Kempsey Snoring and Sleep Apnea clinic

In a person suffering from Sleep Apnea or sleep disordered breathing, the AIRWAY COLLAPSES in on itself.  This happen when the person breathes in and out, shutting off the airway either completely or partially.

Millions suffer from sleep disorders; most people with sleep disorders do not know it.

Untreated sleep apnea can:
– Increase the risk of high blood pressure, heart attack, stroke, obesity, and diabetes
– Higher chance, or worsen, heart failure
– Make arrhythmias, or irregular heartbeats, more likely
– Increase the chance of having work-related or driving accidents


– Headaches (migraines, tension headaches, cluster headaches)
– Jaw joint pain, joint sounds, muscle tenderness in the face, limitation of mouth opening
– Worn teeth caused by Bruxism (clenching or grinding of teeth)
– Neck and back pain
– tiredness/fatigue and irritability in the mornings and during the day
– Snoring
– Excessive daytime sleepiness whilst sitting and reading or watching TV.  Or in a car whilst stopped at a traffic light, or lying down in the afternoon etc.
– Poor memory
– Reflux problems (acidity)

In Children
– Bedwetting
– Crooked teeth
– Worn teeth caused by bruxism (grinding or their teeth)
– Headaches
– Hyperactivity (ADHD)
– Mouth breathing
– Dry Lips

There are 3 categories of sleep disordered breathing
1. snoring (the mildest form)
2. upper airway resistance syndrome
3. obstructive sleep apnea


Snoring is often a cry for help. Modern medicine has been ignored this night time distress signal until recently.
Snoring is a clear signal that an airway is blocked.
– Enlarged tonsils and adenoids easily block airways in children and in some adults.
– An under-develop jaw which often caused by in correct swallowing and mouth breathing. This mean the tongue muscles is weak.  In turn the pharynx (the throat) muscle is also weak. This mean the lower jaw can drops back and block the air way when sleeping.
Snoring often signals the presence of dangerous night time sleep disorders. Sleep disorders are known to be an independent risk factor for a number of diseases. This including hypertension, cardiovascular disease, cerebrovascular disease (strokes) and diabetic insulin resistance.
Snoring has been found to be a predictor of poor school performance. Children that snore were also more likely to require later tonsil and adenoid removal.

There are 2 major types of sleep apnea

Obstructive Sleep Apnea (OSA) is a complete cessation of breathing during sleep for at least 10 seconds. During an episode of OSA, the entire upper airway is blocked causing airflow to stop. This disrupts sleep due to the lack of oxygen. The person awakens repeatedly as he/she trying to breath.
Central Sleep Apnea is defined as a period of 10 seconds without airflow.  This is due to lack of stimulus from higher levels of the brain.  The apnea can happen for a longer periods of 10 seconds.
Mixed – Combination of the 2 above
Risk factors for sleep apnea are: obesity, increasing age, male gender, family history, alcohol, sedative use, smoking, hypertension.  Other risk factors are breathing disorders such as asthma, menopause, and anatomic abnormalities of the upper airway. A further risk factor is malocclusion (bad bite) and bruxism.


Initial evaluation is done using an Epsworth Sleepiness Scale.
Definitive diagnosis is made using an overnight sleep study called Polysomnogram (PSG). The persons sleep is monitored and measured throughout the night. Sleep Disordered Breathing is further divided in problems of nasal origin and those with oral airway problems.

The 3 treatment options of sleep apnea are:

1. CPAP (Continuous Positive Airways Pressure) is a breathing machine.  CPAP made up of an air pump and a mask which are joined by a tube. When use, it opens up the airway with positive pressure.  CPAP has been found to be effective in moderate or severe OSA.

Research found that compliance is very poor. In young person, compliance to CPAP therapy can cause under developed mid face. This is due the pressure from wearing the strap to hold the mask. Wearing CPAP many hours during sleep over months and years, the facial bone under the mask can be pushed in.
2. Surgery is helpful where there is an anatomical obstruction.  Examples are enlarged tonsils and/or adenoids, an enlarged uvula or nasal anatomical problems. Surgery has only been found to be about 40% effective
3. Oral Appliances are indicated for people with mild to moderate OSA who prefer them over CPAP therapy.
This treatment is non-invasive, less obtrusive than CPAP. Oral appliances is effective in the treatment of mild to moderate cases of OSA. Oral appliances must be worn overnight, to hold the lower jaw forward.  This will therefore prevent lower jaw to drop back and blocking the airway during sleep.
Success rates have been found to be high due to it is easier for patient to wear the oral appliances!!!


Dr Nathan Le also offer this Treatment at Best Western Dental Centre in Sydney.

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