Loss of Sleep Can Lead to a Number of Medical Problems
By Thomas G. Schell
For the Valley News; ‘A Doctors Perspective’
Monday 5/25/09
Achieving better health is on everyone’s mind these days.
People get up early to hit the gym, they count calories, take antioxidants, stay up late to watch a recorded “Biggest Loser” episode, seeking the physical fitness that will increase their lifespan. For more than 20 million Americans though, the biggest health kick might just be some good sleep. Many are surprised to discover the health benefits of a good night’s sleep. For example, people who sleep less than seven or more than nine hours each night average 15 percent shorter life span than their seven to eight hour counterparts. That figure rivals smoking!
For the lucky among us, better health may be as easy as turning off late night television. For others, a good night’s sleep is impossible due to a treatable condition called Obstructive Sleep Apnea Syndrome (OSAS). Apnea occurs when a body stops breathing for a period of 10 seconds or more during sleep. Imagine holding your breath until your head pounds and your chest heaves in panic. This is a regular event throughout the night for sufferers of sleep apnea. Snoring is commonly associated with the condition but not everyone who snores suffers from it. Gasping, coughing or choking are also signs of the disorder as well as being frequently elbowed by your sleeping partner. These breathing disturbances prevent air from reaching the lungs, causing a dramatic drop in blood oxygen levels. This oxygen deprivation raises blood pressure, causing the heart to beat harder, faster and sometimes erratically. The apnea sufferer starts to suffocate and briefly awakens in their effort to breathe. This can happen 50 or more times an hour. As a result of being startled awake, the apnea sufferer cannot accumulate much time in the deeper restorative phases of sleep.
Chronic apnea-induced oxygen deprivation can cause or worsen:
• high blood pressure and other cardiovascular diseases • risk for stroke
• risk for heart attack • depression and anxiety • pulmonary hypertension
• weight gain
• headaches, including migraines
• hyperactivity in children
• memory problems
• impotency and sexual dysfunction
• job impairment
• motor vehicle accidents
Statistics show that 57 percent of all people with high blood pressure also suffer from sleep apnea. It is suggested that sleep apnea is more prevalent than diabetes or asthma. Apneics are three times more likely to be in a motor vehicle accident involving serious injury and seven times more likely to be in multiple accidents. Apneics commonly suffer marital discord and other quality-of-life impairments.
Research shows that a bed partner of a snoring or an apneic person can also suffer many of the side effects of sleep deprivation. These include increased pain complaints and emotional side effects. Successful apnea treatment has been proven at the Mayo Clinic to increase spouses’ sleep time by an average of 62 minutes.
Once a diagnosis is made at a sleep center, the patient has several treatment options, these include a sleep mask to keep the airway open, surgery to remove excess tissues that close the airway, reposition the tongue and/or a bone near the voice box to keep the airway open.
For those who cannot tolerate a sleep mask and wish to avoid surgery, there are dental devices available for mild to moderate apnea treatment and snoring. Very much like a night guard or bite splint, they help to gently advance the lower jaw and hold it in a relaxed position during the night. Their efficacy is well documented and they are suggested for use by the American Academy of Sleep Medicine in mild to moderate cases of apnea or where a mask and surgery are not options. These appliances can also be used in conjunction with other treatments to gain the best possible benefit for patients who suffer from more severe forms of this disease.
Due to potential complications with dental appliance therapy, dental devices need to be administered by a dentist trained in their application. To keep up with this rapidly advancing field, the dental practitioner should also be a member of the American Academy of Dental Sleep Medicine (AADSM). Sleep apnea patients can only legally be treated by a dental professional with a specific referral from their physician. Despite how simple these dental treatments seem and how much research is behind them, additional research is still necessary to help minimize complications and apply this application to a broader range of patients.
Many conditions seemingly unrelated to the sleep problem may benefit from treatment. Speak to a physician if you suffer from one or more of the following:
• snoring with intermittent pauses (94%)
• hypertension (57%)
• personality changes and irritability (48%)
• excessive daytime sleepiness (78%)
• waking up with a gasp or choking sensation
• excessive perspiration at night
• poor memory and clouded intellect (58%)
• depression or anxiety • morning headaches (36%)
• dry mouth in the morning • heartburn
• decreased sex drive and impotence (58%)
• frequent trips to the bathroom at night
• restless sleep, tossing and turning
• rapid weight gain
Percentages shown here represent the relative number of people demonstrated in research to encounter this condition
Locally, we have many highly qualified physicians to help diagnose and treat the myriad sleep-related illnesses including OSAS. A sleep study need not be unpleasant, and obstructive apnea or its consequences shouldn’t be something that you or those close to you need suffer with. Many rather comfortable and effective choices exist for the effective management of this serious condition.
Thomas Schell, DMD is an adjunct assistant faculty member at Dartmouth Medical School and a staff member of the Dartmouth-Hitchcock Medical Center. He sits on a CPAP Alternatives Case Conference Panel at the DHMC Sleep Clinic that discusses various different modalities to treat patients where traditional sleep apnea therapy is unsuccessful. Dr. Schell’s memberships include both the American Academies of Sleep Medicine (AASM) and Dental Sleep Medicine (AADSM) among others.
|
