Tag Archives: Sleep disorder

Snoring, Sleep Apnea and Dentistry

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Continuing our discussion concerning the health connection between the mouth and the body, we will review the condition known as Obstructive Sleep Apnea, its common symptoms and what can be done to minimize the potentially devastating effects of this disease.

Obstructive Sleep Apnea or OSA is a potentially serious sleep disorder in which patients repeatedly stop and restart breathing during sleep. The throat muscles intermittently relax during the sleep cycles, and the airway becomes  temporarily blocked.  The muscles normally support the soft palate and tongue. When these muscles relax, the airway either narrows or closes as a breath is taken, and the flow of air is blocked. As a result the blood level of oxygen is reduced, the nervous system thereby senses impaired breathing and awakens the patient so that an open airway is restored. These events can occur as many as forty or even more times each hour throughout the night. The end result is an inability to reach the normal, deep, restful and necessary phases of sleep.  This lack of quality sleep results in sleep deprivation.

sleep_apnea

People with sleep apnea usually snore (often loudly), may wake during the night with  gasping or choking, or may seem to stop breathing periodically according to their bed partners. OSA is most commonly seen in middle-aged and older adults and people who are overweight.  Men are more frequently affected, but women and children may also exhibit symptoms of Sleep Apnea.

Common signs and symptoms of obstructive sleep apnea include:

  • Snoring (often loudly)
  • Episodes of interrupted breathing during sleep
  • Abrupt  awakenings during the night
  • Daytime drowsiness
  • Dry mouth or sore throat in the morning
  • Morning headaches
  • Mood changes including depression or irritability insomnia

In addition, certain factors increase the likelihood of a patient’s having Obstructive Sleep Apnea.  Those with one or more of these signs are urged to speak with their primary care physician about the need to be tested for OSA. These factors include:

  • Being overweight
  • Having a neck size greater than 17 inches for men and 16 inches for women
  • Having high blood pressure especially if resistant to medications
  • Having a narrow airway possibly due to enlarged tonsils and/or adenoids
  • Chronic nasal congestion
  • Diabetes — type I or 2
  • Family history of sleep apnea
  • Smoking
  • Frequent use of alcohol

 

If a patient is unaware of their Sleep Apnea condition or if is left untreated, a variety of complications may develop.  Conditions associated with OSA include:

  • Cardiovascular problems including high blood pressure, coronary artery disease, heart attack, as well as heart failure and stroke and heart arrhythmias.
  • Daytime drowsiness, fatigue and irritability as well as difficulty concentrating.
  • Children with OSA may have problems in school and commonly have attention or behavior disorders.
  • Sleep deprived partners — commonly bed partners may choose to sleep in a separate room.

 

In addition to seeking the advice of your doctor, there are steps that you can take to at least minimize the effects of OSA.

  • Try to sleep on your side
  • Avoid drinking alcohol close to bedtime
  • If you are drowsy, avoid driving or using machinery
  • If you are overweight  lose weigh
  • Exercise regularly
  • Quit smoking
  • Use nasal decongestant

If you are diagnosed as having Obstructive Sleep Apnea, there are three traditional therapies which are used to control this condition.   The first is positive airway pressure in which a device called a CPAP is worn over the nose and/or mouth while you sleep.   It employs a steady stream of air to maintain an open airway.

Continuous Positive Air Pressure (CPAP)

Continuous Positive Air Pressure (CPAP)

The second is a dental appliance which is designed to hold the jaw in a downward and forward position.  In this position, the tongue and soft tissue at the back of the mouth are held  to effectively maintain an open airway. These devices are also used to minimize or eliminate snoring.

                                      Sleep Appliance
                                              Somnodent Sleep Appliance

Third, there are various surgical procedures which may be appropriate for some patients.

If you have any questions about obstructive sleep apnea or the oral appliances which are used to treat this disease, please call us at 908.359.6655 or via our website at www.DesignsForDentalHealth.com

 

 

 

Crooked Teeth and Sleep Apnea

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As I mentioned in our last blog, we will be describing various connections between oral health and systemic (or total body) health. Today, I’d like to report on a very interesting class which I attended about a week ago. This was an Invisalign Study Club meeting which was meant to increase our skills in planning Invisalign orthodontic cases. But, every now and then, we watch a gifted speaker provide you with much more information than the announced topic would suggest.

My longtime patients know that I have been a lifelong student of dentistry and especially occlusion’s (the bite’s) role in preserving dental health for the long term. I have studied the various connections between occlusion and overall health including TMD and head/neck pain, occlusion and advancing gum disease, as well as occlusion and the airway to name but a few.

Well, at this particular lecture, the speaker showed slides of various patients with crowded teeth as well as some with narrow dental arches. Many of these patients, like many of those I see every day in my office, have what we call, tori, on the inside of their lower jaws. Patients are often aware of these tori, most are generally not bothered by them, but some ask if they should be concerned about them. I had always considered these to be a sign of patients who are chronic clenchers of their teeth, and many of them are. However, the speaker made a legitimate case for the chronic growth of these tori in patients whose teeth are tipped towards the tongue.

Anatomy-of-Obstructive-Sleep-Apnea (1)

But perhaps I am getting off of the point. The combination of people who have narrow jaws and tooth crowding are very likely to have sleep apnea. I have always known that there is a connection between narrow jaws and sleep apnea, but this presentation made it so clear that patients like those described above do not have adequate space in their mouth for their tongues. As a result, their tongues are forced back into their airways, and the result is sleep apnea.

Such patients may have had orthodontics when they were children,and had four teeth extracted because of their crowding. Such patients are quite likely to have sleep apnea because their jaws are narrow and their teeth have been moved back to where the tongue wants to be to close the space created by the extracted teeth. The tongue is thereby forced to rest towards the airway. Now, I am considering whether or not to treat such patients orthodontically to expand their arches. This is one means of improving their airways and reducing their likelihood of developing obstructive sleep apnea.

When such patients come to my office, they must be carefully screened for obstructive sleep apnea, high blood pressure, adult onset diabetes, cardiovascular disease and other systemic issues which are related to obstructive sleep apnea.

If you have a bite which sounds like the type that I have described above, please contact us so that we can perform a proper screening for obstructive sleep apnea. If you have any questions about your occlusion or sleep apnea, please feel free to contact us by telephone at 609.359.6655 or via our website at www.DesignsForDentalHealth.com

For Your Health: Sleeping in Sync with Your Partner

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Sleep Disorders and Sleep Problems

“A 2005 survey by the non-profit advocacy group National Sleep Foundation found that more than a quarter of co-habitating American adults lose sleep from their partner’s sleep issues, and nearly one in four adults spend the night in separate beds or bedrooms because of those problems.”

       -Huffington Post

Sleep problems affect your sleep partner too!There are many sleep issues that can affect not just the person with the problem, but also the person sleeping (or trying to sleep) next to them.  From the noise of snoring, grinding and sleep talking to nighttime ninja fights with those who thrash in their sleep, sleeping partners can suffer from a lack of sleep.

Percentage of Americans suffering from sleep problems:

  • Thrashing 0.5%
  • Sleep Walking   3.6%
  • Sleep Talking    5%
  • Grinding Teeth/Bruxism   8%
  • Chronic Insomnia 10-15%
  • Snoring   59%

Of all of these problems, snoring is by far the most common and widespread, keeping partners from getting a good night of restful sleep.  The lack of sleep can affect their daily life, their ability to concentrate, their attitude and mood, even their health.  According to the Huffington Post article Sleep Problems, “The health benefits of sleep go far beyond feeling rested the next day. Insufficient sleep has been linked with numerous chronic conditions, including diabetes, cardiovascular disease and depression. So much so that the Centers for Disease Control and Prevention now considers getting sufficient ZZZs — from seven to nine hours per night — an important matter of public health.”

What exactly can you do if your partner’s sleep problems or sleep disorder is becoming your own sleep problem?

Couples have many ways of dealing with these sleep problems.  As mentioned above, almost 25% of American couples have gone so far as to sleep in separate rooms or beds.  If the problems are affecting the couple’s health and relationship, there are ways that professionals can help, depending on the issue.  Sleep studies, medications, behavioral therapy, nighttime orthotics and snoring appliances may help bring some nighttime rest depending on the specific problem.  Sometimes the solution can be as small as rearranging the sleep environment to help promote more restful sleep.

The solutions vary greatly depending on the problems, and whether they are due to a full-blown sleep disorder or just a few minor, manageable symptoms.  However, no matter how minor it may seem, if your sleep is being affected by your partner’s sleeping problems, there will be a toll on your physical and emotional health — as well your relationship.

If you have any questions about how sleep problems and disorders can affect your health we’ll be happy to send pertinent information to you.  If you would like to make an appointment for a sleep apnea screening, please call 908-359-6655.

LINKS AND RESOURCES

2005 Sleep Survey by the Sleep Foundation: 

Sleep Problems: How Your And Your Partner Can Sleep In Sync

WebMD: What to Do When Your Sleep Partner Has a Sleep Disorder

Learn more about the hidden health risks of sleep disorders in our series of articles and posts about Sleep Apnea