snoring Pillow

Nitetronic, the company behind the Goodnite anti snore pillow, claims to be the first and the only clinically proven anti-snoring smart pillow currently on the market. The German-based company was established in 2012 and their product was an instant success in Europe.

Nitetronic is based out of Hamburg, Germany where all of the research and development was performed. Their manufacturing facility is located in Shanghai China. What started out as a small company in 2012 has now spread globally with distribution centers in Canada, Thailand, Japan, Hong Kong, China, Netherlands, and Europe. On August 1st, 2016, the GoodNite pillow was introduced to the United States and Canada when the company opened Nitetronic America LLC in Upland, California.

The first generation GoodNite Pillow was released in 2012 and in January 2016, an improved second generation Goodnite pillow was released which offers improvements in comfort as well as advancements in the algorithm which controls the pillow and an updated version of the app – NiteLink2.

About the GoodNite Smart Pillow

Nitetronic Goodnite Anti-snore pillow with retail packagingAt first glance, the GoodNite Pillow may seem a bit daunting. The unit contains a pillow with a hose exiting from it which connects to a control box. In addition, there is a smartphone app that is also used.

My first reaction was “Wow, how the heck does this thing stop snoring?” After reading and digesting all the information that I could find online, I was no longer intimidated by this pillow but rather intrigued, as I was then able to see exactly how such a device could actually work. As it turns out, the unit is able to operate independently from the phone app, although the app does offer valuable information as well as provides evidence that the pillow is actually working by recording how much you snore throughout the night along with a plethora of other information. It establishes a baseline by recording snoring habits for three nights prior to activation. This allows you to perform a before and after analysis to determine whether or not the Goodnite pillow is effective.

The Anatomy of The GoodNite – How The GoodNite Works

How GoodNite Pillow worksThe GoodNite is a queen size pillow, measuring 24″ X 14.5″ X 3″. The pillow can be fitted with a standard pillowcase which can be exchanged to keep it clean and fresh.

Inside the pillow, there’s a polyester filled pocket on both the top and bottom face of the pillow. In the middle, is the working parts of the pillow which are responsible for monitoring snoring and head position as well as inflating the air chambers.

What makes this pillow unique is the fact that there are six individually controlled air chambers that run horizontally along the full length of the pillow. Each chamber has three bags that are stacked on top of each other. Also within the pillow is a series of MEMS sensors which are able to detect the noise and vibration associated with snoring. With the machine turned on, these sensors are constantly listening for the sound of snoring. When snoring is detected, the sensors deliver the message to the control unit informing it of the snoring and the exact head position. The control unit then responds by activating the built-in air pump which delivers air through the tubing into one or more of the six air chambers. The end result is that the chambers slowly inflate where needed and the head is slowly shifted to the side which opens the airway and stops the snoring. The sensors continue monitoring and making adjustments throughout the night. This design is unique in comparison to other inflatable smart pillows that I have seen which are only capable of raising or lowering the head and contain only a single air chamber which does not necessarily shift the head left or right.

An initial concern that I had with this product was that the constant slow movement of my head would keep me up all night.

Within the Goodnite study (mentioned below), it was stated in the conclusion that there was  “no deterioration of the sleep and breathing sleep disturbances” related to the active head position changes. In other words, the head movements are gentle enough not to wake you up. My fears were put to rest knowing that this information was coming from an actual published study which was conducted in a sleep lab using sophisticated equipment that monitors breathing, heart rate, brain wave activity, etc.

Why Does It Work?

How it worksThe technology behind the Goodnite pillow is indeed fascinating but this leaves one very important question – How does slowly moving the head to the side while asleep prevent snoring?

While asleep, the tongue, as well as other muscles within the airway, tend to relax and fall back which often obstructs the airway. This problem is more prevalent in those who are overweight and are older. While breathing through an obstructed airway, oxygen is forced through this narrow obstructed opening and tissue within the airway begins to collide which in turn causes the sound of snoring.

A surprising number of snorers can treat their snoring by simply moving their body or head to one side which permits free breathing. This is possible because moving the head to one side reduces the effects of gravity on the airway. This is referred to as positional therapy and is the reason why a smart pillow may be effective.

Not convinced? Try this: relax, lay back and mimic the sound of snoring. Next, continue to create the snoring sound and slowly shift your head to the left or right. Be sure not to alter the intensity of your “snoring”. When you turned your head, did you notice that the sound of snoring was greatly reduced or even eliminated? If this is the case, this pillow may be a good choice for you.

How Much Does the GoodNite Cost?

Man examining gold dollar signHow much do you expect to pay for such a product? It seems as if a lot of effort and capital have been invested in bringing this device to market, so I wouldn’t expect it to be inexpensive. The retail price for the GoodNite pillow is currently set at $299. Nitetronic does offer free shipping which is, of course, nice considering that it’s a fairly large investment.

In comparison to other product that is similar in nature, the GoodNite is competitively priced.

Risk-Free Trail and Warranty 

Nitetronic backs their product with an impressive 30-night risk-free trial in which they allow you to test their pillow for 30 nights prior to deciding whether to keep it or not. The trial period begins the day that you receive it and ends 30 days later. This will give you enough time to acclimate to a new pillow as well as monitor your progress with their smartphone app. According to Nitetronic, after establishing a baseline with the app, you should notice results the first night that it’s activated and every night thereafter. This guarantee seems fairly generous, considering that this is an expensive piece of equipment that can be returned.

There is one caveat which is that returns are subject to a $50 restocking fee.

The GoodNite pillow is backed by a 1-year limited warranty which begins on the date of purchase and covers defects in material and workmanship while under normal use. The warranty can not be transferred and does not cover abuse, misuse or normal wear and tear. Nitetronic covers return shipping for warranty claims.

Can the Nitetronic Pillow Be Used Instead of A CPAP?

If you are currently using a CPAP to treat Obstructive Sleep Apnea, you may be wondering if the Nitetronic pillow can serve as a replacement for your CPAP. This product has been studied for the treatment of snoring only and not OSA. Because of this, you should not replace your CPAP with the GoodNite pillow. According to the manufacturer, you could potentially use this pillow as a supplement for your CPAP, but not as a replacement. As always, you should first speak with your physician prior to making this decision.

Nitetronic Goodnite Pillow vs Smart Nora

Nitetronic goodnite vs Smart NoraSmart Nora, one of Nitetronic’s only competitors, offers a similar product that’s used to stop snoring. There are however a few key differences between the two.

The first difference has to do with the location of the sensor(s) which monitor the sound of snoring.  The Goodnite pillow has sensors integrated into the pillow which are able to identify snoring as well as locate the position of the head. When the sound of snoring is detected, this information, as well as the position of the head, is transmitted through a wire that is housed within the cord connecting the pillow to the control unit.

In contrast, the Smart Nora uses a “pebble”, which is a small wireless device that is about the size of a computer mouse, to listen for the sound of snoring. It’s placed on the nightstand or mounted directly above the head. When snoring is detected, it sends a wireless signal to the controller which responds as needed. The Nora, however, does not feature head position sensors.

Another key difference between the two has to do with the air bladder which inflates and deflates. With the Nora, a single air chamber inflates and deflates in order to move the head up or down which stimulates the airway just enough to cause it to tighten and prevent snoring.

In contrast, the Goodnite pillow contains six individual air chambers that work together to actually rotate your head from one side to another in order to provide a clear path for air to flow. The pillow sensors detect the sound of snoring as well as head position and use this information to inflate one or six chambers to rotate the head to the left or right.

Finally, the Nora allows you to place their insert inside of your regular pillow while the Goodnite components are integrated into a provided pillow.

These two products do share several similarities. Both smart pillows allow you to easily store the control unit under your bed, both can be used with a smartphone app to track your snoring, and both cost right at $300.

The Nitetronic Clinical Study

people researching with magnifying glassIn the “anti-snoring” industry, very few products have been clinically proven to be effective. There are a number of reasons for this, one being the costs associated with conducting a study. Another reason may be because a product simply does not work. Clinical evidence is a strong selling point for any anti-snoring product.

Prior to conducting a study, an empirical test which included 157 people indicated a 67% reduction in snoring.

In December 2014, Nitetronic Europe GmbH conducted a study to determine the effectiveness of their product, Goodnite. The study was conducted by Dr. Uwe Mehrmann from Nitetronics and supervised by Dr. Joachim T. Maurer at the University ENT Clinic at Mannheim sleep lab.

It was a controlled crossover study that examined how changing the position of the head may affect snoring. Participants stayed overnight in a sleep lab for two consecutive nights during this study. The first night they slept with a pillow that was inactive (did not move) while the second night they slept with an active Goodnite pillow. Participants were both men and women over the age of 18 with a BMI of less than 30.

A polysomnography (PSG) study was conducted and the patients were asked about their experiences.

The results were very convincing. There was a significant decrease in the snoring index when the pillow was being used. The conclusion – the snoring of every patient was greatly reduced and the sleep and breathing-related parameters were unaffected. In other words, it reduced snoring without compromising sleep.

 

My Experience Testing Out the Nitetronic GoodNite Smart Pillow

The Nitetronic clinical study was convincing enough that it persuaded me to try out the Goodnite pillow myself and see how it compared to other snoring treatments that I am familiar with such as the snoring mouthpiece.

The Arrival

Person delivering packages on dollyThe GoodNite Pillow arrived in a large shipping box and was carefully packed inside of a retail box. Once the box was opened, it revealed a soft pillow with a braided line exiting from the center, which contained what I assumed to be the tubing that inflates the air chambers as well as the sensors which pick up the sound of snoring. This line was connected to the control unit which was packed to the right of the pillow in a separate compartment. The package also contained an instructional manual which was written in several different languages.

Before reading over the instructions, I had to know what was inside of the pillow. When I grabbed a hold of it, I noticed that it was very soft and cozy. A zipper on both the left and right sides of the pillow allowed me to take a closer look inside. Inside of the pillow were three additional zippers – one at the top, one at the bottom and one in the center. The upper and lower zipper compartments were filled with an extremely soft polyester material. I noticed that the top portion contained more filler than the bottom which makes sense because if they were filled equally, the profile would be very high.

At the center was the inflatable unit which is responsible for moving the head to prevent snoring. I wanted to take a closer look inside but there was a lock holding the two zippers together. Additionally, there was a tag that read “Do not open”. I was able to hold the unit up to the light and see that there were six distinctive chambers which ran across the entire span of the insert. Additionally, there was a thin piece of perforated foam running across the six air chambers. After examining the pillow, I zipped everything back up and moved on to looking at the rest of the unit.

The braided line leading the pillow measured just over 5′ in length which should be plenty to reach under my bed.

Attached to the braided line was the control unit which contained the brains as well as the working parts such as the pump that sent air through the tubing which inflates and deflates the bags. The control unit is rather large in size, measuring approximately 11″ X 6″ X 3.5″. At one end was the On/Off switch. The braided line exited from the other end and a DC power port was located nearby which allows you to plug into the 5v power adapter that is provided.

The top of the unit had a Bluetooth button which I’m assuming is used to connect the nitetronic pillow to a smartphone. The bottom of the control unit had large rubber feet which help to prevent the unit from easily sliding.

After examining all components, my overall impression was that the Goodnite pillow was well engineered and made from quality materials.

I was anxious to get started but first needed to read over the instructional manual.

The user manual was thicker than expected, but after opening it I quickly realized why. Since the Nitetronic is sold worldwide, the instructions are printed in several different languages. In fact, of the 54 total pages, only 5 pages were printed in English. Surprisingly, the quick start instructions only required 3 steps:

  1. Connect the power supply to the main unit.
  2. Place the pillow on your bed.
  3. Turn on.

I was expecting the setup to take several minutes and require many adjustments, but no – it was ready to use in literally two minutes.

The manual suggested allowing 5-10 nights to become accustomed to sleeping with their pillow. Since I planned on using the Goodnite pillow for several nights, this should allow plenty of time to become adjusted.

Getting Started

As mentioned, the initial setup was quite simple. In order to test it, I recreated the sound of snoring. After three or so loud snores, I suddenly felt my head slowly lifting up on one side. As I continued to make the snoring sound, the air bladder continued to inflate very slowly and my head starts to shift to the side. A few minutes later I tested it again and the opposite side of the pillow inflated, shifting my head the opposite direction. It was interesting to see how the unit responded to the replicated sound of snoring. I also found it interesting how quiet the control unit pump was. The sound was virtually undetectable. Pump noise was a concern of mine at first but this was no longer the case.

Method

When testing the effectiveness of all anti-snoring device, I always spend at least 14 nights putting it to the test to ensure that I’m able to:

  1. Determine if it works and
  2. Discover any issues that may exist.

To start off I decided to test the Nitetronic pillow by itself for the first 3 night, without pairing it with my smartphone. The idea is that this information would be helpful to those who do not own a smartphone or are not interested in using the app.

As for measuring the effectiveness of the Nitetronic without the app,  I’ll have to rely on my wife who sleeps next to me each night. She typically stays up much later than I do, so she will be able to tell me whether or not it’s working within the first ten minutes of me falling asleep.

For the remaining 11 nights, I will measure the effectiveness using the Nitelink2 which is a free app that is available for both Android and Mac users.

The Results

Results

Nights 1-3

Before going to bed, I had turned the control unit on and laid my head at the center of the pillow. The pillow was rather soft and comfortable. I would even go as far as saying that the pillow was more comfortable than the one that I was currently using.

While laying waiting to fall asleep, I didn’t notice the pillow inadvertently activating which was, of course, a good sign.

It wasn’t long before I was sound asleep with my wife monitoring my snoring closely. Within seconds of the start of my snoring, the pillow activated and slowly raised and rotated my head until the sound of snoring slowly diminished. Thereafter, if I started snoring again, the pillow would begin making adjustments in order to silence the sound of snoring.

The first three nights went well. My snoring was kept at bay and my wife had approved.

Nights 4-6

Over the next 3 nights, I decided to test the capabilities of the Nitelink2 app that had I downloaded to my smartphone.

The instructions indicate that you should spend the first three or so nights recording your snoring with the pillow deactivated, meaning that it will inflate or deflate. The enables you to establish a baseline in which you can compare the nights in which the pillow is activated. That being said, I went into the settings and deactivated the pillow. In addition to deactivating the pillow, I had also set a schedule which allowed it to record from my bedtime of around 11 pm until 7 am the following morning.

After the first night, I went back and reviewed all of the data that was collected throughout the night. It was very interesting to see the percentage of the night in which I snored as well as my sleep efficiency and snoring index. The app even kept track of my snoring intensity, snoring count, and the longest snoring. I was somewhat surprised to hear that I was spent so much of my night snoring.

The following two nights in “inactive” mode showed similar data. The data confirmed what I already knew which is that I snore, and I snore a lot.

Nights 7-14

Now that I had established a 3-day baseline, I was curious to see the quantitative results with the pillow activated and compare this information to what to the prior three days. Before going to bed, I went into the settings and reactivated the pillow.

Over the next eight nights, there was a stark difference percentage-wise between the first three nights when it was deactivated and the following eight nights activated. This information was enough to confirm the effectiveness of the Nitetronic Pillow.

Concluding Thoughts and Recommendations

After two weeks of testing GoodNite anti-snoring smart pillow, the results have proven that it’s, in fact, an effective product. During my trial, the Goodnite pillow had proven itself night after night using both observations as well as recorded data.  Overall, I had a great experience which exceeded my expectations. Nitetronics lived up to all of their claims, which is a breath of fresh air in an industry where so many anti-snoring products fail to meet expectations.

As for the $300 price tag, the look, and feel of what you receive justify the cost. It’s a quality product that’s German engineered and well crafted.  If the cost of the Goodnite pillow vs performance is a concern, you can rest assured with a risk-free 30-night trial. This will give you more than enough time to decide if this product is a good fit for you.

One of the most attractive features of the Goodnite pillow is the fact that it’s the only clinically proven anti-snore pillow with smart technology. Being clinically proven is a strong selling point that gives this product credibility.

Weighing Pros and ConsDue to the fact that it’s clinically proven, high quality comes with a risk-free trial and is easy to use, I have decided to give it my highest recommendation when it comes to smart pillow technology.

 

Pros:

  • Easy setup / easy use
  • Clinically proven to work
  • Personally tested and proven effective
  • Non-invasive snoring solution
  • German engineered and well crafted
  • Air pump is virtually silent
  • Offered with a 30-night risk-free trial
  • Allows you to establish a baseline to compare snoring before & after
  • Can be used independently or with smartphone app
  • Inflation systems and sensors are integrated into a comfortable pillow

Cons:

  • $50 restocking fee if returned
  • Not a suitable replacement for CPAP

 

 

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☆☆☆☆☆ 4.5 Star Rating Nitetronic – The Manufacturer of The GoodNite Anti-Snoring Pillow Nitetronic, the company behind the Goodnite anti snore pillow, claims to be the first and the only clinically proven anti-snoring smart pillow currently on the market. The German-based company was established in 2012 and their product was an instant success in Europe. […] Read more

Adaptive Servo Ventilation (ASV) and CPAP Therapy

Snoring is the most common and recognizable symptom of sleep apnea, a serious and sometimes life-threatening sleep disorder.  There are two main types of sleep apnea: obstructive sleep apnea and central sleep apnea.  Both types have several forms of treatment options but the most commonly prescribed and used treatment for both is the use of Positive Airway Pressure therapy or PAP.  There are specific types of PAP units for each type of apnea.  Those with obstructive sleep apnea get treatment from a

CPAP machine and those with central sleep apnea use an Adaptive Servo Ventilation machine. To better understand how the units treat the apneas, it is important to know the difference between OSA and CSA first.

Obstructive Sleep Apnea (OSA)

Obstructive sleep apnea is the most common form of sleep apnea at the moment.  OSA occurs when you stop breathing throughout your sleep in the middle of the night.  The pause in breathing can last for several seconds and can occur up to 100 times in just one night.  This pause in breathing is caused by an obstruction of the airway.  The obstruction could be caused by your tongue relaxing and blocking the flow of air, or it could be related to sinus congestion or excessive phlegm buildup in the throat.  Other causes could be problems with a deviated septum, adenoid issues, or inflamed tonsils.  The most common sign of OSA is loud snoring followed by an abrupt pause in snoring, which is when the body stops breathing, and then followed by a deep breath and loud snore.  This occurs because your body is trying to catch your breath after it has just momentarily paused.

Central Sleep Apnea (CSA)

Central sleep apnea is different from obstructive sleep apnea in that the body stops breathing because there was no signal from the brain telling the respiratory system to breathe.  Central sleep apnea is not as common as OSA but is still just as dangerous.  In both cases, there is a lack of oxygen going into the body and most importantly into the brain.  When the body is lacking oxygen, it, in turn, has an overabundance of carbon dioxide, which leads to several chronic and life-threatening medical conditions.

There are several causes of central sleep apnea:

Being Overweight or Obese

Central sleep apnea can also occur due to you being overweight or obese.  Inflammation and high blood pressure typically fall hand in hand with being overweight.  Both of these conditions can impact the health of your brain and if the nerves happen to misfire at all, it could trigger central sleep apnea to take place.

The Use or Overuse of Narcotics

The use or misuse rather of opioids and narcotics in the United States and Canada has tremendously increased in recent years.  These painkillers will actually numb the nerves not only in specific parts of the body where the pain is being felt but also in areas of the brain.  If brain nerves become paralyzed or numb, then there is no way for the body to signal to the respiratory and nervous systems that it needs to breathe in order to survive.  If you currently are using a prescribed opioid or narcotic medicine and think that you suffer from sleep apnea, you should consult your doctor immediately to reevaluate your condition, as this could be life-threatening.

 

Brain Stem Malfunctions

Since the underlying reason for central sleep apnea involves brain misfires, it’s common for people who suffer from brain diseases, brain infections, spinal issues or stroke to have central sleep apnea.  Any of these conditions can be the reason why the brain does not signal to the body to breathe continuously during the night.

Adaptive Servo Ventilation or ASV

Adaptive Servo Ventilation is specifically designed for people who suffer from central sleep apnea.  This type of therapy is relatively new to the industry and has only been around for a few years.  ASV is noninvasive and is said to be more comfortable and user-friendly than CPAP machines used to treat obstructive sleep apnea.  The difference is that ASV machines continuously change the pressure flow of air based on the actual person’s breathing patterns.

The most common complaint of users with sleep apnea and undergoing PAP therapy is that the patient has to get used to the continuous flow of oxygen – it’s set at one preset flow and may feel unnatural to the user at first.

ASV differs because it actually has ‘smart’ technology and senses one’s breathing patterns and continuously fluctuates the air pressure so that it still promotes the flow of oxygen but is making it more natural for the patient using it.  Since this technology is so new, there are constant studies being performed

on this therapy to ensure its safety and effectiveness.  In May of 2015, researchers found a disturbing correlation between ASV and chronic heart failure.

It is still unknown as to why ASV promotes heart failure, however, it has been recommended to doctors in the industry to avoid suggesting this therapy to people who have chronic hypoventilation, severe lung disease, or neuromuscular disease.

Continuous Positive Airway Pressure or CPAP

CPAP machines have been the gold standard treatment for obstructive sleep apnea as they maintain the constant flow of oxygen in through the nose, down the throat, and then into the lungs.  CPAP machines are not recommended for the treatment of central sleep apnea because people with central sleep apnea usually still tend to breathe throughout the night but their breathes are more shallow and do not fully capture the oxygen needed.  The forced airflow from the CPAP does not really do anything for that kind of patient because the steady stream of airflow still does not signal to the brain that it should be breathing.  The more natural irregular flow of oxygen from the ASV machine is more effective for those who suffer from central sleep apnea.

It’s important to understand the two different types of PAP machines and treatment options available for central sleep apnea and obstructive sleep apnea.  Both therapies are effective as long as you are using the correct PAP device for your apnea.

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Adaptive Servo Ventilation (ASV) and CPAP Therapy Snoring is the most common and recognizable symptom of sleep apnea, a serious and sometimes life-threatening sleep disorder.  There are two main types of sleep apnea: obstructive sleep apnea and central sleep apnea.  Both types have several forms of treatment options but the most commonly prescribed and used […] Read more

The Relationship Between OSA, Arthritis, and Osteoporosis

Only in recent years have we discovered the relationship between snoring, sleep apnea and several medical conditions including heart disease, high blood pressure, anxiety, depression, and ADHD.

We are now learning of two more conditions that are related to snoring and sleep apnea – Osteoporosis, and Osteoarthritis. While snoring itself does not cause either condition, it is one of the most common symptoms of OSA and because it’s so common, it’s often overlooked and does not receive much attention by both patients and physicians.

Let’s examine these three conditions and then discuss how recent medical research has found a link between the three.

What is OSA?

This image illustrates why OSA occurs

Obstructive Sleep Apnea (OSA) is classified as a sleep-related breathing disorder and it affects nearly 25% of adults 30 years and older. The condition occurs when the airway becomes obstructed during sleep which causes breathing pauses and arouses the body to awaken throughout the night in order to stimulate the airway to clear the obstruction and resume normal breathing. This perpetual cycle occurs throughout the night, causing the affected person to wake up feeling tired and lack energy throughout the day.

The issue with OSA is that stopped breathing, even momentarily, causes carbon dioxide levels to rise and oxygen levels to fall which can lead to a number of other conditions.

In addition, the lack of quality sleep leads to daytime sleepiness which has a multi-million dollar economic impact due to lost productivity as well as workplace and auto accidents.

What is Osteoporosis and How Does It Relate To OSA?

Osteoporosis is a common bone disease that occurs when bone density is reduced, causing bones to become weak and brittle. It’s most common in people who are older than 50 and the diagnosis often comes as a surprise after one breaks a bone. It’s estimated that over fifty million Americans are affected by this condition. The disease is more common in women – affecting nearly 50% while only 25% of men are affected.

Injuries that are common in those with Osteoporosis include broken hips, wrist, or spine although breakage can occur in a number of other areas. Serious complications can occur after an older person breaks a hip, which is one of the reasons why this condition should be treated soon after discovery.

Osteoporosis can be detected by conducting a bone density test. When examined closely under a microscope, a normal bone structure appears as a honeycomb with tissues formed tightly together. With Osteoporosis, the “holes” become larger due to tissue loss, resulting in bones that are more prone to breaking.

Recent research has found a strong link between sleep apnea and osteoporosis. The results of the research showed that having sleep apnea may increase your risk of developing Osteoporosis by 2.7 times. ‘

While researchers are not completely sure how the two conditions are related, there are a few theories.

One theory has to do with the acidic environment that is caused by oxygen deprivation. As mentioned earlier, with OSA, breathing stops which causes not only a rise in CO2 but also a drop in blood oxygen levels. When oxygen levels are lowered, it causes inflammation which increases acidity in the body which can promote bone loss.

The other theory has to do with the consequences of lack of quality sleep. During sleep, our bodies go into “repair mode”. With OSA, we never fully achieve deep sleep and heart rhythm can be affected which can cause bone metabolism imbalances and ultimately bone loss.

What is Osteoarthritis & Rheumatoid Arthritis and How Does It Relate To OSA?

Yet another common medical condition is being linked with sleep apnea – Arthritis.

Rheumatoid Arthritis (RA) is the most common form of arthritis and is actually classified as an autoimmune disease that affects an estimated 1.3 million American adults, mostly elderly women.

RA occurs when the body mistakes healthy body tissue as a foreign object and attacks it, resulting in pain, swelling, and eventual bone loss and deformity. While this often occurs in joints such as the hands, it can affect other parts of the body including the heart, lungs, and skin.

Osteoarthritis is another form of arthritis that also results in inflamed joint and discomfort. The primary difference between osteoarthritis and Rheumatoid Arthritis has to do with the cause of the disease.

As mentioned, RA is an autoimmune disease that attacks healthy tissue, resulting in inflammation and pain. In comparison, osteoarthritis is caused by physical wear and tear which also causes inflammation. The key difference here is that osteoarthritis is not an autoimmune disease.

Exactly how are sleep apnea and arthritis related?

Once again, we can not say with complete certainty why the two are related, although there’s at least one theory as to why those with sleep apnea are at higher risk of developing arthritis.

With sleep apnea, pauses in breathing cause inflammation of the blood vessels throughout the body. Over time, this constant inflammation may cause arthritis which can appear in the joints as well as other parts of the body.

What Can I Do to Prevent Osteoporosis and Arthritis Caused By OSA?

While it may be some time before we know exactly why OSA contributes to so many conditions such as arthritis and osteoporosis, we do know that there is a correlation between each. The question is, what can we do to reduce the risk of developing these and other conditions caused by OSA?

The answer is to get screened for OSA if you suspect that you may have this condition. Common symptoms of OSA include the following:

  • Loud snoring
  • Pauses in breathing while sleeping often followed by snoring or gasping for air
  • High blood pressure
  • Daytime Tiredness
  • Nighttime sweats
  • Difficulty concentrating
  • Dry mouth or a sore throat in the morning
  • Morning headaches
  • Mood changes
  • Depression or Anxiety

If you are experiencing any of these symptoms, consult with your doctor who will evaluate the possibility of OSA. Your physician will ask a series of questions to determine if you should visit a sleep specialist for further evaluation. If sleep apnea is likely, you may be asked to perform an overnight sleep study where several sensors will monitor functions such as heart rate, breathing, brain activity, blood oxygen levels, etc.

If it’s determined that sleep apnea is present, you may be prescribed a CPAP machine or Oral appliance to assist with nighttime breathing which helps to prevent apnea events from occurring throughout the night. If you are overweight, your doctor may also help you develop a weight loss plan which is often helpful in treating OSA.

Aside from Osteoporosis and arthritis, OSA can cause several other health conditions. Doctors are only recently paying close attention to this condition as research is showing that OSA is related to so many conditions.

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The Relationship Between OSA, Arthritis, and Osteoporosis Only in recent years have we discovered the relationship between snoring, sleep apnea and several medical conditions including heart disease, high blood pressure, anxiety, depression, and ADHD. We are now learning of two more conditions that are related to snoring and sleep apnea – Osteoporosis, and Osteoarthritis. While […] Read more

Sleep Apnea and Anxiety

Snoring and sleep apnea limit the amount of oxygen to the brain leaving an overage of carbon dioxide which may be linked to anxiety.  When the brain is lacking oxygen, certain areas of the brain become impacted by the oxygen shortage and can trigger anxiety, fear, panic attacks, and depression.  This is a serious issue and a lack of oxygen to the brain occurs when a person has sleep apnea.  Is there a link between snoring, sleep apnea, and anxiety?  Let’s take a closer look at the evidence behind this.

High carbon dioxide levels in the body can increase acidity in the body – specifically in the amygdala.

The amygdala is a piece of gray matter located in the cerebral hemisphere of the brain.  Its main function is to control emotions that include motivation, fear, and stress.  So what does sleep apnea have to do with the amygdala?  First, you must understand what happens during sleep apnea and how oxygen becomes limited to the brain.

Sleep Apnea – Step by Step

You Fall Asleep

Some people use sleep aids in order to fall asleep at night.  These can include alcohol, prescription drugs, or narcotics.  All of these sleep aids may cause you to over-relax, especially if you sleep on your back, and may promote the relaxation of your tongue.

A Blockage in the Airway Occurs

When the tongue relaxes, it rests towards the back of your mouth and actually blocks your airway, prohibiting the flow of oxygen to your body and the brain.  Other airway blockages can occur that do not relate to the tongue.  These include excessive phlegm located in the back of the throat or mouth, congestion in the nose, and excessive fat deposits in the neck due to being overweight or obese.  Whatever reason for the blockage, in one form or the other, it obstructs the flow of oxygen while you sleep.

Snoring Begins

Loud, obnoxious snoring is one of the main indicators that you suffer from sleep apnea.  Snoring is directly related to the obstruction of your airway.  When the blockage of air occurs, again for whatever reason above, it narrows the airway passage that carries oxygen into the lungs and the rest of the body.  Although the passageway is narrow, oxygen is still able to get in, and it finds a way to bypass the obstruction and continue to flow.  The back of the mouth and throat is lined with tiny flabby tissues and when the air flows passed these flabby tissues trying to make its way into the lungs, the tissues start to gently vibrate as you inhale.  The vibrating tissues create a noise as the oxygen flows by and this is the resulting sound of snoring.

Oxygen is Limited to the Brain

The blockage in your airway limits the amount of oxygen flowing into your lungs and causes you to stop breathing for several seconds.  This is commonly witnessed by your partner sleeping next to you.  Since the snoring is usually loud and burdensome, it’s easy for the bed partner to notice the loud snoring and then abruptly hear complete silence.  This moment is when your body has stopped breathing.  The flow of oxygen to the brain has completely stopped. It can be very scary for the bed partner to hear or witness this.  It’s very dangerous and sleep apnea is a serious sleep disorder that needs to be addressed with your doctor.

The Brain Realizes it’s not getting Oxygen

When the flow of oxygen stops, the brain quickly realizes that it has an abundance of carbon dioxide present.  This increases brain acidity and it activates proteins and the amygdala that cause fear and anxiety. The brain activates the nervous system at this point and signals to the respiratory system that it needs to breathe again immediately.

You Wake up Startled, Frightened, and Try to catch your Breath

Once the lungs start to function again, you inhale a deep breath of oxygen and usually awake and sit up frantically gasping for air because your brain signals to you that you were oxygen deprived.  The feeling of fear is also triggered in this moment due to the high acidity levels now present in the brain.  It may take a second or two for you to realize that you couldn’t breathe and then you lay back down.  In some cases though, the person with the sleep apnea takes a loud gasping breath but does not wake up and just continues to sleep and snore again.  When you have sleep apnea, you unknowingly awaken, breathe, forget you woke up to breathe, and then go right back at it again.  This is the most dangerous part of having sleep apnea because if you do not have a bed partner to witness this, you may never know that you snore or stop breathing.

The Process Repeats

Some people who suffer from sleep apnea can stop breathing anywhere from 4-55 times a night, based on the severity of the sleep disorder.

What are the causes of sleep apnea?

There are several reasons why a person develops sleep apnea.  These include:

  • Having large adenoids
  • Having large tonsils
  • Deviated septum
  • Jawbone issues
  • An airway blockage due to:
    • Being obese or overweight
    • Nasal Congestion
    • Relaxed throat muscles
    • Relaxed tongue from sleeping on your back, drinking alcohol, or the use of certain medications

What you can do to stop or prevent snoring and sleep apnea

The first step in preventing snoring and sleep apnea is to consult with your doctor on the matter.  Your physician will refer you to a sleep clinic and you will most likely undergo an overnight or at-home sleep study in order to determine the presence of sleep apnea.  If you do have sleep apnea, there are a series of treatment options available that include CPAP therapy, the use of oral appliances, surgery, or other holistic treatments.

Snoring & Anxiety

As mentioned above, the lack of oxygen passing to the brain can trigger brain matter and proteins to produce unnecessary acids which then impact the amygdala, where fear emotions are managed.  This can lead to anxiety during your night’s sleep but also may progress to short term or long term anxiety issues.  If you are able to have the sleep apnea diagnosed and then treated, the anxiety should disappear, however, may still linger with some patients.  Here is a list of recognizable signs of anxiety below.

Signs of Anxiety

  • excessive and exaggerated worry
  • physical twitches or chest pain that mean no harm medically
  • being overwhelmed by small things or non-issues
  • stress
  • nausea
  • dizziness

When you do not get a deep night’s sleep due to being woken up in the middle of the night from sleep apnea, the nervous system is not fully rested and can create anxious thoughts and feelings that leave you stressed, irritable, or nervous.  Make sure you schedule an appointment with your doctor in order to address any concerns related to sleep apnea, snoring, and anxiety.

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Sleep Apnea and Anxiety Snoring and sleep apnea limit the amount of oxygen to the brain leaving an overage of carbon dioxide which may be linked to anxiety.  When the brain is lacking oxygen, certain areas of the brain become impacted by the oxygen shortage and can trigger anxiety, fear, panic attacks, and depression.  This […] Read more

Routinely waking up each morning with an unexpected headache is a concern that should be appropriately addressed as it may be an indicator of an underlying condition.

While there are a number of possible explanations for morning headaches such as severe high blood pressure, dehydration, hangovers,  bruxism, low blood sugar, and caffeine withdrawal, we are going to examine the possibility of morning headaches that are related to sleep apnea.

If you are experiencing morning headaches, it’s important to speak with your doctor who will be able to help you identify the issue and discuss proper treatment.

How Obstructive Sleep Apnea Can Cause Morning Headaches

Obstructive Sleep Apnea (OSA) is a sleep-related breathing disorder that is characterized by a breathing pause while asleep. This condition is fairly common in the United States, affecting an estimated 18 million American adults. Disturbingly, only a small fraction of those affected are aware of their condition.

Among the long list of symptoms related to OSA is morning headaches which is a fairly common symptom along with daytime tiredness, loud snoring,  and difficulty concentrating. There are several other symptoms that are related to this condition.

What exactly does sleep apnea have to do with morning headaches? As mentioned, with OSA pauses in breathing occur while asleep. This is a result of the flow of air being physically cut off due to an obstruction, hence the “obstructive” portion of OSA. This obstruction can be caused by the relaxing of the airway which occurs when we sleep. Relaxing of the airway is caused by age, weight gain, alcohol, and sedative use, or simply due to how we are genetically built.

An airway obstruction causes breathing to stop.

When an obstruction occurs, air is unable to travel to and from the lungs. Due to the lack of oxygen, the body responds by awakening you (often without you ever remembering in the morning) in order to stimulate the airway which clears the obstruction. This cycle can occur several times per hour which is why those with OSA experience daytime tiredness.

Another consequence of obstructed breathing is the rise of carbon dioxide in the blood and deprived oxygen.

When air is unable to enter the lungs, blood oxygen levels tend to drop. Additionally, air that is unable to escape the lungs due to an obstruction will cause a rise in carbon dioxide levels which is primarily what we breathe out. Carbon dioxide becomes trapped in the lungs and tends to build. As a result, blood vessels within the head begin to dilate which results in morning headaches and migraines. Said backward, morning headaches are the result of dilated blood vessels that are caused by a build-up of CO2 which is caused by lack of oxygen which is caused by an airway obstruction which is caused by age and or extra fat. It’s a vicious compounding cycle that is caused by OSA and often goes undiagnosed.

What Can Be Done to Treat Morning Headaches Caused By OSA?

Treating morning headaches that are caused by OSA is accomplished by treating the root of the problem which is of course OSA. Today’s treatment options often include weight loss, CPAP, and Oral Appliance Therapy. Recently, the American College of Physicians (ACP)  has set new guidelines which place a heavy emphasis on weight loss as a first line treatment option for obstructive sleep apnea. A short summary of each treatment option follows.

Weight Loss

While not all who experience OSA are overweight, a disproportionate number of individuals are. This is clearly demonstrated by the correlation between weight gain in the United States and the rise of sleep apnea.

What exactly does carrying extra weight have to do with sleep apnea?  Carrying extra fat, particularly in the neck area, applies downward pressure on the airway. This is especially true when one sleeps on their back which allows gravity to weigh accumulated fat against the airway.

It’s well known that obesity and OSA are often closely related. Because of this, the ACP guidelines now recommend weight loss along with CPAP therapy as a method of controlling OSA. Loosing only a small portion of weight can have a dramatic effect on restoring normal breathing function during sleep which may result in not having to depend upon equipment to facilitate nighttime breathing.

Continues Positive Airway Pressure 

Long considered the “gold standard” of OSA treatment, the Continues Positive Airway Pressure (CPAP) therapy is one of the most prescribed treatment methods for OSA. With CPAP therapy, a continuous stream of air is delivered to the face from a CPAP machine. This stream of air effectively “blows open” the airway which treats the obstruction and allows normal breathing to occur.

It’s likely that you have hard of CPAP therapy because someone that you know may use one. The reason why the CPAP has become the most popular treatment option is that it’s simply very effective when used as directed, although long-term compliance is one of the biggest challenges faced by patients. Machines that are not properly adjusted, masks that are not a good fit or machines that dry out the airway due to lack of humidity cause patients to discontinue use within weeks of beginning.

Oral Appliance Therapy

As the name implies, Oral Appliance Therapy involves therapy that uses an oral appliance or mouthpiece. A physician will create a custom fitted mouthpiece that works by holding the mandible forward. In doing so it helps by relieving pressure from the airway caused by the jaw falling backward at night.

While oral appliances are not prescribed nearly as often as CPAP machines, they are becoming increasingly popular, especially for those who have mild to moderate sleep apnea. One of the greatest advantages of oral appliances is that they don’t come with the burden of carrying around a large machine, tubing, and a mask. An oral appliance is simply inserted into the mouth before going to bed and is removed in the morning. Also, oral appliances do not require electricity to operate so you can take them with you nearly anywhere that you travel.

Oral appliances that are used to treat non-OSA related snoring can be ordered online. Our website has extensive information on the use of an oral appliance for snoring. Remember that you should always consult a doctor if you suspect that your snoring is related to OSA.

Final Thoughts On Headaches and OSA?

If you are constantly experiencing morning headaches, it’s important to discuss these and other symptoms that you may be experiencing with your doctor who can provide their professional opinion. If your doctor determines that you have sleep apnea and it may be the root cause of the morning headaches, it’s important to seek treatment quickly as your body may be deprived of oxygen and or is holding carbon dioxide, both of which have harmful effects on the body.

Morning headaches that are caused by OSA are typically easy to treat, however, the link between the two is often not discovered by doctors and OSA is commonly left undiagnosed.

Treatment options include weight loss, oral appliance therapy, and CPAP. There are also alternative treatment options such as positional therapy, and surgeries such as Laser-assisted uvulopalatoplasty.

 

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Routinely waking up each morning with an unexpected headache is a concern that should be appropriately addressed as it may be an indicator of an underlying condition. While there are a number of possible explanations for morning headaches such as severe high blood pressure, dehydration, hangovers,  bruxism, low blood sugar, and caffeine withdrawal, we are […] Read more

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