All Posts Tagged: sleep disturbances

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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The Impact of Cell Usage on College Kids

Research shows that use of electronics pre-bedtime can affect sleep. A recent study of college students’ use of Cell Phones after “lights out” was shown to definitively contribute to sleep disturbances and mental distress.

This was a large, significant group of almost 4,400 college students self-reporting cell phone use and specifically, use in bed after “lights out”. The pre-post testing took place over 8 months and measured many variables. Excessive cell phone use was defined as 4 hours per day or above.

To most of us, this does not seem excessive, but it was considered excessive in this research. Excessive cell phone use was positively associated with sleep disturbances and mental distress scores at follow up (8 months…a great long-term study).

They also looked at the results when the students stopped using the phones after lights out, the symptoms declined back towards baseline measures of normal sleep and distress…that’s good news!

84% of students (college) used their phones every day (4+ hours) and compared it to adolescents (junior high) excessive use (2+ hours/day).

The study also compared the effects of Melatonin secretion (great study) when the cell phone was used pre-bedtime VS after “lights out”.  Melatonin is a hormone that is secreted as the sun goes down and helps “ready” the body for sleep. Use of the cell phone pre-bedtime decreased the initial amount of melatonin secretion, but it “caught up” over the night….it was delayed and slowed…which would disturb sleep onset and perhaps initial quality of sleep. After lights out there were EEG changes and delayed melatonin secretion.

Of interest, they also commented on texting VS talking. If conversations are emotional, thoughtful, or considerable they contribute to insomnia because of the release of emotional hormones. Text doesn’t require the sender or receiver to be ready for the communication, and a response may be well after the sender’s “purpose” has been forgotten. That could re-engage or excite hormonal release. Texting is far more common than talking for “convenience” and (my opinion) doesn’t require as much emotional engagement with all topics.

Overall, this was interesting in that Text messaging after “lights out” had a negative and statistical effect on sleep quality, duration, anxiety, insomnia.

Take Away: put the phones in another room pre-bedtime and leave them there until morning. Your brain will thank you for it!!

Sleep Research Society. The associations of long term mobile phone use with sleep disturbances and mental distress in technical college students: prospective cohort study. Published in SLEEP, zsy213

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