When I think of all the lifesaving information I hope to share with you this week, there is a single topic that stands apart…and it’s the opportunity to BREATHE! This simple need seems to sum up life as we know it!

While this topic and the topic of sleep apnea therapy is not new to us, this past weekend, in NYC, Dr. Bob and I had a wonderful opportunity to further our learning as a part of a small group from world renowned TMJ and Sleep Specialist, Dr. Michael Gelb, DDS, MS. With this experience fresh in mind, I felt this was an appropriate way to kick off OSHW!

Sleep Apnea is a disorder characterized by pauses in breathing or very low breathing while you sleep. Each pause in breathing can last from a few seconds up to whole minute and may occur many times in a given hour. Maybe a partner has pointed out that you’ve paused breathing in the middle of the night. Maybe you’ve woke up startled for an unknown reason. Or maybe you recognize one of the symptoms noted below in Dr. Gelb’s blog, with the most understated as feeling tired upon waking in the morning. This is not an adult condition alone; pediatric intervention can have profound impacts. It is a disorder that may require multifaceted medical approach.

My hope is that through awareness about this disorder, and knowing that dentists are in a pivotal position to help, many people will gain the focus and the health to live a happier life!

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From Dr. Gelb’s April Blog Titled:
The Secret Condition That Is Waking You Up at Night

Interrupted sleep is so common that most of us don’t stop and second guess why we wake up at night. However, just because something is incredibly common doesn’t make it normal or healthy, making this a question worth a second look.
So stop and ask yourself…
Why do you wake up at night? And what’s waking you up in the first place?
If you’ve ever struggled with insomnia, often the answers look something like this:
• “I had racing thoughts.”
• “I was worried.”
• “I just couldn’t sleep.”
• “I was stressing out.”
• “My heart was racing.”
• “I had to go to the bathroom.”
Truth of the matter is these aren’t the things that actually wake you up. They are the things that you become aware of once you awaken. Something else must be startling you awake before you become aware of your racing thoughts.
What’s actually waking you up is… your breathing. Or rather lack thereof.
An estimated 90% of awakenings in the middle of the night are due to restrictive breathing episodes. Normally, you should wake up gradually. So, for you to become fully awake in the middle of the night because you can’t breathe is not only not normal, it’s also very concerning.
Sleep medicine has only been recognized as a specialty of medicine in recent years. This means not only do we have much more to learn about the importance of sleep on our health, but some of the most basic information we accept as facts when it comes to sleep, should be questioned.
The Not So Silent Epidemic – Sleep-Disordered Breathing
Statistically, there’s a good chance you have sleep-disordered breathing. You probably have a serious sleep disorder if you:
• Snore
• Wake up throughout the night
• Clench or grind your teeth
• Have interrupted sleep
• Struggle with insomnia
• Take multiple trips to the bathroom throughout the night
• Are taking sleeping medications or supplements
• Wake up feeling unrefreshed
• Struggle with energy throughout the day
• Have drug resistant anxiety or depression
• Have cold hands and feet
Insomnia isn’t just a frustrating condition – insomnia is devastating and costly. In fact, chronic insomnia:
• Causes harm to the brain
• Impairs heart function
• Enhances physical pain
• Worsens anxiety and depression
• Increases your risk of an accident by 2.5 to 4.5 times
• Inhibits your ability to fight off infections
• Exacerbates mental health issues
The Astronomical Cost of Poor Sleep
In addition to declining physical and mental well-being, the sleep-disordered breathing epidemic is costing us financially as well. In 2011 alone, 40 million prescriptions for sleeping pills were written, making up $2.8 billion in sales.
As a country, we spend billions of dollars looking for solutions for sleepless nights in the form of over the counter drugs, supplements, vitamins, minerals, supplements, and prescriptions drugs. Furthermore, billions of dollars more are wasted in lost productivity and workplace accidents. The U.S. economy is estimated to lose $411 billion annually due to insufficient sleep.
Isn’t that startling?
We know we need to get better sleep, so why aren’t we looking for better solutions?
Why Don’t People Get Help for Sleep-Disordered Breathing?
If this is such a serious problem, why aren’t people getting more help to correct sleep-disordered breathing?
Well, there are a few reasons for this. First, sometimes people are completely unaware that they have interrupted sleep. For example, they might think they are just getting up to go to the bathroom frequently. But even when awareness is brought to the fact that there might be something different about their sleep, people are still reluctant to get help.
The thing about sleep-disordered breathing is it’s so common and widespread people often write it off as not a big deal. Usually, it isn’t until they have a partner who hears them stop breathing, choking, tossing, turning or snoring throughout the night encourages them and in some cases demands, they seek help.
But perhaps the most common reason some people don’t get help for their sleep-disordered breathing it’s because it’s a low level chronic condition that can go ignored for years, even decades without attention.
The Different Levels of Sleep-Disordered Breathing
You don’t need to have full blown sleep apnea to have sleep-disordered breathing.
• Sleep apnea occurs when 100% of your breathing is stopped for 10 seconds or longer, causing you to become startled awake because your brain thinks it’s suffocating.
• Hypopnea occurs when there’s a 30-90% reduction in breathing with a 4% drop in oxygen for 10 seconds or longer during your sleep. This may or may not wake you up.
• Upper airway resistance syndrome occurs when there is flow limitation leading to fragmented sleep. This may or may not wake you up, but it will prevent you from getting fully into your deepest stages of restorative sleep.
Even a small level of flow limitation can cause your sleep to be interrupted. When you have a low level sleep-disordered breathing condition, it can take years for the consequences to snowball into an event significant enough to send you to the doctor.
Dr. Barry Krakow’s TED Talk, Why Do You Wake Up At Night? He talks about how even people with sleep apnea, who suffer from hundreds of mini suffocations throughout the night, usually don’t seek help for years, even decades. Sometimes they only seek help after a partner has asked them to or because they’ve suffered serious consequences, such as heart disease or cognitive decline.
So, it’s easy to see why somebody who’s only suffering a 3-4% reduction in oxygen flow might not realize that they have a serious sleep-disordered breathing problem. Furthermore, it’s going to take them a lot longer before anything gets bad enough that they actually want help.
This is incredibly unfortunate because there’s a lot that can be done to improve sleep, which provides increased energy, decreased disease risk, and an overall better quality of life.
Medication is Not The Answer to Better Sleep
It’s a common misconception that sleep-disordered breathing treatments will always result in needing a CPAP. CPAPs used to be the gold standard for sleep-disordered breathing treatments, however there are now many options that are less cumbersome and less expensive.
First, there are nasal saline rinses and nose strips. Nasal sprays help eradicate chronic congestion and nasal strips help open the airway. The Mute device is another option that helps open the airway.
A growing segment of sleep practices are oral devices or appliance therapy. These are becoming the new standard for sleep-disordered breathing. These oral devices are gently placed over your teeth to prevent the jaw from dropping back during sleep. This opens the airway and permits more air flow during sleep eliminating the majority of sleep disordered breathing events.
ProSomnus® Sleep Technologies offers many oral devices for sleep-disordered breathing. These devices help reduce common airway complaints such as:
• Fatigue
• Exhaustion
• Brain fog
• Irritability
• Difficulty concentrating
• Depression anxiety
• Acid reflux
• Morning headaches
• High blood pressure
The ProSomnus®ACG Select Sleep and Snore Device was designed for women, who tend to have smaller mouths. This device has proven to be helpful in those who cannot tolerate other sleep and airway appliances.
If you suspect you suffer from sleep-disordered breathing, it’s critical you deal with it sooner rather than later. The longer you go with an uncorrected sleep condition, the more grave the consequences. Talk with your dentist today about your options for correcting sleep-disordered breathing – your body will thank you.

Resources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2413168/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1978319/
https://www.rand.org/pubs/research_reports/RR1791.html
http://fortune.com/…/sleep-productivity-rand-corp-411-bill…/
https://www.youtube.com/watch?v=izgtCxsLVd0
https://prosomnus.com/dentist…/dentist-prosomnus-acg-system/