Currently, seventy million Americans have sleep disorders and sleep apnea affects at least 12 million to 18 million of them.  Sleep apnea is a disorder that causes uncontrollable pauses in breathing, or shallow breaths during sleep. Snoring is a common symptom, although you may have sleep apnea even if you do not snore. Untreated, sleep apnea can be potentially life-threatening, can lead to serious medical consequences and a decreased quality of life. Pauses in your breathing cause less oxygen to make its way to the brain, overworks the cardiovascular system and other organs in your body. People with sleep apnea are triggered to wake up suddenly out of sleep and gasp for air in a Flight or Fight response. These sleep apnea episodes will wake you up from a deep sleep into light sleep stage, never allowing you to get the restful sleep you need. The multiple episodes of low blood oxygen (hypoxia or hypoxemia) can lead to sudden death from an irregular heartbeat. Sleep apnea can cause symptoms, including loud snoring, choking noises, poor sleep, and feelings of fatigue during the day. Long-term complications of sleep apnea can include an increased risk of heart disease, stroke, diabetes, obesity, depression, memory problems, viruses and sexual dysfunction. Sleep Apnea can cause accidents, learning or memory problems and a poor performance in school or at work.

Fortunately, sleep apnea can be treated with a custom oral appliance, which supports the jaw in a forward position to help maintain an open upper airway. Lifestyle changes which include losing weight, reducing inflammation, improving your diet and starting a regular exercise routine will also help prevent Sleep Apnea.

1. Oral Appliance Therapy

Sleep Appliances are worn much like an orthodontic appliance or sports mouth protector. Worn during sleep to prevent the collapse of the tongue and soft tissues in the back of the throat, oral appliances promote adequate air intake and help to provide normal sleep in people who snore and have Sleep Apnea. Oral appliances are considered first-line therapy for patients who have been diagnosed Obstructive Sleep Apnea according to the American Academy of Sleep Medicine. They are also a great alternative for patients that cannot tolerate their prescribed CPAP. The oral appliance holds the lower jaw forward keeping the airway open. It prevents the tongue and muscles in the upper airway from collapsing and obstructing the airway.

Our oral appliances at Raphaelson Dental Sleep Center are very sleek in design- consisting of smooth, durable and comfortable material. It is also one of the strongest appliances currently available, making it an ideal treatment option for all patients, especially those who clench or grind their teeth at night.

2. Maintain a Healthy Weight

When you are overweight the fat deposits around your upper airway can obstruct normal breathing. If you’re a man with a neck circumference over 17 inches (43 centimeters) or women over 15 inches (38 centimeters, you have a significantly higher risk for sleep apnea.

Obesity increases a person’s risk for Sleep Apnea and poor sleep causes obesity affecting a person’s Leptin and Ghrelin (it is a vicious cycle). Sleep Apnea is most common among adults over 45 who are overweight, especially men, but can also affect women, people of normal weight and even children.

If you’re overweight or obese start with a goal of losing ten percent of your body fat. Here are some tips that can help you:

Eat a high fiber diet:  This means adding more fresh vegetables, fruit, nuts, seeds, sprouted beans or legumes, and ancient whole grains to your diet. Try to add at least 25–30 grams daily.

Eat foods that have healthy fats and high protein: Try cooking with coconut oil. It has natural fat-burning characteristics, and it benefits your gut too. Others healthy foods to add: olive oil, avocado, animal fats from lean meat, nuts and seeds. High protein foods are satisfying for hunger and help will help you build lean muscle too. Start off your morning with cage-free eggs, add some chicken to your lunch and maybe a fish to your dinner.

Get regular exercise: Exercise is not only essential to losing weight and live a healthy lifestyle but is also promotes a good sleep. It helps regulate hormones, burns calories and can break up nasal congestion. Go for a thirty-minute walk a couple of days a week. Park your car a little further from your destination. Take group classes at your local gym.

Natural oils:  Grapefruit, cinnamon, and ginger oil can help control your appetite, hormones and digestive symptoms.

4. Avoid Excessive Alcohol and Smoking

Alcohol relaxes the throat muscles, including the uvula and palate, which are important for controlling breathing. Smoking and alcohol can cause inflammation and fluid retention in the airway. And just in case you needed another reason to quit, people who smoke are three times more likely to have obstructive sleep apnea. So try to stop smoking and skip your night cap. If you plan drink do it at least three hours before going to bed.

Over the counter sleep aids, sedatives, and some prescriptions can have the same effects. Keep in mind, you are still waking up at night with these over the counter and prescription sleep aids although you may not be conscious of it. They only way to get a better sleep is to treat the root problem. Also, a lot of these medications can cause you to be more groggy during the day.

5. Treat Acid Reflux, Congestion and Coughs

Acid reflux/heartburn, congestion, and chronic coughs can interfere with normal breathing. Nasal congestion leads to difficulty breathing through the nose and can worsen symptoms of obstructive sleep apnea. Acid reflux causes irritation and swelling around certain throat muscles. Coughs might also irritate your upper airways and increase snoring. Reducing exposure to allergies and raising your head while sleeping can help reduce reflux and congestion. A humidifier will help drain your sinuses and more air to move through your airways. You can also rub essential oils such as eucalyptus oil which is also found in Vicks Vaporub on your chest before sleeping to help naturally open your airways and soothe a stuffy nose or a sore throat.

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Sudden cardiac arrest kills more than 300,000 Americans each year and often strikes without warning. Recent evidence suggests that there is a link between sudden cardiac arrest and sleep apnea, a common sleep disorder that causes a person’s breathing to pause or become shallow. This sleep disorder increases a person’s chances of developing heart disease and places them at a higher risk for sudden cardiac arrest.

Researchers found people with sleep apnea were 2.6 times more likely to have sudden cardiac arrest while sleeping during the hours of 10pm and 6am “The prevalence of obstructive sleep apnea in Western populations is high, (over 18 million) and will likely only continue to grow given the obesity epidemic and direct relationship between obesity and sleep apnea,” said lead author Dr. Apoor Gami, M.D., MSc, FACC, a cardiologist at Midwest Heart Specialists – Advocate Medical Group in Elmhurst, Ill.   In his study that sought out 10,000 Minnesota residents with suspected sleep disorders, it was determined that 78 percent of them had moderate sleep apnea. These patients were tracked and observed for up to 15 years, with an average follow-up every five years. During this time, it was reported that 142 of these patients had a fatal SCA or required resuscitation via CPR or automated external defibrillator (AED). Which concludes that the overall risk of this study was 0.27 percent. However, given that one in five adults suffer from even mild sleep apnea, this could add hundreds of thousands of people to that risk.

So why is sleep apnea so dangerous to the heart? It all has to do with your low blood oxygen levels. The body’s organs respond to the oxygen interruptions by demanding more blood.  This overworks the cardiovascular system and other major organs, which are supposed to be at rest. These sleep apnea episodes will wake you up from a deep sleep into light sleep stage, as your body reacts with a Flight or Fight response. The low oxygen levels during sleep can make you feel very tired in the morning and will contribute to more restless sleep. The multiple episodes of low blood oxygen (hypoxia or hypoxemia) can lead to sudden death from an irregular heartbeat. Individuals with severe sleep apnea, have an 80 percent risk for SCA due to their blood oxygen levels dropping below 78 percent.

Research shows that oral appliance therapy is a very effective treatment option for Obstructive Sleep Apnea. The oral appliance supports the jaw in a forward position to help maintain an open upper airway. It is considered the first line of treatment for OSA by the American Academy of Sleep Medicine. Oral appliance therapy is a benefit provided by many medical insurance plans and our sleep coordinators will be happy to assist you with any questions.

Raphaelson Dental Sleep Center is very proud to be one of the few dental practices on Long Island to help the medical community treat Sleep Apnea. “We are excited to screen our patients for Sleep Apnea, knowing that we are improving their health and potentially saving their lives”. We believe it is our moral responsibility to the health of our patients to screen them for Sleep Apnea. Our sleep specialists are here to help, Transform Your Sleep, Redefine Your Health”.

Symptoms of sleep apnea can include: snoring, silent pauses in breathing, choking or gasping sounds, daytime sleepiness or fatigue, insomnia, morning headaches, feeling irritable, depressed, or experiencing mood swings, and waking up frequently to urinate. Talk to us about your symptoms, we are here to help! Call us for a Free Airway Evaluation today.

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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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Federal officials now say that sleep apnea played a role in the Hoboken Terminal Crash that occurred on September 29, 2016, which caused the fatal death of a woman and injury to over a hundred people. It has been confirmed that Thomas Gallagher, 48, who was the operator of the train, has been diagnosed with sleep apnea. The crash occurred at the Hoboken Terminal, at double the speed limit of 10mph. Thomas Gallagher told investigators that he had no recollection of the crash and only remembered waking up on the floor of the train cab.

The Federal Railroad Administration has issued a safety advisory that will urge railroads to screen and treat their engineers for Sleep Apnea. Those that are diagnosed with Sleep Apnea will not be able to operate a train until they are treated. They have also suggested installing inward facing cameras in train cabs to record and monitor the engineers actions and speed (especially in stations where the tracks end at a platform). This will help aid in any future investigations. The federal agency first recognized that Sleep Apnea was problem in 2004, when it began revising and outlining safety regulations for operating a train. Currently, engineers only have their vision and hearing tested every three years, as of a physical screening required by their job.

Amtrak, Metro North, and some freight railroads have already implemented screenings and treatment for Sleep Apnea. An interesting statistic- According to spokesman Aaron Donovan for Metro-North (a commuter railroad in New York City suburbs) a recent study found that 1 out of 9 of its engineers has Sleep Apnea.  Metro North also had a deadly Sleep Apnea related crash in 2013, killing four people.

So what exactly is Sleep Apnea? Sleep apnea is chronic condition that causes one or more pauses in your breathing disrupting your sleep. Many people with Sleep Apnea suffer from excessive daytime sleepiness and fatigue, increasing their risk of an accident.  Sleep Apnea can also increase the risk of recurrent Heart Attacks and abnormal heart beats as a result of low blood oxygen.  It has also been related to other medical conditions such as Stroke, Diabetes, Depression, ADHD, and weight gain.

Some Sleep Apnea symptoms to we aware of:

  • Morning headaches
  • Sore throat or dry mouth
  • Difficulty staying asleep (insomnia)
  • Excessive daytime sleepiness (hypersomnia)
  • Attention problems
  • Irritability
  • Snoring loud enough to disturb the sleep of others or yourself
  • Shortness of breath, gasping for air or choking that awakens you from sleep
  • Excessive daytime drowsiness, which may cause you to fall asleep while you’re working, watching television or even driving

As of now, the Long Island Railroad is in the process putting into effect sleep apnea screenings as part of their safety protocols. We are pleased that the Federal Railroad Administration is recognizing the dangers of untreated Sleep Apnea. If you have or know someone who displays any of the Sleep Apnea Symptoms that are mentioned above, please call our office to schedule a complimentary Airway Evaluation. Sleep Apnea can be easily treated with a custom made oral appliance, fitting much like a sports mouth guard or an orthodontic retainer. It supports the jaw in a forward position to help maintain an open upper airway. Also, it is many times a benefit that is covered by your medical insurance. At Raphaelson Dental Sleep Center, we are concerned about our patients health and safety and we are looking forward to helping you achieve a restful sleep.

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