Sleepless in America
For a long time, the mainstays of the "basic human needs" bucket list have been
this classic trifecta: food, shelter and clothing. Certainly these resources are
essential for survival in modern life; however it is becoming clear that a missing
fourth entry to this list is sleep. The growing field of Sleep Science sheds light on
the fact that sleep is pivotal to living a happy and productive life. Given that we
spend over a third of our life sleeping, it's not that surprising that sleep is
fundamental to not only who we are, but how we are as well. Unfortunately, as the
scientific community discovers more and more about the nature of sleep, it is also
becoming increasingly understood that many people in this day and age suf fer
from problematic sleeping. Sleep problems, we are learning, are associated with
compromised health and wellbeing,
but even with this understanding, we are
seeing an epidemic of chronic sleep deprivation. According to the Centers for
Disease Control and Prevention (CDC), 1 in 3 US adults don’t get enough sleep.
Obstructive Sleep Apnea
Obstructive sleep apnea – also known as “OSA” or simply , sleep apnea is
of the most common sleep problems. It is a condition that is characterized by
shallow breathing or pauses in breath while sleeping. For those 2025
adults who suffer from OSA, their breathing can be halted for a few seconds to
over one minute for potentially hundreds of times in one night. While you sleep,
your muscles typically relax. For those with OSA, the mechanism that relaxes their
muscles during sleep results in the collapse of the palate’ s soft tissue, which
causes their airway to become blocked. The result of a chronically blocked airway
during sleep, which is the case for those with OSA, is reduced oxygen levels while
the event occurs.
OSA: Know The Signs
The risk of sleep apnea is typically increased if the following signs and/or
conditions are present:
- Gasping or choking during sleep
- Excess body weight
- Narrow airways
- Jaw misalignment
A Close-Up On Snoring
As a comic book standard, the concept of snoring is often used as a funny
character quirk. Giant blocklettered
“Zs” pouring out of a nightcapped
grandpa’s slack jaw or Bruno the bulldog’ s soggy nose you
know the drill. But
talk to someone whose partner is a chronic snorer or consider the way snoring
can have an impact on your overall health and it becomes clear that outside the
comic book world, snoring is not a laughing matter .
Though it may not seem that serious, snoring is classified as a legitimate sleep
problem – one of the most common sleep problems, in fact. The condition directly
affects one’s sleep quality, which, in turn, has serious consequences to one’ s
quality of life. It is important to recognize the symptoms of snoring and discuss
any concerns you may have with your doctor or dentist.
The term, “snoring” refers to a sound that occurs when the soft tissue of the
upper airway resonates with a person’ s breath when they sleep. Though it used
to be considered a condition that primarily af fected men, today we understand that snoring can af fect all genders. Aggressive snoring can be a symptom of
sleep apnea, however snoring is not the sole indicator of the condition, nor does
the presence of snoring necessarily mean you have sleep apnea.
Conditions and behaviors that are known to increase the risk of snoring include:
- Nasal obstruction
- Alcohol consumption
Related Conditions: Is Treating OSA
In a word, yes! Treating OSA is incredibly important to your health and wellbeing,
both now and in the future. In the short term, untreated OSA can lead to
excessive daytime sleepiness, morning headaches and memory loss. Letting your
OSA go untreated also puts you at risk of drowsy driving and accidents in the
More research is coming out about the long term ef fects of untreated OSA. It is
becoming increasingly understood that untreated OSA elevates your risk of
serious health problems including:
Obesity: in adults, the most common cause of OSA is excess weight and
Early onset of dementia and Alzheimer’s: studies have shown that people
with OSA are at greater risk of developing memory problems and other symptoms
of mild cognitive impairment (MCI) earlier than those without OSA.
Drowsy driving: those who drive while fatigued put themselves and others at an
elevated risk of road accidents. Drowsy driving is a major issue in the USapproximately
1 in 25 adult drivers report having fallen asleep while driving in the
previous 30 days. Drivers with untreated sleep disorders, such as OSA, are at a
greater risk of drowsy driving.
High blood pressure: the fluctuation in blood oxygen levels during episodes of
sleep apnea can strain the cardiovascular system and increase blood pressure.
Heart disease: OSA is associated with both obesity and high blood pressure,
two major risk factors for heart disease.
Stroke: The occurrence of strokes has been found to be far more common in
those with moderate to severe OSA, especially in men with OSA whose risk of
stroke is three times higher compared to men without OSA.
Diabetes and other metabolic conditions: having sleep apnea increases
one’s risk of developing insulin resistance and type 2 diabetes.
Erectile dysfunction (ED): In a 2009 study, it was found that 69% of male
participants with OSA also reported ED. It is not yet known why men with OSA
have higher rates of ED.
Chronic acid reflux: GERD (gastroesophageal reflux) and sleep disorders are a
common pairing. It is thought that the changes in airway pressure that results
from OSA contribute to the occurrence of reflux or that acid reflux at night leads
to vocal cord spasms that result in sleep apnea.
Treating OSA: An Action Plan For Getting Help
1) Talk to your doctor or dentist:
- If you are concerned that you or your partner ’s snoring may be more than
the occasional nighttime disturbance, or if you are frequently feeling
excessively fatigued during the day , consult your physician or your dentist.
- Explain your concern and express that you would like to be evaluated for
2) Get diagnosed:
3) Get treated:
- Only boardcertified
sleep physicians as
opposed to your primary care
physician or dentist can
issue a formal diagnosis of sleep apnea.
However, a primary care physician or dentist should be able to consider
your symptoms and advise you whether your odds of having sleep apnea
are high. If your family doctor or dentist determines that you may indeed
suffer from sleep apnea, they can refer you for a formal diagnosed.
- In order to make the diagnosis, sleep physicians must collect data on your
sleep activity. To acquire this data for a potential diagnosis, they can give
full evaluations of your symptoms in several ways including:
- Admittance to a sleep center for an overnight evaluation
- A self-administered at-home
sleep apnea test
- After you are tested, if you are diagnosed with sleep apnea, your sleep
physician will provide you with information including the severity of your
condition. They will diagnosis you as having either , “mild,” “moderate,” or ,
“severe” obstructive sleep apnea (OSA).
How Your Dentist Can Help:
- Research shows that the use of oral appliances for the treatment of mild to
moderate sleep apnea and snoring is ef fective and most patients find an
oral appliance to be a comfortable and convenient option for the treatment
of their apnea. The American Academy of Sleep Medicine recommends
use of an oral appliance for cases of “mild” and “moderate” OSA.
- For patients with “severe” OSA who cannot comply with use of a
Continuous Airway Pressure (CPAP) machine, Oral Appliances may be
recommended as an alternative.
- An oral appliance is fitted and monitored by dentists and/or oral surgeons;
the appliances help you maintain an open upper airway during sleep
- Oral appliances are to be worn at night, have a similar fit to a sports mouth
guard or orthodontic appliance, are portable and require low maintenance
- If you are diagnosed with obstructive sleep apnea, oral appliance therapy
is covered by many medical insurance plans.
- MAD-FIT™s, APP-NEA™ LLC's flagship product, bypasses the trial
and error in fitting oral appliances, making it easier for dentists to
get the right fit the first time.
Note:If you choose a dentist who has received training and is certified by AppNea
, LLC, you will be able to choose a MADFIT
dentist, which will allow you
to avoid the timeconsuming
and inconvenient “trialanderror”
typical of other oral appliances.
How Your Doctor Can Help:
- If you are diagnosed with “severe” obstructive sleep apnea you may be
advised to use a Continuous Airway Pressure, or CP AP, machine
- Talk to your doctor about what the best course of treatment is for you.
Although CPAPs are the standard practice for the treatment of “severe”
OSA, they may not be readily tolerated by all patients
- If you are unable to tolerate a CP AP, an oral appliance becomes your
second line of defense, which is a better option than letting your apnea go
How You Can Help:
- There are a number of behavioral and lifestyle changes you can consider
when trying to lessen the symptoms of your sleep apnea and snoring.
- Losing weight
- Avoiding alcohol and smoking
- Sleeping on your side
No matter what your diagnosis ends up being and what treatment option
you choose, we recommend that you make these life changes, regardless!
Relevant Clinical Studies
Effect of exercise training on sleep apnea: A systematic review and meta-analysis.
Associations between Macronutrient Intake and Obstructive Sleep Apnoea as
Well as Self-Reported
Sleep Symptoms: Results from a Cohort of Community
Dwelling Australian Men
Benzodiazepine prescribing patterns and deaths from drug overdose among US
veterans receiving opioid analgesics: case-cohort
Effect of Sleep-Disordered
Breathing Severity on Cognitive Performance
Measures in a Large Community Cohort of Young School-Aged
Obstructive sleep apnea and psychomotor vigilance task performance
Reciprocal dynamics between self-rated
sleep and symptoms of depression and
anxiety in young adult women: A 14-day
diary study .
Risk of Occupational Accidents in Workers with Obstructive Sleep Apnea:
Systematic Review and Meta-Analysis
What Is the Prevalence of Symptomatic Obstructive Sleep Apnea Syndrome in
Chronic Spinal Pain Patients? An Assessment of the Correlation of OSAS with
Chronic Opioid Therapy , Obesity, and Smoking.
Sleep–wake disorders persist 18 months after traumatic brain injury but remain
Sleep Duration and Sleep Quality in Relation to Subsequent