My dental hygiene patients are often surprised at a question I ask always during their preventive maintenance appointments: How would you describe your quality of sleep? Sleep may seem completely unrelated to oral health, but dentists and dental hygienists are typically the first ones to detect signs of disease and dysfunction within the body through a very clear window—the mouth.
Obstructive sleep apnea (OSA), or “sleep apnea,” is a life-threatening condition in which a person repeatedly stops breathing in the night. It affects approximately 1 billion people worldwide with millions more undiagnosed.1 It is often accompanied by such common ailments as high blood pressure, obesity, heart disease, depression, acid reflux disease, diabetes, high cholesterol, and asthma.2 Even more concerning, untreated sleep apnea can cause sudden events such as heart attack and stroke due to a continued shortage of oxygen in the blood and its critical demand on the heart.3
How does a person know if they have sleep apnea? An in-lab or at-home sleep test is the only definitive way to confirm or rule out this serious condition; however, there are some common risk factors that may serve as important cues to investigate sleep further.
More about sleep apnea … Bringing your dental sleep practice to the next level: It takes a village
You have a habit of snoring
No one likes to admit that they snore. For some of people, it may feel unattractive or embarrassing. For others, it may make them feel like they’re getting old. It’s common for people to deny or diminish accusations of snoring by their loved ones with the hopes that it’s not that bad; however, it’s important to know why snoring happens.
When a person is sleeping, they experience a significant degree of whole-body “atonia,” or loss of muscle tone. The airway is supported by muscles, too, and when they relax, the breathing space can narrow—or in the case of sleep apnea, completely collapse. A narrow airway is what causes snoring, the sound of tissues vibrating against each other as air passes in and out. Snoring does not guarantee that a person has sleep apnea, but an overwhelming percentage of people who snore do, and that is reason enough to pursue sleep testing.
You have a hard time getting out of bed in the morning
When a person is suffering from oxygen deprivation throughout the night, it can cause multiple interruptions in their sleep and prevent them from progressing through necessary stages in their sleep cycle. Even if you’re not consciously waking in the night, the brain can become aroused enough to disrupt the restorative sleep it desperately needs. This can result in a person feeling like they never get enough sleep, no matter how long they’re in bed.
Unfortunately, the effects of poor sleep are bound to last throughout the day with feelings of fatigue, sluggishness, and sleepiness. In extreme cases, accidentally dozing off during daytime hours can result in embarrassment, difficulty completing daily activities, problems with work, or even life-threatening accidents and injuries. This may in turn result in a person’s dependence on caffeinated beverages, energy drinks, or dietary supplements to meet the demands of the day.
Your doctor has growing concerns about your health
In our society, we associate new diagnoses, taking prescription medications, and having a variety of surgical procedures with the aging process. While it’s common for these things to happen in older adults, we need to remember that common does not equal normal. People in many other parts of the world are able to live long, healthy lives without the need for as much medical care as we require in the United States. Many researchers believe that to be due in part to a more active lifestyle, nutritious diet, and health care centered around the root cause of common ailments.
Modern medicine offers many benefits, but it’s also wise to explore underlying factors that may be contributing to health problems so we can manage them in a more functional way. While sleep apnea is not always the cause of well-known comorbidities, health-care professionals are finding that it is often there in the background. We are continuing to learn more about the relationship sleep apnea has with diseases that plague millions of Americans, including the fact that a chronic oxygen deficit will cause many systems in the body to operate suboptimally.
More about sleep apnea … Overcoming sleep dentists’ diagnostic obstacles
The good news about sleep apnea is that it’s easy to detect, diagnose, and treat. There are many effective treatment options that allow people to finally get the sleep they deserve—on their own terms. Therapies ranging from CPAP to prescription oral appliances have improved the health and wellness of countless people, with surgical options available as well. The first step is recognizing some of the common signs and discussing them with your dental or medical professional. We can take it from there.
Editor’s note: This article first appeared in Through the Loupes newsletter, a publication of the Endeavor Business Media Dental Group. Read more articles and subscribe to Through the Loupes.
References
- Benjafield AV, Ayas NT, Eastwood PR, et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med. 2019;7(8):687-698. doi:10.1016/S2213-2600(19)30198-5
- Pinto JA, Ribeiro DK, da Silva Cavallini AF, Duarte C, Freitas GS. Comorbidities associated with obstructive sleep apnea: a retrospective study. Int Arch Otorhinolaryngol. 2016;20(2):145-150. doi:10.1055/s-0036-1579546
- Jehan S, Farag M, Zizi F, et al. Obstructive sleep apnea and stroke. Sleep Med Disord. 2018;2(5):120-125.
