admin Blog 0 Comments


Several years ago an article in the British Medical Journal showed that learning to play the DIDGERIDOO  and especially learning how to do the circular breathing required could reduce sleep apnea and snoring.   I have long taught my TMJ and Headache patients breathing exercises to reduce pain and dysfunction.  I have also have many patients who have learned proper breating in yoga classes.

There have been other articles about breathing exercises helping numerous problems.  A new study looked at breathing exercises to reduce post operative problems in cardithoracic and upper abdominable surgery.

Incorrect breathing following childbirth is probably related to post partum depression and chronic muscle pain and headache.  Normal breathing becomes impossible near the end of pregnancy.  Diaphragmatic breathing becomes impossible and the expectant mother switches to thoracic breathing.  Many never return to their health breathing patterns.  Children with allergies and asthma, patients who snore or have small airways (patients with apnea or UARS)  frequently do not do diaphragmatic or abdominal breathing.

Postoperative outcomes following preoperative inspiratory muscle training in patients undergoing cardiothoracic or upper abdominal surgery: a systematic review and meta analysis.

The article concludes that training breathing muscles “Preoperative inspiratory muscle training significantly improves respiratory (muscle) function in the early postoperative period, halving the risk of pulmonary complications.”  If we can improve surgical outcomes when we are most at risk, imgagine the improvments in health we could see in the general public.

I strongly believe TMJ, Headache, Migraine and Sleep Apnea patients can benefit from a program addressing their breathing.  An excellent site to learn more about breathing exercises is


The Pub Med  abstract is below:

Clin Rehabil. 2014 Aug 26. pii: 0269215514545350. [Epub ahead of print]

Postoperative outcomes following preoperative inspiratory muscle training in patients undergoing cardiothoracic or upper abdominal surgery: a systematic review and meta analysis.



To evaluate whether preoperative inspiratory muscle training is effective in preventing postoperative pulmonary complications and reducing length of hospital stay in people undergoing cardiothoracic or upper abdominal surgery.


Medline, CINAHL, AMED, PsychINFO, Scopus, PEDro, and the Cochrane Library.


A systematic review and meta analysis of randomized controlled trials (or quasi-randomized controlled trials) investigating a form of preoperative inspiratory muscle training, compared with sham or no inspiratory muscle training. Participants were adults (16 years and over) awaiting elective open cardiac, thoracic, or upper abdominal surgery. Methodological quality was assessed using the PEDro scale.


Eight studies involving 295 participants were eligible for inclusion. The trained group had significantly higher maximal inspiratory pressure at the end of the preoperative training period (mean difference: 15 cm H2O, 95% confidence interval (CI): 9 to 21). This benefit was maintained through the early postoperative period, when lung function also recovered significantly more quickly in the trained group. Inspiratory muscle training also substantially reduced postoperative pulmonary complications (relative risk 0.48, 95% CI 0.26 to 0.89). Although not statistically significant, length of hospital stay also tended to favour the trained group. There were no statistically significant differences between the groups for the remaining outcomes. Participant satisfaction with inspiratory muscle training was high.


Preoperative inspiratory muscle training significantly improves respiratory (muscle) function in the early postoperative period, halving the risk of pulmonary complications. The training does not increase length of stay, but more data are required to confirm whether it reduces length of stay.

© The Author(s) 2014.


Systematic review; cardiothoracic surgery; preoperative care; respiratory muscle training; upper abdominal surgery



[PubMed – as supplied by publisher]

Sleep Disorders and Health Problems

Dr. Shapira Other Health Problems cause by lack of sleep 0 Comments

Good sleep is a key to a healthy life

sleep-disorders-and-health-problemsDo you think you are sleeping well enough? Do you lie awake at night sometimes unable to get to sleep or find yourself constantly tired with either morning headaches or chronic headaches during the daytime? These can all be symptoms of a sleep disorder, like sleep apnea, which can have a lot of effect on your long term health if nothing is done about it. Good sleep is a key to a healthy life!

If you fail to get enough sleep, day in day out, you take the risk of developing a serious illness.

Some of these illnesses include;

  • Heart disease
  • Stroke
  • High blood pressure
  • Depression
  • Diabetes
  • Thyroid function
  • weight gain, slow metabolism and inability to lose weight
  • decreased cognitive function
  • motor vehicle accidents

Problems sleeping are not always caused by a sleeping disorder and may be related to something in your lifestyle. There are some cases when people are unable to get a good night’s sleep. These could include things like exam pressure, relationship break ups, teenage children issues, money problems, unemployment, health of a parent and so on. In many cases these eventually sort themselves out and you and your sleep patterns return to normal. Another important cause of poor sleep is poor sleep hygiene.  This can be exposure to TV, computers or excess light in the evening.  It can also be disturbances in the bedroom.

It is important you work out what is the root cause of your inability to get enough sleep, before it starts to ruin your health.

Sleep disorders and health problems are linked

If you have trouble sleeping, but don’t have any obvious reasons why you are always tired, you should get an evaluation by a health professional to see if you have sleep apnea. Sleep apnea, if left untreated, can have long term consequences for your health. In particular, it has been linked to greater stress on your heart and circulatory system. Serious heart disease problems like high blood pressure, stroke and even heart failure can result from stress on the cardiovascular system.

In addition, being constantly tired with no relief in sight can make you depressed. Research has linked the disorder to a greater susceptibility to type 2 diabetes. This is partly due to the effect of sleep apnea on increasing obesity and poor diet choices when depressed and tired.

Two health gains for the price of one

One of the better outcomes of getting effective treatment for sleep apnea is that you will be able to sleep more easily. You will snore less and be more energetic during the day. Ultimately, being more relaxed and energetic will help you to ward off any serious illnesses which have been linked to sleep disorders.

Sleep apnea treatment has a double bonus, then. It gives you back the ability to sleep, as well as safeguarding your long term health.

Protect your health with unobstructed sleep

If you have the symptoms of sleep apnea or another sleep disorder, then you should have a thorough evaluation to make sure that no other lifestyle factors are affecting your ability to sleep. These may need to be addressed as well as looking for ways that can be used to help you sleep better.

Our dental practice can you with an effective device that can help to relieve the symptoms of sleep apnea and help to protect your long term health with unobstructed sleep.

TMJ Sleep Disorders

Dr. Shapira Chicago, Deerfield, Evanston, Highland Park, Kenilworth, Lake Bluff, Lake Forest, Libertyville, Lincolnshire, Mettawa, Morton Grove, Northbrook, Northfield, Skokie, Sleep Apnea and Sleep Disorders, Sleep Disorder, TMJ and sleep disorders, Vernon Hills, Wilmette, Winnetka 0 Comments

TMJ sleep disorders

tmj-sleep-disorders-chicagoThe TMJ (abbreviation for the temporomandibular joint) connects the jawbone to the skull. Located in front of the ears on each side of the head, the joint is cushioned by a soft disk that allows it to move smoothly. Disorders of the TMJ can lead to a variety of problems, some of which might not seem to have anything to do with the jaw.

Symptoms of TMJ disorder include:

TMJ can be related to sleep problems

The connection between TMJ and sleep disorder is often overlooked, but it has been evidenced in research.

Obstructed-AirwayTMJ problems can be affected by sleep position, breathing patterns, and other factors that happen when we sleep, which can make it difficult for an individual to realize that anything is wrong – until they wake up with a headache, dizziness, or feeling tired. Problems in your jaw may be the last thing you’d associate with sleep problems, but the evidence of the connection is overwhelming.

A 2009 study on sleep disorders and TMJ disorders concluded that people who have TMJ disorder should be referred to sleep specialists because of the likelihood that they suffer from a sleep disorder. TMJ can cause snoring, and snoring is one of the primary symptoms of sleep apnea, a common sleep disorder in which the person literally stops breathing many times during their sleep. TMJ patients with sleep apnea could find greater relief by getting treatment for both of these issues.

Treatments for Sleep Apnea and TMJ Sleep Disorders

tmj-cpapPeople who are diagnosed with sleep apnea usually sleep while using a CPAP, a forced air machine that requires wearing a device that fits over the nose and mouth. Other sleep apnea patients opt for an oral appliance that keeps the airway in the throat open during sleep.

While some patients tolerate sleeping with these types of devices well, others find them cumbersome, particularly the CPAP device. Oral appliances are often successfully used by people who cannot tolerate a CPAP, but they generally only work in mild to moderate cases of sleep apnea.

It is recommended that treatment for TMJ disorder be conservative. Simple things that you can do yourself can help, such as sleeping on your side instead of on your back, avoiding gum chewing and avoiding cradling a phone when you talk. Invasive treatments, such as injections or procedures that change the structure or shape of the jaw, are generally only performed in cases that involve major facial trauma.

TMJ symptoms can affect anyone, children, and adults alike

The highest risk of TMJ disorders is in women between the ages of 20-40.

tmj-yawningAnyone who is experiencing any of the symptoms of TMJ disorder, including headaches, especially those that are persistent; ear ache; neck pain or stiffness; sensitivity to light; loose or worn down teeth or tooth pain; facial pain; difficulty chewing; clicking sounds when chewing; locking jaws; or jaw pain or tenderness, might be able to find relief in TMJ treatment.

If you wake up feeling tired even though you’ve had plenty of sleep, wake up with a headache, or if you know you have sleep apnea, insomnia or other sleep problems, it is possible that a TMJ problem could be a contributing factor.

TMJ symptoms or sleep disorders can be best treated by someone with knowledge and experience in TMJ and how it relates to sleep and proper breathing. If you suffer from symptoms of TMJ or sleep disorder, or believe there may be a connection between your sleep and TMJ, contact our office for more information or to make a consultation appointment.