How It’s All Linked: The Facts

Let’s face it; what we all want is to spend quality time with those we love. We value health and happiness, experiencing life’s adventures, and snuggling in warm and cozy on a winter’s day. But the truth is most families experience health issues, questions arise and the unknown keeps us from living our lives the way we want to.

Following are answers to common questions about links between sleep, TMJ, oral breakdown and other serious health concerns.

Sleep apnea is responsible for a wide variety of medical problems, which may seem confusing to dentists and patients alike. It is far more common in children that thought to be, especially in the US where tonsil’s and adenoids aren’t removed when enlarged in children. This is partly due to insurance constraints and very low reimbursement to providers for the small, but possible risk of severe post- surgical infection/complication.

Enlarged adenoid and/or tonsils affect facial growth and increase the likelihood of future TMJ problems as well as adult sleep apnea.

About 6 million adults are diagnosed with obstructive Sleep Apnea (OSA) and the estimate is that 23.5 million adults remain undiagnosed or treated. This places a large burden on the healthcare system because untreated OSA is shown to be a factor in developing TMJ problems, Diabetes, Heart attacks, Strokes, High blood Pressure, and Periodontal Disease (Gum Disease).

It’s reported that Sleep Apnea has been found to have been present in 60%-80% of post cerebral vascular [1] events.  Irregular heartbeats are also seen in untreated Sleep Apnea patients and can be the source of a nighttime heart attack.

Untreated sleep apnea can also contribute to attention deficits in all ages groups, memory problems, multi-tasking, among other executive functions.

Symptoms of sleep apnea vary by gender and age. Toddlers and grade school children often have difficulty falling asleep and waking in the morning. They are often restless sleepers, moving around the bed, kicking the wall, etc. Younger children with sleep breathing disorders often resist going to bed, sometimes causing a stressful nighttime routine.

Men typically present with snoring, pauses in breathing while asleep (reported by others), and clenching/grinding the teeth.

Women more often complain of difficulty falling asleep or staying asleep. This will worsen with hormonal changes in mid-life. The perimenopausal years significantly increases the onset of sleep apnea in women due to the airway “protective” effect of hormones. Hormone replacement can lessen the severity of sleep breathing problems, but can’t eliminate it.

Nighttime Reflux or GERD has a strong association with Sleep Apnea. Each time the airway closes, the attempt to breathe causes acid to push into the esophagus, causing irritation and also eroding the enamel, which Dentists can recognize. Clenching and bruxing is associated with sleep apnea (as mentioned earlier). Both cause the neck muscles to tense and represent a rapid way for the brain to “stiffen or open” a closed airway from sleep apnea.

For more information or an evaluation with an expert, please schedule an appointment.

[1] J Stroke Cerebrovas Dis., 2017;26,1745

General reference also from Cristina Casa-Levine, RDH, edD, Decisions in dentistry, Nov. 2018

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