Women Snore, T00!

For years the medical community has understood obstructive sleep apnea to be more predominant in males than females. However, when a recent Swedish report released a medical finding showing the frequency of sleep apnea in women is actually higher than once assumed, many were surprised by the data. The women’s sleep study was published in the European Respiratory Journal in 2012.

The research team working on the study randomly sampled 400 women out of 10,000, aged 20 to 70. The results quantified that 50% of women scored within at least the mild range of sleep apnea! The report also indicated that within the group of women with sleep apnea, 20% percent had moderate sleep apnea and 6% had severe sleep apnea. The research further concluded that the age bracket distribution was not equal, nor was the distribution within the varying weight ranges.

Evidence from the report showed that sleep apnea was related to age, obesity and hypertension but not to daytime sleepiness. From the overall sampling, 84% of the obese women, between the ages of 50-70, had some form of sleep apnea. In addition, 80% of the women with high blood pressure, between the ages of 55 and 70, were also found to have sleep apnea — either mild, moderate or severe.

With snoring as the number one sign for sleep apnea, this led to another related thought. Does the problem in acknowledging women as sleep apnea sufferers lie partially within the female population? Try asking a female if she possibly snores at night. You might as well ask about her weight, too. Very few women openly admit to snoring and that’s a huge problem. It’s like admitting to passing gas or even worse — admitting to your real age.

We know that sleep apnea sufferers experience repeated pauses in breathing during sleep, causing multiple awakenings. What many of us are still unaware of is that the pauses in breath lower the saturation of oxygen in your blood. This can result in high blood pressure and an increased risk of many heart related conditions. In addition, sleep awakenings cause acute surges in blood pressure and heart rate, further increasing stress on the heart.

In people with sleep apnea, the cardiac rest achieved in normal and proper sleep is not possible. This is the most alarming component of sleep apnea, since it can lead to complications such as hypertension, Type 2 diabetes, dementia, high blood pressure, depression, weight gain, and many other health issues.

If you have a loved one who experiences any sleep apnea symptoms such as snoring, gasping for air during sleep, daytime fatigue, or has already been diagnosed with sleep apnea but is possibly CPAP intolerant, please call a doctor immediately. Within a few minutes you could be on your way to helping a friend or family member and possibly even saving a life.

The reality is, women have been overlooked as obstructive sleep apnea sufferers for too long. It’s time to address the problem and seek help.

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A Dental Screening Could Save Your Life

We all know about the importance of sleep, and we know we should be getting more of it. When we wake up exhausted, drag ourselves to work or hit that afternoon slump, we blame ourselves: “Should have gotten more sleep last night.”

Instead of “Did I get eight hours?” we should be asking ourselves, how well did I sleep?” We tolerate feeling exhausted during the day, but it’s not normal to feel tired.

When the airway collapses like this, breathing becomes compromised. This is where you get snoring, which is just the sound that’s made when air is getting forced through a partially obstructed airway.

Once the brain senses that breathing is dangerously compromised, it gets out of the deepest stage of sleep to regain control of the jaw muscles and reopen the airway, and keep you alive and breathing.

After just one night of the lack of deep sleep that the body craves, you awake in a damaged state. Cumulative damage could lead to high blood pressure, depression, mood disorders, suppression of the immune system, diabetes, cancer and weight gain.

Symptoms of untreated sleep apnea

  • You feel sleepy or tired during waking hours
  • You‘re anxious, irritable or stressed during the day
  • You grind your teeth,
  • You forget
  • You are sleepy after waking up

You can ask yourself how well you’re sleeping without considering sleep apnea, which affects an estimated one in 15 Americans.

Doctors can’t detect sleep apnea during routine office visits, but a screening from your dentist may help, especially a dentist trained in sleep related breathing disorders.

Recent studies have shown that teeth grinding is a major indicator for obstructive sleep apnea. The simple dental health screening that can improve the quality of your sleep begins with asking your dentist, “Do I grind my teeth?”

What is obstructive sleep apnea?

The most common type of sleep apnea is obstructive sleep apnea. The key word is “obstructive”, the thing “obstructing” the airway being the jaw, which falls back as the brain approach the deepest stages of sleep, and the muscles of the airway fully relax.

Snoring – note that not everyone who has sleep apnea snores, and not everyone who snores has sleep apnea.

I might have sleep apnea. What should I do?

See your dentist. Get screened at your next dental checkup for teeth grinding. Your dentist can tell you definitively if you grind your teeth at night or not.

Also, see a medical sleep specialist. These specialists are the only ones who can officially diagnose sleep apnea.

Many of us tolerate this anxiety and exhaustion every day of our lives and never get the chance to repair our bodies with the deepest stages of sleep. Asking your dentist if you grind your teeth will hopefully make the sleep apnea diagnosis a little less daunting for the millions of people who suffer from it.

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Do You Have TMJ/TMD?

Headaches are primarily a disorder of the trigeminal nerves and tissues they innervate. The evidence is becoming increasingly stronger that the majority of headache patients also have symptoms of temporo-mandibular disorders and the treatment of these disorders is essential to management and relief of headaches. Patients wishing to avoid migraines and extensive drug regimens should turn to someone trained in orofacial pain.

  • Sports injury
  • Bruxism, teeth clenching/grinding
  • Systemic diseases
  • Neuromuscular imbalances
  • Inflammation of the joint
  • Rheumatoid arthritis
  • Osteoarthritis (degenerative)
  • Developmental abnormalities

Another common cause involves displacement or dislocation of the disk that is located between the jawbone and the socket. The disk can also develop a hole or perforation, which can produce a grating sound. Disorders can occur if:

  • The disk erodes or moves out of its proper alignment
  • The joint’s cartilage is damaged by arthritis
  • The joint is damaged by a blow or other impact
  • The muscles that stabilize the joint become fatigued from overworked, which can happen if you continuously clench or grind your teeth

Temporo-Mandibular Joint Disorder and Orofacial Pain

The management of chronic headaches and temporomandibular disorders (TMD) is a complex problem in medicine. In order to effectively manage TMD and orofacial pain disorders, the patient must be correctly diagnosed so that the correct treatment can be selected.

Causes of TMJ Disorder/Syndrome

It is important to first explain that a “syndrome” is simply a collection of the symptoms and a “disorder” is the actual condition.

Research has shown that many factors may lead to this disorder – TMJ dysfunction (TMD).  It can occur by itself or be a part of a more complex problem.

Statistics indicate that the vast majority of TMJ disorders are caused by trauma, such as in an automobile accident.

Signs and Symptoms of TMJ

Signs and symptoms vary and can be very complex to identify. People generally experience one or more of the following symptoms:

  • Headaches are primarily a disorder of the trigeminal nerves and tissues they innervate. The evidence is becoming increasingly stronger that the majority of headache patients also have symptoms of temporo-mandibular disorders and the treatment of these disorders is essential to management and relief of headaches.

Jaw, face and/or neck pain are common indicators of inflammation of the TMJ. This can cause significant pain around the TM joint and can also spread to places outside the TMJ area.

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Pediatric Obstructive Sleep Apnea (OSA)

For children to be successful in school and life, they need the basic necessities to be met first, just like the rest of us. Respirtatoy problems are one of the more often seen medical problems in children, and problems with being able to breathe and take in oxygen add up over time. This is one of the most basic needs–an oxygenated brain–and when this need is not met, this affects the child in many other parts of their school and home life.

What do we mean by Oxygenated Brain?

Brains need constant supplies of oxygen to function. In children, a continuous lack (even just a little lack) of oxygen can result in poor growth and development, orthodontic problems, and symptoms that are often misdiagnosed as ADD and ADHD.

Believe it or not (believe it!), one of the most common breathing disorders that prevent children from getting enough oxygen, leading to the above mentioned effects, is obstructive sleep apnea. That’s right, OSA!

Different from adults with OSA, in children, the obstructed airway is usually caused by enlarged tonsils and adenoids in the throat. Breathing through the mouth and/or having a narrow mouth structure are also factors that may contribute to pediatric obstructive sleep apnea.

Basic pediatric signs and symptoms that should raise flags are:

  •         history of breathing through mouth
  •         bad breath
  •         large tonsils
  •         snoring
  •         witnessed trouble breathing
  •         wet pillow in morning
  •         tiredness/fatigue in excess of normal
  •         history of frequent disturbed sleep
  •         history of frequent colds, ear infections, and sore throats

Health is a big part of the picture for being successful in school and being able to live to the fullest. If you think that your child may be suffering from an obstructed airway due to structural reasons, please contact us* or your child’s pediatrician*.
 
When making plans for your child’s health needs, please don’t forget that disordered breathing can negatively affect your child’s life in many ways and needs treatment if present.
 
As always, please feel more than welcome to get in touch if you have any questions or concerns.

Yours,
DB

*** If your child is unable to breathe or in distress,  please contact emergency medical services (911) and seek immediate medical care.***

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Facts about Obstructive Sleep Apnea

Here are some fact to digest about Obstructive Sleep Apnea, to start thinking about how the dots are  connected. As always, if you have any questions, please get in touch!

  • Use of benzodiazepine & narcotic medications are highly contraindicated (meaning you shouldn’t take them) in patients who also suffer from obstructive sleep apnea (OSA), many of whom are undiagnosed.
  • These sedative medications depress already strained central nervous system respiration & can easily worsen sleep-related breathing disorders (e.g. OSA). In patients with chronic obstructive pulmonary disease (COPD) or any stage of heart failure, benzodiazepines are known to have an even more significant negative affect on airway clearance and disordered breathing during sleep.
  • Moderate and severe OSA are well documented to significantly increase risk of stroke and cardiovascular disease.
  • People with OSA experience chronic intermittent hypoxia (repeated periods when the body is without oxygen) during rest. Growing bodies of evidence demonstrate that chronic intermittent hypoxia increases systemic inflammation. Systemic inflammation in the body creates a widespread, constant stress that makes the body more susceptible to disease. People with high blood pressure and uncontrolled diabetes often have markers of systemic inflammation in their blood.

 

References
“Benzodiazepines, breathing, and sleep” by C. Guilleminault
“Obstructive sleep apnea and cardiovascular risk: Meta-analysis of prospective cohort studies” by J.Y. Dong, Y.H. Zhang, and L.Q. Lin
“Chronic intermittent hypoxia and hypertension: A review of systemic inflammation and Chinese Medicine” by C.X. Wu, Y. Liu, and J.C. Zhang

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