Airway Related Sleep Problems: Snoring, Sleep Apnea and Forward Head Posture

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Do you have airway related sleep problems?

airway-related-sleep-problemsDo you wake up at night feeling you are unable to breathe? Does your bed partner say you snore or quit breathing during the night.

Do you wake during the night to urinate?  Do you wake in the night and can’t fall back to sleep?

These can all  be considered  warning signs that signal serious, sometimes life-threatening problems.  They  are  signs of  disruptive  sleep patterns.

Airway related sleep problems can cause:

  • irritability
  • nervousness
  • breathing problems
  • daytime sleepiness and
  • inability to concentrate
  • motor vehicle accidents or near misses
  • panic attacks
  • weight gain and inability to lose weight
  • metabolic issues
  • hypertension
  • sexual disorders
  • personality changes
  • marital problems

airway-related-sleep-problems-chicagoThis is only  a partial list of the numerous serious ailments that you could probably do without. Many of these problems are caused by airway constriction which may not be clearly visible when an examination is carried out by a doctor.  Frequently patients with airway disorders are unaware of their sleep problems.

When these problems just don’t seem to be going away you may be able to seek relief through dentistry.

Your airways could be keeping you awake

Maintenance Insomnia is when patients wake during the night and cannot go back to sleep or are awake for extended periods.

If your airways continually become obstructed and breathing issues persist over time, you may suffer from something called obstructive sleep apnea. There could be more serious health outcomes, such as high blood pressure and heart disease, too. These become more likely if you are not getting enough rest and sleep at night.  Untreated sleep apnea has been shown to increase risks of heart attacks and strokes 600% or more. Patients with untreated sleep apnea are more likely to die in their sleep than during exercise.

There are a number of reasons why you might have night breathing difficulties. The position of your tongue may be blocking your airway, for example. Any of these problems may cause a lack of oxygen. Your dentist may be able to find a solution for your breathing trouble by using a tried and tested device.  CPAP IS CONSIDERED THE GOLD STANDARD OF TREATMENT FOR SLEEP APNEA BUT THE MAJORITY OF PATIENTS CANNOT TOLERATE CPAP.  90 % of patients prefer the dental alternative to CPAP when offered a choice.

Dental solutions for airway problems

There are a variety of dental solutions available to keep your airways clear while you sleep. One is what is called a tongue retraining device (TRD). This is a splint which positions the tongue in the correct place to allow plenty of space to breathe and prevents collapsed airways.

A second device is what is called a mandibular advancement device (MAD) which looks similar in appearance to a sports mouth guard. The airways are kept clear because the MAD exerts a force on the lower jaw. It pushes it forwards and down a little. The potential benefits of these dental devices include sleep improvements and a reduction in the incidence of snoring.

There are over 100 different types of oral appliances that open or stent the airway to treat sleep apnea and snoring.  The American Board of Dental Sleep Medicine offers Diplomate status to dentists with the highest degree of education and training.

Start feeling rested in the morning

If you are finding sleep difficult because you are unable to breathe properly and you have been unable to find a medical diagnosis for your problem, then your solution could be dental sleep medicine and/or physiologic dentistry.  Physiologic Dentistry can measure the current physiologic state and guide treatment positions.

We will examine your condition to ensure that nothing else is causing your airway problems. At last you should be able to breathe more easily and you will no longer feel tired throughout the day.

Forward head posture is a warning sign of airway problems

The blockage of the airway because of jaw and tongue position alters our normal head posture.  We bring our head forward , when awake to breathe better but this puts us at risk for headaches, neck pain, low back pain and particularly TMJ problems.…

TMJ Pain and Sleep

Dr. Shapira Jaw Problems, Sleep Problems, TMJ Pain and Sleep 0 Comments

TMJ Pain and Sleep: Why do I have trouble sleeping?

tmj-pain-and-sleepDo you find trouble sleeping and at the same time have jaw pain? A lot of Americans suffer from one sleep disorder or another but the most common is something called sleep apnea. Sleep apnea occurs when the airways become blocked and you find that you keep waking up as your body reacts to the lack of oxygen.

There are other reasons that can help to stop you sleeping well and these are related to your temporomandibular joint (TMJ). The jaw joints that connect the lower jaw to the skull are the TMJ Joints.  When they do not function smoothly you may hear clicking, popping or grinding noises in your joints or experience mild to severe pain when using your jaw.  This is the part of the face that allows you to move your jaws up, down or sideways.  When the TMJ is not working you may experience locking of your jaws or experience pain with movement.

If your ‘bite’ becomes misaligned you might experience symptoms such as face, ear, neck and jaw pain, because a ‘bad bite’ can affect your TMJ. A problem with the TMJ may then also cause snoring and sleep problems.  Your bite and your two TMJ joints act like a three-legged stool, if the legs are even the stool is stable.  If one or more of the joints or the bite is not correct you will have instability resulting in problems.  Muscle pain, neck pain and headache are some of the most common results of instability.

A jaw joint disorder could be causing your sleep problems

If you have a problem with your TMJ, then the pain could cause a TMJ related sleep disorder. The link between your TMJ and some sleep disorders like sleep apnea is crystal  clear, but just the jaw pain may still prevent you from getting a proper night’s sleep.

TMJ problems are often caused by a misaligned bite, which can put your tongue in the wrong place so that it readily blocks your airways. If you snore a lot and cannot sleep because of your TMJ, you do need to find a remedy because it could lead to more serious health issues, including heart disease and high blood pressure. A sleep disorder is more than a lack of sleep as it is a warning that further health problems are possible if treatment does not start.

The National Heart Lung and Blood Institute of the NIH published a report on “THE CARDIOVASCULAR AND SLEEP-RELATED CONSEQUENCES OF TEMPOROMANDIBULAR DISORDERS”  I  wrote a paper for Cranio Journal titled “TMJ, The Great Imposter has a Co-coconspirator Poor Sleep”   I  was requested to write the editorial for Cranio by Riley Lunn, the editor and owner when the Journal  changed it’s name from  the Journal for Craniomandibular Practice to the Journal for Craniomandibular Practice and Sleep.

Sleep problems can cause a multitude of pain Disorders including Fibromyalgia

It does not matter if jaw pain or airway problems are causing your disturbed sleep.  Once you sleep is disturbed it creates a host of new problems with widespread muscle pain.  There is a very specific sleep finding in Fibromyalgia, Alpha Intrusion into Delta Sleep or in simple English you wake or have disturbed deep sleep.  Studies have shown that many patients have Fibromyalgia symptoms if you disturb their sleep.  The disruption in sleep also alters our endocrine system affecting insulin resistance, cortisol levels, growth hormone, adrenal function, sexual hormones and thyroid hormone.  All of these factors can increase the pain and dysfunction associated with TemporoMandibular Disorders.

Dental treatments for your jaw problems and sleep disorder

This may be the right time to consider dentistry to correct the TMJ problem and any sleeping disorders, too. We will first ensure that no other health problems are causing your TMJ problem and any other sleep disorders. The first test we might use is an ultra low-frequency electronic device which will relax the muscles in your face.  Many patients have comorbid conditions or health problems that contribute to their TMJ disorder but there are also many patients who experience a host of medical problems because of their TMJ disorder.   One study showed that patients with TMJ disorders have a 300% increase in spending in every field of medicine.

If your TMJ is the culprit, then a special orthotic appliance is put in place which prevents the bite misalignment. If teeth grinding (bruxism) seems to be the main reason for the TMJ disorder, fitting a night guard is quite likely. This is a custom-made mouthpiece that you will wear when you sleep. These treatments can lead to less pain and better breathing.  Many patient who grind their teeth have sleep apnea and the bruxism helps to stiffen and open their airways.  Sometimes, a troublesome behavior can have both  positive and negative  consequences.  It is extremely important that patients with sleep problems and/or TMJ problems always see an expert in both fields.

Dr Shapira is a Diplomat of the American Board of Dental Sleep Medicine, A Diplomat of the Ameican Academy of Pain Management and a Felllow of the International College of CranioMandibular Orthopedics.

Stop the pain and get back to sleep

If you have been experiencing jaw pain and find it hard to get to sleep you may have a problem with your TMJ which could be helped by physiologic dentistry combined with Dental Sleep Medicine. We will need to make a thorough examination and eliminate other possible causes of the pain and any sleeping problems you have been experiencing. By utilizing advanced clinical and diagnostic protocols available in modern dentistry techniques, Dr. Shapira will be able to help you find a night filled with better sleep and a reduction or elimination of your daytime pain.