Are you drowsy during the day with no explanation?
Sleep Apnea & TMD
Sleep apnea is the involuntary cessation of breathing that occurs while the patient is asleep. There are three types of sleep apnea: obstructive, central, and mixed. Of the three, obstructive sleep apnea, often called OSA for short, is the most common. Despite the difference in the root cause of each type, people with untreated sleep apnea (all types) stop breathing repeatedly during their sleep, sometimes hundreds of times during the night and often for a minute or longer. In most cases the sleeper is unaware of these breath stoppages because they do not trigger a full awakening.
Left untreated, sleep apnea can have serious and life-shortening consequences: high blood pressure, heart disease, stroke, automobile accidents caused by falling asleep at the wheel, diabetes, depression, and other ailments.
Sleep apnea is a condition in which your breathing stops periodically during sleep, as many as 20 to 30 times an hour. Each time you stop breathing in your sleep, the resulting lack of oxygen alerts your brain, which temporarily wakes you up to restart proper breathing.
Since the time spent awake is so brief, most people with sleep apnea don’t remember it, and many feel like they are getting a good night’s sleep when in fact they are not. The constant wake-sleep, wake-sleep cycle prevents those with sleep apnea from achieving deep sleep, resulting in a constant drowsy feeling during the day.
The following symptoms can indicate the presence of sleep apnea. If you notice one or more of these, contact our practice.
- Insomnia or difficulty staying asleep
- Loud snoring at night
- Waking up at night short of breath
- Snorting or choking sounds during the night (indicating a restart of breathing)
- Headaches upon waking in the morning
- Falling asleep unintentionally during the day
- Extreme drowsiness throughout the day
There are three categories of sleep apnea. The most common is called obstructive sleep apnea (OSA), and occurs due to a physical blockage, usually the collapsing of the soft tissue in the back of the throat. Less common is central sleep apnea (CSA), in which breathing stops because the muscles involved don’t receive the proper signal from the brain. And some people suffer from “mixed” or “complex” sleep apnea, which is a combination of obstructive and central.
Obstructive sleep apnea is more common in males than females, and more common in older adults (40+) than younger adults and children. However, anyone — regardless of gender or age — can suffer from sleep apnea.
Other risk factors include obesity, smoking, drinking, use of sedatives or tranquilizers, and family history. Central sleep apnea strikes most often in people with heart disorders, neuromuscular disorders, strokes, or brain tumors. It is also more common in males.
Sleep apnea is considered a serious medical problem. If left untreated, it can lead to high blood pressure, increasing the risk of heart failure and stroke. The ongoing state of fatigue caused by sleep apnea can lead to problems at work or school, as well as danger when driving or operating heavy machinery.
Sleep apnea can also cause complications with medication or surgery; sedation by anesthesia can be risky, as can lying flat in bed after an operation. If you know or suspect you suffer from sleep apnea, let your family doctor know before taking prescribed medication or having surgery.
Treatments for sleep apnea depend on the severity of each individual case, and the type of apnea. Basic treatment can be behavioral — for instance, patients are instructed to lose weight, stop smoking, or sleep on their sides instead of on their backs. Beyond that, oral devices can be used to position the mouth in such a way that prevents throat blockage. In more severe cases, surgery may be the best option.
Contact our practice, and we can refer you to a sleep apnea specialist. The specialist may recommend a “sleep study” to diagnose the precise extent of the problem, and can prescribe appropriate treatment. Depending on the patient’s situation, treatment may involve an oral device that we can custom-design for you. Many times patients with severe apnea will have combination therapy, which is using the oral appliance in addition to a CPAP (Continuous Positive Airway Pressure). The oral appliance opens the airway so the pressure of the CPAP can be significantly reduced, making it more comfortable.
TEMPOROMANDIBULAR DISORDER (TMD)
Millions of Americans suffer from chronic facial and neck pain as well as recurring headaches. In some cases, this pain is due to Temporomandibular Disorder, or TMD.
Your temporomandibular joints (TMJ) connect your lower jawbone to your skull. These joints get a lot of use throughout the day as you speak, chew, swallow, and yawn. Pain in and around these joints can be unpleasant and may even restrict movement.
SYMPTOMS OF TMD INCLUDE:
- Pain in the jaw area
- Pain, ringing, or stuffiness in the ears
- Frequent headaches or neck aches
- Clicking or popping sound when the jaw moves
- Swelling on the sides of the face
- Muscle spasms in the jaw area
- A change in the alignment of top and bottom teeth
- Locked jaw or limited opening of the mouth
Should you notice any of these symptoms, please contact DHC right away. We can identify the presence of TMD and create an effective treatment just for you.
There are a few simple steps you can take at home or work to prevent TMD from becoming more severe, or to prevent it from occurring:
- Relax your face — remember the rule: “Lips together, teeth apart”
- Avoid grinding your teeth
- Avoid constant gum chewing
- Do not cradle the phone receiver between your head and shoulder — either use a headset or hold the receiver in your hand
- Chew food evenly on both sides of your mouth
- Do not sit with your chin resting on your hand
- Practice good posture — keep your head up, back straight, and shoulders squared