Device stops snoring, rests sleepers' fears

by Hilary Thomson
Staff writer

Snoring is just a noisy nuisance, right?

Wrong. Snoring can be a symptom of a potentially life-threatening disorder, Obstructive Sleep Apnea (OSA), and UBC professor of Oral Health Sciences Alan Lowe has invented a device to help.

"OSA may cause patients to stop breathing during sleep, dozens, if not hundreds, of times a night -- sometimes for more than one minute at a time," says Lowe, who specializes in orthodontics. "Yet many patients are quite unaware of their apnea."

Symptoms include intermittent snoring, excessive daytime sleepiness, waking in the night gasping and choking, fragmented light sleep and morning headaches.

One potential cause of the disorder is the position of the tongue and lower jaw during sleep.

When a sleeping person inhales, the tongue can be sucked back against the rear of the throat, obstructing the airway.

If the obstruction is sustained for more than 10 seconds and occurs more than five times per hour, the person has OSA and will likely feel sleep-deprived the following day.

In severe cases, hypoxia -- chronic low levels of oxygen during sleep -- may result, eventually harming the cardiovascular system. Severe OSA may cause high blood pressure, stroke or heart attack.

About 20 million North Americans have some degree of OSA according to Lowe. It affects nine per cent of women and up to 24 per cent of men aged 30-60 years.

OSA has been treated by removal of the uvula, the small piece of soft tissue suspended from the palate at the back of the throat. Another treatment uses a pump that forces air into the nose and mouth, a process called continuous positive airway pressure.

Lowe believes one solution may be to create more room at the back of the throat at the base of the tongue.

He invented Klearway, an oral appliance that the patient can adjust in increments of one-quarter of a millimetre through a total of 44 positions, covering an 11 millimetre range.

"By gradually moving the jaw forward, the patient gets more room to breathe and avoids the discomfort of a radical change in jaw position," he says.

Made of clear acrylic resin, similar to a sports tooth guard or orthodontic retainer, the device fits over both the top and bottom teeth.

Patients usually make two forward adjustments per week. Often OSA symptoms are relieved within six to eight weeks.

The device cannot be swallowed and patients can move their jaw in all directions and swallow while wearing it.

The appliance makes breathing easier and often stops snoring completely.

"Successful treatment of OSA is defined as reducing apneic events to less than 15 per hour," says Lowe.

Negative side effects may include excessive salivation and dry mouth and transient tooth or jaw discomfort.

Lowe cautions that not all snorers suffer from OSA, nor do all OSA patients snore. Assessment by a medical doctor or sleep specialist is required before a definitive diagnosis of OSA snoring can be made.

Lowe's patients are often assessed at the Vancouver Hospital Sleep Disorders clinic that is co-directed by Prof. John Fleetham, head of UBC's Division of Respiratory Medicine, and Psychiatry Assoc. Prof. Jonathan Fleming.

Working with UBC's University-Industry Liaison Office (UILO), Lowe patented the device in 1995. More than 3,000 appliances have been sold.

"Klearway accounts for about five per cent of our total income from royalties last year," says UILO associate director Angus Livingstone.

Revenues fund a post-doctoral fellowship in the Faculty of Dentistry.

Cost of the appliance and one year of supervision by the dental team in the Faculty of Dentistry is about $1,800.

For more information call Sandy Harrison, the Faculty of Dentistry's Clinical Trials co-ordinator, at 822-5775.