All Posts Tagged: obstructive sleep apnea

It’s Just Snoring

 

While many people do snore, heavy or severe snoring isn’t part of a healthy sleep pattern. Snoring is a sign that you’re not getting enough air with each breath. Pauses in breathing mean that your airway has closed. This is Obstructive Sleep Apnea. Snoring can also be a symptom of a serious health condition like heart disease.

If anyone tells you that you pause in breathing, snort or gasp while sleeping, or you consistently feel unrested in the morning, you should be evaluated for Sleep Apnea.

Symptoms of serious snoring problems:

  • periodically stop breathing for a couple seconds at a time
  • high volume of snoring is a sign that your body is working really hard to get sufficient oxygen
  • excessive daytime sleepiness

Lifestyle changes that may help include:

  • losing weight
  • not sleeping on your back
  • avoid alcohol or drugs that relax your nervous system
  • quit smoking (It’s proven that stopping smoking immediately makes it easier for a person to breath better.)

Proper sleep stages throughout the night are important for the body to repair and restore different organs and systems while we sleep. We typically should go through 4 sleep stages every 90 minutes or so, throughout the night. Each sleep stage has its job of what gets restored. Snoring, restless sleep, gasping, frequent waking can all be signs that you have Obstructive Sleep Apnea; a potentially deadly condition.

In a study[1] of 744 college aged who had only mild/moderate obstructive sleep apnea and normal blood pressure at baseline were followed for high blood pressure. There was a strong association for young and middle-aged adults to develop high blood pressure because of their mild-moderate sleep apnea. They also had a higher statistical onset of metabolic syndrome (early diabetes). Older adults (over age 60) didn’t develop high blood pressure. Age seemed to be a benefit.

Custom and highly specific orthotic appliances are provided for differing TMD conditions and offer an alternative to CPAP for patients suffering from snoring and Sleep Breathing Disorders.

Credentialed Dentists in Dental Sleep Medicine and TMJ can work with your sleep doctor to design, adjust, and monitor your progress. Oral appliances are easy to wear and travel with. They require monitoring by a trained dentist periodically.

If you or someone you know has symptoms of sleep apnea, such as snoring, we can help get them diagnosed and treated before high blood pressure or pre-diabetes develop. The earlier it is diagnosed and treated, the healthier you will be over the decades.

[1] Mild-to-Moderate Sleep Apnea is associated with Incident Hypertension: Age Effect

Alexandros N Vgontzas, MD Yun Li, MD Fan He, MS Julio Fernandez-Mendoza, PhDJordan Gaines, PhD Duanping Liao, MD, PhD Maria Basta, MD Edward O Bixler, PhD

Journal SLEEP

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Why might I need a sleep study and how do I get one?

A sleep study would be indicated by consistent snoring, feeling unrested after a night’s sleep (frequently), clenching or grinding of the teeth (indicates a high probability of a sleep breathing disorder), or repeated waking throughout the night. Any treatment a Dentist might provide to diagnose or treat a sleep breathing problem, needs the patient’s physician to manage the process by written permission to the dentist.

If someone witnesses or hears you “stop breathing” or gasping, snorting, jerking awake, it’s almost certain that you have Sleep Apnea. There are several ways to evaluate if you have, or the severity of, a sleep-breathing disorder.

PSG: Polysomnogram:

A very sophisticated evaluation of your entire physiologic and neurologic system during sleep. This is important in cases where patients may have several health conditions that might be related to or affected by Sleep Apnea. It’s the best diagnostic test.

Home Sleep Test:

A much simpler evaluation of basic parameters of Sleep Apnea in healthier patients. It can measure heart rate, breathing pauses, oxygen saturation, some can assess basic brain waves too. These are often used to evaluate the effectiveness of Dental Sleep Appliances after the initial Sleep Evaluation was done.

Pulse Oximetry:

Basically, a medical-grade “Fit Bit” with better accuracy. Not often used and doesn’t pick up much data.

If you mention snoring or fatigue to your Physician, they may not suggest having a sleep study. A dentist trained in TMJ or Dental Sleep Medicine can identify oral and other facial features, historical information and 3D imaging evaluations that would strongly suggest the need for a sleep study.

A sleep study must be ordered by a Physician because of the wide-ranging medical problems that Sleep Apnea can directly cause or contribute to such as:

  1. Hypertension
  2. A-Fib
  3. Heart Attack Risk Factor
  4. Stroke
  5. Frequent Urination Overnight
  6. Clenching/Grinding of Teeth
  7. TMJ Damage from Clenching/Grinding
  8. Neck Pain or Stiffness
  9. Nighttime Headaches/Migraines
  10. Feeling of Fatigue Despite Sleeping 7-8 Hours

A simple “pulse oximetry” test, or information from your “Fit Bit”, may miss critical information that could identify some of these risks based on your medical history and exam by your physician. Most of these conditions are out of the scope, licensure, and experience of Dentist’s to evaluate.

Over my years, we have seen patients who had heart conditions, blood pressure spikes (stroke risk) during sleep that weren’t picked up in their normal medical visits.

For a dentist to provide a Sleep Study, we must contact the Physician and get a written order to dispense a home unit or pulse ox. Dentist’s aren’t legally permitted to diagnose or test for, fabricate a “Snoring” or “Sleep Apnea” appliance without a written prescription from the patient’s Physician or Sleep Physician, which we always obtain.

Snoring IS a form of sleep disorder and must be approached as such.

In our practice, we have different sleep study devices that can be used to assess for the presence of a sleep breathing disorder or assess the success of a Dental Sleep Appliance in treating Sleep Apnea, snoring or other sleep-breathing problems involving oral appliances.

I always notify the patient’s Physician and discuss my findings that would suggest evaluation of a sleep breathing condition. The Physician makes the decision on the type of study that is done.

We work with many physicians and can provide fast, easy, home screenings with physicians written RX of patients we see to for TMJ or facial pain conditions, if indicated.

Contact us today for more information.

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Dehydration, Nighttime Urination, Bedwetting and How It Relates to Obstructive Sleep Apnea

Dehydrated? Get more sleep….Tired? Drink more water….it’s all connected.

This article reviews what we already know about proper sleep time and quality: if your sleep is disrupted it affects our entire body chemistry. Kidney function is also impacted by Sleep Apnea and other sleep breathing problems.

Proper length and depth of sleep is known to affect judgment, executive functioning, attention, mood, as well as a significantly affect our heart health, blood pressure, and increases risk for type 2 diabetes.

It’s been known for decades that children who bed-wet and adults who need to urinate 2-3 times at night likely have Sleep Apnea or one of a couple sleep-breathing problems.

Rosinger & colleagues analyzed 2 large database studies from China, looking at over 20,000 healthy young adults. Sleeping (16-59% more likely) less than 6 hours was correlated with dehydration by symptoms (thirsty) and measuring urine concentration and amount.

What’s the relationship?

Disturbed or shortened sleep disrupts the release of vasopressin, a hormone released at night when sleep quality and duration is normal. This hormone is released later in the sleep cycle in greater quantities and with increasing frequency the longer you sleep. WHY???? Without vasopressin, our kidneys would continue to “fill” throughout the night, causing us to wake up and urinate 2-3 times over a normal 8-hour sleep period. Vasopressin is released throughout the lateral stages of sleep and, with increasing release later in the sleep cycle. This makes sense…if you’re sleeping a “normal” 8 hours and entering all the stages of sleep such as REM and Stage lll, the body releases Vasopressin in those deeper sleep stages to slow the kidneys from filling up and causing you to wake up, go to the bathroom and, have to go back through the sleep stages…it’s disruptive to the body/brain repair sequence as we sleep.

Children with enlarged adenoids and tonsils can’t breathe well in deep sleep, so the body makes them restless and deprives their brain of REM sleep…all the while allowing their kidneys to fill. The result: bedwetting.

Adults who snore, have sleep apnea or women with sleep anxiety or frequent waking also don’t release as much Vasopressin, causing us to wake 2-3 times to urinate. Typically the 1st waking is just after midnight…

By morning, the body has dehydrated itself by the continued water loss and can cause long term dehydration symptoms such as muscle weakness, headaches, fatigue (similar symptoms as sleep apnea contribute to)…

Amazing how our physiology is so intricately designed!

Sleep Deprivation May Cause Dehydration

Published Wednesday 7 November 2018,  

Medical News Today

By Ana Sandoiu

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