630-305-7500
1060 East Ogden Avenue,
Naperville, IL60563
IF THE QUALITY OF YOUR SLEEP ISN’T WHAT IT SHOULD BE, YOU MAY BE SUFFERING FROM CONDITIONS THAT STEM FROM A MALFUNCTION OF YOUR JAW AND/OR THROAT.
Apnea: The complete cessation of breathing for ten seconds.
Hyopnea: Decrease in tidal volume associated without oxygen saturation, constriction of breathing.
Sleep Disordered Breathing (SDB): labored respiration during sleep caused by airway obstruction.
Snoring and sleep apnea are related night time noise may indicate a serious problem. Snoring is always indicative of development or existence of a sleep breathing disorder. If you suffer from SDB, as you fall asleep you experience a loss of muscle tone called airway patency. The soft tissues in your airway relax against the tongue, partially cutting off air flow to your lungs. SDB can be severe to the point of complete airway collapse. Those who suffer from SDB experience breathing difficulty ranging from mild to acute: snoring, upper airway resistance syndrome (UARS), and obstructive sleep apnea (OSA).
When a person has sleep apnea the muscles of the soft palate, tongue and uvula relax, sag and obstruct the airway. As the airway collapses, breathing stops periodically and sleep is temporarily interrupted. Sleep is characterized by two distinct states, non-REM sleep and REM sleep that alternate in 90 to 110 minute cycles. A normal sleep pattern has 4-5 cycles throughout the night. Tissue in the back of the throat collapses in REM sleep, which troubles breathing and also causes you to wake up a lot. If you don’t receive enough REM sleep, then you have trouble retaining information, and excessive daytime tiredness.
Not one surgery is recommended by the American Medical Association. 3 years after surgery the tissue grows back.
- TMJ appears to have a relationship to other conditions such as Obstructive Sleep Apnea (OSA), since both problems have a functional importance as they involve breathing, speaking and swallowing.
- Signs and symptoms of TMJ and other musculoskeletal patients often overlap.
- There is significant overlap between TMJ and OSA patients, suggesting the presence of common causative factors.
- TMJ related pain has been associated with dysfunctional respiratory mechanics.
Orthotics designed to treat OSA use a similar principle and alter the position of the jaw to allow the oral function of breathing occur more easily.
- Combining benefits of jaw position changes with benefits of oral functions enhancement allow self reduction of forward head posturing.
1. Snoring: intermittent with pauses
2. Excessive Daytime Sleepiness (EDS)
3. Awakenings with gasping or choking
4. Fragmented, non-refreshing, light sleep
5. Poor memory, clouded intellect
6. Irritability, personality changes
7. Decreased sex drive, impotence
8. Morning headaches
9. Gastro-esophageal reflux (GERD)
CLINICAL CONSEQUENCES:
Sleep Apnea, Snoring and Breathing Problems:
- Daytime Sleepiness
- Irritability, personality change and memory problems
- Restless sleep, night sweats, headaches and dry throat on awakening
- High blood pressure and abnormal heart rhythms
- Heart failure, heart attack, strokes, cardiac arrest, sleep-related convulsions and premature death in severe cases.
Excessive Daytime Sleepiness:
- Increased Devastating Motor Vehicle Accidents ( a seven to twelve fold increased risk)
- Increased Work-related Accidents
- Poor Job Performance
- Depression
- Family Discord
- Decreased Quality of Life
Cardiovascular:
- Systemic Hypertension
- Cardiac Arrhythmias
- Myocardial Ischemia
- Cerebrovascular Disease
- Pulmonary Hypertension/Cor Pulmonale
FACTORS THAT INCREASE THE RISK OF HAVING THESE PROBLEMS
- Being overweight- obesity is a major risk factor, although thin people can develop severe sleep apnea also.
- Nasal congestion or obstruction, “sinus trouble”, or allergies.
- Large tonsils and/or adenoids, having a “crowded throat”, a large tongue or small jaw.
- Lung disease, atrial fibrillation and heart failure
- Scoliosis or muscle weakness.
- Sedating medicines and alcohol.
- Hypothyroidism and certain other endocrine (hormonal) disorders.
- Increasing age
- Family history
- Malformation of the orofacial area (misaligned teeth, jaw, palate)
- Bruxism (teeth grinding)
- Polycystic Ovarian Syndrome (PCOS)
- Menopause
- Progesterone/Estrogen deficiency
- Anatomy and physiology of the airway
- 35 million Americans have sleep disorders
Compare with Asthma – 10 million, Diabetes – 16 million
- 95% of patients suffering from sleep disorders are undiagnosed!
- 25% of children diagnosed/treated for ADHD may actually have a sleeping disorder
- 50,000 premature and preventable deaths occur from sleep apnea.
- 200,000 auto accidents each year are sleep related
- Direct cost to US economy of $15.9 billion related to sleep disorders.
- US government reports that 70 million Americans experience problems sleeping.
- Half of those 70 million (35million) have an undiagnosed sleep disorder and should be tested.
- 90% of those who snore exhibit apnic tendencies
- More than 40% of adults over 40 snore
- 50% of people with sleep apnea experience hypertension.
- Sleep apnea and snoring have a significant association with memory loss, hypertension (high blood pressure), coronary artery disease, stroke and even death.
QUIZ: COULD YOU OR A LOVED ONE BE SUFFERING FROM A SLEEP DISORDER?
-awaken with neck pain, backaches, or fibromyalgia?
-have trouble falling asleep?
-feel exhausted upon morning awakening, even after getting a good night’s sleep?
-sleep poorly because of a bed partner’s restless sleep?
-often wake up at night and have trouble falling back to sleep?
-often seem to wake up because of dreams?
-find it difficult to sleep well when traveling?
-have sinus problems and allergies that interfere with sleep?
-have severe snoring or other indications of a sleep disorder?
-have ever fallen asleep driving?
-or…simply wish to ensure restful sleep for family and guests?
HYPERTENSION:
-Those who suffer from OSA experience repeated awakenings during the course of sleep. During sleep, the airway relaxes, losing its muscle tone and narrows or closes completely. Oxygen is depleted. After 10-20 seconds (sometimes even a minute) the body forces the person awake so that it can open the airway again. These interruptions are very short but occurring frequently, hundreds of times per night. The drop in oxygen levels caused by not breathing and the frequent awakenings puts stress on the heart. The result is a rise in blood pressure during the night and a resulting rise in blood pressure during the day, permanently. Lowering your blood pressure may be difficult if your sleep apnea remains untreated. Correcting your sleep apnea problem will likely lessen the severity of your hypertension.
CORONARY ARTERY DISEASE
-CAD results from constricted arteries or atherosclerosis (the build up of fatty material and plaque). OSA causes a drop in blood oxygen levels and a rise in heart rate and blood pressure. As a result, the heart is forced to work harder. Simultaneously, the heart needs more oxygen due to the OSA and the arteries are narrowed due to the CAD. Lack of blood flow occurs, the heart responds trying to pump more blood through a smaller area-straining the heart to such a degree that a heart attack could result.
STROKE
-A stroke occurs when the supply of blood and oxygen to the brain is either partially or completely cut off. In a person with OSA, blood flow and oxygen is already reduced, further exacerbated the likelihood of a stroke.
-Above information was taken from Health Technology, Ltd.
FIBROMYALGIA
-Fibromyalgia sufferers tend to lack normal amounts non-REM sleep. These stages are the deepest stages of sleep. If a normal person doesn’t get enough of non-REM sleep (stages 3 and 4) they can develop fibromyalgia symptoms. The treatment of fibromyalgia is connected to ensuring the best quality of sleep possible. Determining if any sleep disorders are present that could be rendering sleep, controlling it will often cause a dramatic improvement in the symptoms. Poor sleep, stress, inactivity, anxiety and depression are all factors that seem to worsen fibromyalgia. Fibromyalgia is one of the most common causes of chronic musculoskeletal pain.
TREATMENT OPTIONS FOR OSA, SDB and SNORING:
Surgery: Laser-assisted uvulopalatoplasty (LAUP). This procedure involves removal of excess tissue from your soft palate and uvula with a small, hand-held laser. The operation makes your airway larger. Some people may need up to five or six sessions before their snoring is improved. Sore throats are a common side effect, and laser surgery can raise or lower the pitch of your voice.
If your sleep apnea is caused by a jaw deformity, an operation to correct the deformity (which usually involves lengthening the jaw bone) will be performed.
If no cause for your sleep apnea can be found and it is not considered life threatening, a procedure called uvulopalatopharyngoplasty (UPP) can be performed, where a surgeon trims and tightens throat tissues. This procedure only has a 30-50% success rate.
NON-SURGICAL, ORAL ORTHOTIC THERAPY
The American Academy of Sleep Medicine has designated dental sleep appliances as the #1 non-surgical treatment for sleep apnea when the CPAP can’t be tolerated.
Oral orthotics reposition and stabilize the mandible, tongue, soft palate and hyoid bone, permitting the airway to open up. They are placed in the mouth are worn like an orthodontic appliance or sports mouth guard. They are worn at night to prevent the collapse of the tongue and soft tissues in the back of the throat so that the airway stays open during sleep. The orthotic helps maximize oxygen intake as well as maintenance and stability. The amount of air increase can be measured by the FDA-approved computer, the Pharyngometer. The Pharyngometer maps the cross-sectional diameter of the oral airway and measures its stability. This allows the doctor to discover points of obstruction as well as your individual optimal breathing position. The orthotics are small, fit easily, and is comfortable to wear and very effective. Oral orthotics can be an effective treatment option for some patients with mild to moderate apnea, or those prescribed CPAP and are unable to wear it.
CPAP:
The gold standard of treatment, it can be very effective for those who can tolerate it. The CPAP is an air mask that fits over the nose and mouth which blows high pressured air down the throat. It is successful but can be very uncomfortable to wear while sleeping. Sleep medicine literature reports the inability to wear CPAP runs from 30% - 60% of those to whom it is prescribed.
The American Academy of Sleep Medicine has designated dental sleep appliances as the #1 non-surgical treatment for sleep apnea when the CPAP can’t be tolerated.
All treatment options are intended to prevent obstructions from occurring, usually by widening the airway. The precise cause of obstruction is usually difficult to find, and may people have obstructions in more than one site or place.
As an alternative to surgery this is a good option, but if an individual falls within the 30%-60% who cannot tolerate a CPAP and cannot lose sufficient weight to affect the apnea. This leaves dental appliances utilizing the Pharyngometer computer to set the bite position and opening – a very effective way of increasing airflow to the lungs, and greatly reducing the apnea. The individual requires a CPAP but cannot tolerate it, and is therefore put at a great risk to his or her health. The inability to wear a CPAP also affects one’s energy and vitality; mild to severe fatigue is a side effect of inability to wear the CPAP. A dental orthotic fabricated with the Pharyngometer computer can conservatively and non-invasively correct these problems. It can also relieve the mental stress of a serious problem with treatment done in an easy, gentle manner.
1) Snoring is a common problem, especially in men, is it really that harmful?
· Snoring can be a symptom of a life threatening sleep disorder, especially if accompanied by severe daytime sleepiness.
2) Can you “cheat” on the amount of sleep you get?
· Sleep experts say most adults need between seven and nine hours of sleep each night for optimum performance, health and safety. When we don’t get adequate sleep, we accumulate a sleep debt that can be difficult to “pay back” if it becomes too big. The resulting sleep deprivation has been linked to health problems such as obesity and high blood pressure, negative mood and behavior, decreased productivity, and safety issues in the home, on the job, and on the road.
3) Is it that important to maintain a regular bed and wake schedule even including on the weekends?
· Our sleep-wake cycle is regulated by a “circadian clock” in our brain and the body’s need to balance both sleep time and wake time. A regular waking time in the morning strengthens the circadian function and can help with sleep onset at night. That is also why it is important to keep a regular bedtime and wake-time, even on the weekends when there is the temptation to sleep-in.
4) Turning up the radio, opening the window, or turning on the air conditioner are effective ways to stay awake while driving, right?
· These “aids” are ineffective and can be dangerous to the person who is driving while feeling drowsy or sleepy. If you’re feeling tired while driving, the best thing to do is to pull off the road in a safe rest area and take a nap for 15-45 minutes. Caffeinated beverages can help overcome drowsiness for a short period of time, however it takes about 30 minutes before the effects are felt.
5) My teenager is falling asleep in class; he/she just has bad habits and/or is lazy.
· According to sleep experts, teens need at least 8 ½ to 9 ¼ hours of sleep each night, compared to an average of 7 -9 for adults. Their internal biological clocks also keep them awake later in the evening and keep them sleeping later in the morning. However with many schools beginning classes early in the morning, that is when a teenager’s body wants to be asleep. As a result, many teens come to school too sleep to learn, through no fault of their own.
6) Is insomnia never sleeping?
· Insomnia has four symptoms generally associated with the disease. Difficulty falling asleep, waking up too early and not being able to fall back asleep, frequent awakenings, and waking up feeling unrefreshed. Insomnia can be a symptom of a sleep disorder or other medical or psychological/psychiatric problem, and can often be treated.