Sleep Apnea

How important is a good night of sleep to your overall health?

Sleep is crucial to your overall health and affects almost every tissue in your body. Poor sleep can weaken your immune system and can affect growth and stress hormone production. Poor quality sleep can affect your appetite, breathing, blood pressure and overall cardiovascular health. Research shows that a lack of sleep can increase inflammation in your body and put you at higher risk for obesity, diabetes, heart disease, cancer, infections. It can also affect your focus and mental abilities.

Can snoring be an issue?

Snoring occurs during sleep when your throat muscles are relaxed and the airflow through the mouth and nose is partially blocked vibrating the throat muscles. Snoring causes a decrease of airflow to the lungs and essentially to the brain. Heavy snoring can be a sign of sleep apnea which is a temporary pause in breathing occurring multiple times during sleep. This can also be a risk factor for high blood pressure, cardiovascular problems, diabetes, and other health problems.

What is sleep apnea?

Sleep Apnea is a sleep disorder when pauses in breathing or shallow breathing occur during sleep. The pauses are called apneas. Apneas can last for a few seconds to minutes and may occur throughout the night.

There are three main types of apnea

Obstructive Sleep Apnea (OSA): This is the most common. The airway becomes partially or completely blocked during sleep when the throat muscles relax, and the tongue gets sucked against the back of the throat leading to difficulties breathing. People with OSA have disrupted sleep and low blood oxygen levels. When blood oxygen levels decrease enough, the person partially awakens, the obstruction clears and oxygen flows again.

Central Sleep Apnea (CSA): The brain fails to send proper signals to the muscles that control breathing. Though the airway is not obstructed, the breathing is absent or reduced.

Mixed Sleep Apnea: This is a combination of OSA and CSA with attributes of both types.

Repeated cycles of decreased oxygenation can lead to very serious cardiovascular issues. These patients suffer from excessive daytime sleepiness, depression, and loss of concentration.

Common symptoms of sleep apnea may include:

  • Loud snoring
  • Abrupt awakenings followed by choking or gasping
  • Daytime sleepiness
  • Morning headaches
  • Difficulty concentrating

If you suspect you may have snoring or sleep apnea, schedule a consultation with Dr. Wuertz. She will review your medical history and provide a thorough examination. Because an accurate diagnosis is important, Dr. Wuertz collaborates with various Sleep Specialists in Houston and works closely with Primary Care Physicians when necessary. There are different types of sleep tests that can be recommended to monitor your breathing patterns, heart rate, and other factors. These tests can either be done in your home or at a local Sleep Center.

Risks of Sleep Apnea

  • Cardiovascular problems: Sleep apnea is associated with an increased risk for high blood pressure, heart disease, stroke, and irregular heart rhythms. The multiple pauses in breathing can strain the cardiovascular system long term.
  • Daytime fatigue and impaired functioning: People with sleep apnea usually experience poor sleep quality due to frequent awakenings to resume breathing. This can lead to excessive daytime sleepiness, reduced concentration, memory problems, and impaired cognitive function.
  • Metabolic issues: Sleep apnea has been linked to insulin resistance, glucose intolerance, and an increased risk of type 2 diabetes.
  • Weight gain: Sleep apnea and obesity are often interconnected. Weight gain can worsen sleep apnea and sleep apnea can contribute to weight gain because of the disrupted metabolism.
  • Depression and anxiety: Sleep apnea is associated with an increased risk of mood disorders such as depression and anxiety.
  • Reduced quality of life: The impact of sleep apnea on sleep quality and daytime functioning can lead to reduced overall quality of life

Not everyone will experience all or any of these risks. It’s important to seek a health professional for care and treatment to improve your overall health and quality of life.

Are sleep apnea and TMD related?

Yes and no. The connection between Sleep Apnea and TMD is often related to bruxism, the grinding or clenching of the teeth especially during sleep. Patients with Sleep Apnea may be prone to bruxism due to the changes in the muscle tension and movement that can occur during Sleep Apnea episodes. Bruxism can contribute to TMD symptoms such as jaw pain, headaches, and facial discomfort.

What are possible sleep apnea treatments?

Dr. Wuertz can provide Dental options to treat your sleep apnea depending on the severity and the patient’s preferences. Below are some options that may be considered. The best option is to schedule a consultation for a full examination.

Continuous Positive Airway Pressure (CPAP) therapy: CPAP is prescribed by a physician and involves wearing a mask over the nose and/or mouth that
continuously pushes air to keep the airway open. Dr. Wuertz works closely with the Sleep Physician and can provide combination Oral Appliance Therapy in
conjunction with a CPAP to help reduce air pressures making it work more efficiently and more comfortable.

Surgery: Dr. Wertz works closely with ENT Physicians and refers if surgical options need to be considered in severe cases or when other treatments are ineffective. The surgery may remove excess tissue or reposition the tongue to prevent airway blockage. Another option is jaw surgery (orthognathic surgery) where the upper and lower jaw are repositioned to enlarge the airway.

Oral appliance therapy (OAT): Custom dental devices are dual mouthguards that keep the airway open by repositioning the jaw and tongue while sleeping.

Lifestyle modifications: Research has shown that weight loss of just 10-15% can reduce the severity of OSA by 50% in moderately obese patients. Unfortunately,
while weight loss can provide meaningful improvements in OSA, it usually does not lead to a complete cure, and many sleep apnea patients need additional or
combination therapies.

Ways to improve your sleep:

  • Get up: Once you’ve woken up, get out of bed within 15-20 minutes.
  • Maintain a schedule: Keep a consistent schedule waking up and going to bed every day even during weekends and vacation.
  • Start a relaxing pre-sleep routine: Doing something that requires little thinking can help you wind down and get ready for sleep. Doing this regularly will help trigger your body to get ready for sleep. Things like meditating, listening to music, or reading can be a relaxing pre-sleep activity.
  • Only use the bed for sleep or intimacy: Keeping the bedroom strictly for sleeping or intimacy will limit the mind for just that when in the bedroom environment. When you watch tv, work, or eat in the bedroom, you open your mind to other factors that affect your thinking when you are in the bedroom environment.
  • Avoid all lighted “screens” before bed: The brain is hardwired to be awake during bright light. When you look at a bright screen (even your cell phone) before bed, your mind does not trigger itself into sleep mode. It makes you think you need to continue to be awake. When it’s dark, your brain knows it’s getting time to sleep.
  • Keep the bedroom dark: The brain is hardwired to sleep when it is dark. Use blackout drapes to keep the light out and your room dark.
  • Avoid naps: Avoid napping 6-8 hours before sleep. If you do need a midday nap, sleep for 10-20 minutes for a boost of energy and refresh your alertness.
  • Avoid loud noises: Use ear plugs or white noise machines to drown out unwanted sounds.
  • Remove potential allergens: Allergens can cause poor sleep because of sneezing, sniffling, or coughing. Use an air purifier with a filter to clear the air of unwanted particles.
  • Avoid caffeine 6-8 hours before sleep: Caffeine blocks the action of adenosine, a neurotransmitter that promotes sleepiness. Caffeine can be effective between 2 to 4 hours but can also stay in your system as long as 20 hours after consumption which can affect your sleep.
  • Avoid large meals, alcohol, or medications that cause drowsiness at least 3-5 hours before sleep
  • Avoid going to sleep hungry. Hunger can disrupt sleep.
  • Avoid eating in the middle of the night. Habitually snacking at night will train your body to awaken during that time to eat breaking your sleeping cycle.
  • Avoid sleeping pills: Sleeping pills short term can assist you but should be used under the guidance of a healthcare professional long term. Dependency, tolerance, side effects, long-term risks, interaction with other medications can be monitored by a professional. Depending on sleeping pills long term can mask underlying health issues.
  • Avoid smoking or nicotine: Nicotine is a stimulant. Avoid using it 1-2 hours before sleep.
  • Exercise regularly but avoid strenuous exercise 3-5 hours before sleep: Regular exercise promotes a regular schedule. Exercising increases the body’s temperature. When you sleep your body’s temperature decreases. So, when you exercise right before bed, your body’s increased temperature does not trigger the brain that it is ready for sleep.
  • Increase your exposure to natural sunlight early in the day. This can prevent Vitamin D deficiency which is associated with shorter duration of sleep, insomnia and obstructive sleep apnea.

If you have questions or concerns regarding your sleep or possible sleep apnea, contact our office at Houston Office Phone Number (713) 784-4200 for a consultation with Dr. Wuertz.