INFORMED CONSENT FOR TREATMENT OF SNORING OR OBSTRUCTIVE SLEEP APNEA WITH ORAL APPLIANCES
Snoring and Obstructive Sleep Apnea are both breathing disorders that occur during sleep due to narrowing or total closure of the airway. Snoring is a noise created by the partial closure of the airway and may often be no more problematic than the noise itself. However, consistent, loud, heavy snoring has been linked to medical disorders such as high blood pressure. Obstructive Sleep Apnea is a serious condition where the airway totally closes many times during the night and can significantly reduce oxygen levels in the body and disrupt sleep. In varying degrees, this can result in excessive daytime sleepiness, irregular heartbeat, high blood pressure and occasionally heart attack and stroke.
Because any sleep disordered breathing may potentially represent a health risk, all individuals are advised to consult with their physician or sleep specialist for accurate diagnosis of their condition before treatment can be started.
Oral appliances may be helpful in the treatment of snoring and Sleep Apnea. Those diagnosed with mild or moderate sleep apnea are better candidates for improvement with this therapy than those severely affected. Oral appliances are designed to assist breathing by keeping the tongue forward, thereby opening the airway space in the throat. While documented evidence exists that oral appliances have substantially reduced snoring and sleep apnea for many people, there are no guarantees this therapy will be successful or safe for every individual. Several factors contribute to the snoring/apnea condition including nasal obstruction, narrow airway space in the throat and excess weight. Since each person is different and presents with unique. Furthermore, some people may not be able to tolerate the appliance in their mouth. Also, many individuals will develop temporary adverse side effects such as excessive salivation, sore jaw joints, sore teeth and slight change in their "bite". However, these usually diminish within an hour after appliance removal in the morning. On a rare occasion a "permanent bite" change may occur requiring restorative therapy.
It is strongly advised that the oral appliance be checked at least twice a year to ensure proper fit and that the mouth be examined at that time to assure a healthy condition. If any unusual symptoms occur, it is recommended that the appliance not be worn until an office visit is scheduled to evaluate the situation.
Individuals who have been diagnosed as having sleep apnea may notice that after sleeping within oral appliance they feel more refreshed and alert during the day. This is only subjective evidence of improvement and may be misleading. The only way to ensure to prevent abnormal heart rhythms is to have a consultation with the sleep specialist and a follow-up sleep test.
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PATIENT (PARENT OR GUARDIAN) SIGNATURE AND DATE
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WITNESS SIGNATURE AND DATE