Oral cancer, heart disease, stroke, lung diseases like chronic bronchitis and emphysema, osteoporosis, cataracts, and now you can add Obstructive Sleep Apnea to that list. Smoking is the leading cause of many medical conditions that can easily be prevented. There have been various studies now linking smoking to Obstructive Sleep Apnea. Those who smoke are three times more likely of developing OSA. About 35% of smokers have OSA.

Obstructive Sleep Apnea occurs when the muscles of the throat or relax and cause an obstruction of the airway. This can be the result of excessive fatty tissue, an oversized tongue or uvula, a soft palate or a narrow airway.  It can also is caused by anatomical swelling in the airway that happens when you smoke. OSA stops your breathing for periods of time and lowers your blood oxygen saturation because of the lack of oxygen.

These disruptions in breathing and lack of oxygen cause sleep fragmentation.  Sleep fragmentation during OSA “breaks up your sleep”, as you are temporarily woken up to resume breathing in a Flight or Fight response. The person’s mind and body have not restored during the night making them fatigued during the day, creating morning headaches or problems concentrating. Not to mention there are many serious medical consequences that result from a lack of sleep and a lack of oxygen in the body.

A study at Johns Hopkins University found 22.5 percent of smokers said they experienced restless sleep, in comparison to 5% of nonsmokers. Another study proves that smokers spend more time during the night in the lighter sleep stages, never reaching REM stage while non-smokers experienced more restorative, deep sleep.  Heavy smokers with OSA had a higher percentage of light sleep in NREM stages N1 and N2 and a lower percentage of deep sleep found in NREM stage N3, because of sleep fragmentation caused by OSA.

Smoking causes induced upper airway inflammation caused by nicotine irritation of the upper airway muscles. It inflames the nose, uvula, and throat, which obstructs and reduces the space in the airway. Long-term smokers with moderate and severe OSA, have increased uvular mucosa and uvular collapse. An inflamed uvula is also known as “battered uvula.”  This can be attributed to the thickened mucosa caused from smoking and a response to nicotine withdrawal during sleep. During the first hour of sleep, nicotine acts as a stimulant, reducing the number of apneas and hypopneas during sleep.  According to the National Sleep Foundation, the stimulating effects of nicotine can cause smokers to develop insomnia if they smoke frequently and close to bedtime. (As we have mentioned in the past OSA is commonly misdiagnosed as insomnia and its primary symptoms.) As nicotine withdrawal continues throughout the night, your sleep apnea increases due to a rebound effect produced by the withdrawal.

Smoking is a known risk for snoring, and snoring is a symptom of OSA. A study found a higher association between heavy smokers and a higher AHI of greater than 50 events per hour (severe apnea is 30 events per hour). Smokers were also found to have longer durations of hypoxia with significantly lower oxygen levels.

If you have sleep apnea and you smoke, please talk to one of our dental professionals. Help is available to you at Raphaelson Dental Sleep Center. Our professionals are here to help to improve your health and quality of life.

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Far too many Americans see sleep as a luxury rather than a necessity. Many of us work long hours and overbook our schedules with other activities, getting an average of 6 hours of sleep. Sleep mental and physical recharge is important for your health. However when it is time to catch some zzzs’ many people have a hard time falling asleep. Below are some natural remedies, herbs, and tips that promote a better night sleep.

The science of sleep…

When you consume tryptophan, it is converted to 5-HTP, which then turns into serotonin. The serotonin then converts to melatonin, which makes you sleepy and tells you is time to go to bed. More melatonin is produced at night, while the amount lessens with more light or in the morning. Melatonin also controls your body temperature, working with the central nervous system to sync our biological clock.

Let’s get started…

1. Cherries or Cherry Juice

Cherries are rich in tryptophan, an essential amino acid.  Tryptophan converts to serotonin which then turns into melatonin.

2. Valerian Root

Valerian root is a natural sedative and sleep aid. It increases the amount of GABA (gamma-aminobutyric acid) which aids in regulating your nerve cells and has a calming effect. It is also used as a natural anxiety remedy because of these calming properties. You should be aware that Valerian Root might be a little smelly.

3. Electronics

Your bedroom is not a place to watch T.V. It’s also not intended to be your second office,  it should be a place to rest. Electronics not only keep you awake and they carry stress into your room. So it’s probably best to get any form of a screen out of sight, it is clinically proven to disrupt your sleep.

4. Schedule A Routine

We are creatures of habit. Establishing a routine every night will help with an easier to transition from being awake to going to sleep. Some ideas before bedtime can include drinking a cup of warm tea or milk, taking a warm bath (consider adding some lavender into your bath for aromatherapy), or reading a chapter in your favorite book.

5. Melatonin

This can be taken in a capsule form, however many foods carry melatonin such as Cherries (like we mentioned earlier Tryptophan is converted to melatonin) and Bananas. Bananas contain tryptophan, and potassium & magnesium as well, which are also muscle relaxants.

6. Exercise

Not only will you sleep better, but you’ll have more energy throughout your day. Set up a daily routine, even if it is just walking 30 minutes a day.

7. Chamomile

Chamomile helps relax your muscles. There is a theory that a substance called apigenin can bind to GABA receptors which affect the central nervous system and sleepiness. If possible, try to use fresh flower Chamomile for your tea. You can add a little bit of honey or lemon for taste as well.

8. Aromatherapy

In a study that followed brain activity with an EEG machine, subjects that were exposed to the scent of lavender experienced better moods and their brainwaves suggested that Lavender does increase drowsiness.

9. Magnesium

Most people have a magnesium deficiency, primarily due to their poor diet. Magnesium is vital to the function of GABA receptors, which is the main neurotransmitter that calms your central nervous system and prepares you for sleep. The best way to boost up magnesium is to eat a balanced diet, however taking supplements will also help.

10 . Saint John’s Wort

Saint John’s Wort is used frequently used to help with depression but it can also aid with disrupted sleep. Its main constituent-hypericin raises the overall level of serotonin in the brain. More serotonin creates more melatonin in your system.

11. Catnip

Catnip has a sedative effect on humans. The compound responsible for this is called nepetalactone. While it can make cats wild and hyper, it has an opposite effect on humans making you relaxed, drowsy, and ready for bed. Enjoy it in the form of a warm tea before bed with a little bit of honey.

These tips are not intended to replace seeking medical attention for a sleep disorder. If you have problems falling or staying asleep for a prolong period of time you should talk to one of our dental professionals or your primary care provider about your symptoms. As we have mentioned in a previous blog insomnia and sleep apnea are linked and if let untreated can lead to serious medical consequences.  Raphaelson Dental Sleep Center offers a home sleep study that can help diagnose your symptoms. It is important to seek to root cause of your sleep problem. Insomnia is one of the primary symptoms of OSA, and can only be treated with an oral appliance, CPAP or corrective surgery. Also, you should always consult with your primary physician before taking any of the herbs mentioned above. 

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Is Sleep Apnea the root cause of Insomnia?

by on January 25, 2017 | Posted in Sleep Apnea

Insomnia is a common sleep disorder that can make it difficult to fall asleep and stay asleep. Insomnia is also a common symptom of sleep apnea.  Although many may believe that chronic insomnia is a completely separate sleep disorder from obstructive sleep apnea (OSA), there is evidence that suggest the two overlap. Clinical studies show that 39% to 58% of patients with Obstructive Sleep Apnea also have insomnia.

The link between these two sleep disorders is very strong. According to a study published by the Journal of Sleep Medicine, Dr. Barry Krakow tested 20 patients with insomnia and found 18 of the 20 suffered from sleep-disordered breathing. Eleven of those patients had Obstructive Sleep Apnea, the most common form of sleep apnea.

In studies conducted by Dr. Wickwire, (Director of Behavioral Sleep Medicine and co-director of the Center for Sleep Disorders at Pulmonary Disease and Critical Care Associates in Columbia, Maryland) it is noted that many of his patients with insomnia also have narrow upper air passageways. In addition, they are either undiagnosed for sleep apnea, or a have a condition called upper airway resistance syndrome (UARS). Upper airway resistance syndrome is very similar to obstructive sleep apnea (OSA) in that the soft tissue of the throat relaxes, obstructs the airway and results in a disturbed sleep. The difference is that the length of time of each breathing pause is not long enough to be called an actual apnea. The multiple pauses in breathing experienced with UARS causes the body to have a stress response keeping the insomniac awake and their mind racing. “There is clear evidence that patients with sleep apnea are at increased risk for comorbid chronic insomnia, and patients with insomnia suffer elevated rates of occult sleep disordered breathing,”  says Dr. Wickwire.

People with insomnia have similar symptoms of sleep apnea including frequent urination during the night (nocturia), dry mouth, morning headaches, daytime sleepiness, and snoring. Unfortunately, patients and primary care physicians are not aware of the connection of insomnia with sleep breathing disorders. Consequently, many of these patients go undiagnosed for years. Patients with insomnia are often treated with sleep medications that can have potential serious side effects. Keep in mind, there is no medication that can provide a good night’s sleep if you have OSA. If you are an insomniac who wakes during the night, you should rule out obstructive sleep apnea as a possible root cause of your sleep problems.

At Raphaelson Dental Sleep Center we offer our patients a free airway evaluation to determine whether there are any obstructions in the airway that can be causing OSA and symptoms of insomnia. We also provide our patients with at convenient home sleep study that identifies and diagnoses sleep apnea. Most major medical insurances offer benefits for sleep apnea treatment and our sleep coordinators will help assist you with any questions

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