How can we sleep better?
Introducing healthy sleep
There are several reasons, purposes and intention behind this website – www.abettersleep.ca – from increasing awareness toward the understanding of the and practical insight into sleep and how it impacts us daily, through to the promotion of products and services I’ve found valuable myself and to the services that I can provide as a healthcare practitioner in this area myself.
I’ve frequently been frustrated by disinterest or resistance from many physicians, government, corporate business, transportation departments, and the majority of other healthcare professionals who appear to take many of these important “sleep-health” matters very lightly.
Good sleep is crucial to good health and longevity.
Although one hopes that things will improve, there is literature indicating that the average time spent in a doctor’s training – sleep medicine remains a neglected topic despite agreement on the importance of sleep for general health curriculum.
Most dental schools do not provide practical training either. We need to increase awareness at all levels.
Increasing the public’s awareness and demand is in all our best interests. As we [the public] demand more, the greater pressure administrators will feel. Perhaps over-worked physicians may be more likely to provide it if it were profitable.
The public need information that is relevant to them – and they deserve many of the existing myths challenged.
We are living in a time when, more than ever before, people are vocal and able to reach others through both traditional and social media as never before – alas this is a time when those who do are being less challenged and frequently believed but without a shred of evidence.
The more you hear (or less you hear) the more important something is or isn’t important. Common sense dictates that this can’t be either true or in our best interests!
Now, more than ever before, we need to advocate for our health. Sleep is a vital part of health.
But how can we do this with vastly differing opinions from individuals and even online where you never quite know whether somethings true or not?
When I trained in Glasgow, the university sleep clinic there was ‘closed due to lack of funding’. Although clearly a very much needed and grass-roots service, ignorance and other financial priorities assumed that it wasn’t important and therefore not necessary.
How many lives would this have saved had true value been appreciated by the accountants and politicians involved?
Good sleep is crucial to good health and longevity.
Sadly, it seems that these days, it’s primarily business savvy ‘healthcare professionals’ who are, presently driving the discipline forward which carries both good and bad elements.
Again, it is that you should care about, and you, that you need to advocate for.
So, why should you see a dentist or dental hygienist if you don’t sleep well?
Most people have a good rapport with their dentist and dental hygienist, and many go to a dentist’s office regularly (people generally only go to their doctors because they’re already ill).
Some dentists understand the importance of, not only healthy sleep, but its effects on their patient’s oral and general health AND their patient’s dental work too.
Unfortunately ‘dental sleep medicine’ (DSM) is still in its (relative) infancy and some dentists or dental hygienists have only done a short course or two as they don’t yet teach it in dental and hygiene schools.
As a profession we are at the beginning of an exciting time that will have great value to all, equally with your doctor of course.
Personal involvement
Why do I care?
Well, apart from a general concern for others, my father died of complications (heart attack) of obstructive sleep apnea (OSA) also snoring loudly. I believe his death was both associated and avoidable, but more of that later.
To aid her sleep, my mother was prescribed a barbiturate for over 20 years (without any clinical follow), not surprisingly she became reliant on them to sleep.
My own OSA is managed as are many of my friends and family (now) – yet I had to point out my symptoms and their relationship to OSA myself. What if I hadn’t known? I would never have had my disease managed, jut like my father before me, when he was 45 years old, hence his premature death.
While obstructive sleep apnea and heavy snoring are not the only sleep disorders they are both common and potentially serious none-the-less. The inability to sleep, insomnia, is the most common sleep disorder we experience, and most of us have.
On a separate note, I once experienced a serious surgical emergency at the hands of an inept surgeon that forced upon me the opportunity to experience just how important an open airway is – I lost mine as my throat became swollen, closed and I nearly died. Clearly, the ability to breathe during the night is important!
During the 20 years of practice in this area, I have seen much frustration in patients, their illness and even their deaths, often unnecessarily so. One hopes that as public and medical awareness and demand increases, so will the quality of the service that we all deserve.
Medical mistakes
I’ve seen many mistakes, and just as nurses have to quietly correct things themselves, as they go along, we can often say little to the professionals who appear to know everything anyway.
I’ve seen patients with narcolepsy, incorrectly diagnosed with obstructive sleep apnea (OSA), while others are driven to distraction by insomnia, and many with OSA quite unaware of their options.
Medical misdiagnoses
I’ve seen many young women told categorically that it simply isn’t possible for them to have OSA because they were female. I’ve even spoken to a practicing physician who said, “I don’t believe in obstructive sleep apnea”!”
I’ve met many physicians who are completely unaware of any connection between snoring and stroke
Obstructive sleep apnea (OSA) is more commonly observed in patients with Atrial fibrillation (AF) and the incidence of AF is considerably higher in those with OSA. In the Sleep Heart Health Study (2006) patients with severe OSA had a 4-fold increased risk for AF.
Hundreds of patients are unnecessarily taking medicines to aid sleep.
“With such rampant accessibility, and a perceived blessing from medical professionals, it’s no wonder so many people fall prey to the power of sleeping pills.”
I am constantly saddened that many of my dental colleagues remain genuinely unaware or disinterested of the impact sleep disorders have on their patients, and indeed the effect of it on the dental work they’ve performed for them.
Many dentists have been trained to believe that Dental Sleep Medicine (DSM) is just another “profit centre” for their offices – and while here’s nothing wrong with making a profit, (that’s what keeps a business or service open) – it does however need to be balanced with service and fulfilment so that profit is not the sole driving force behind the DSM service provided.
The crippling effect on untold numbers of misdiagnosed children.
Sleep disorders are common in children too and yet they are rarely considered, screened for, diagnosed, or managed well – if at all. As a society we could all help so much more, just by being aware of the damage these diseases and disorders can do our children – the adults of tomorrow.
Three cases spring to mind. Sam, a 7-year-old girl changed from her usual passive nature and stabbed another girl with a pencil, her behaviour changing dramatically, after much social work and blind alleys, a young physician recognised the possibility of a sleep disorder and after testing she was diagnosed with ‘restless legs syndrome’ (RLS) and sleep fragmentation, following management she made a complete recovery and returned to a normal young lady.
Jess, a boy of 9, was diagnosed with ADD and after years of medications, (which didn’t work – his life remaining ‘topsy-turvy’), worsened by tooth extractions and dental braces, further compromising his airway.
Unaware well into his twenties and having experienced many missed social and work opportunities, he was finally diagnosed with obstructive sleep apnea. With appropriate management, his life turned around slowly and he has become much more successful in “fitting in”.
Another example included rhythmic movement disorders, head-banging, bedwetting, and arousal disorders seen in Jason, a 5-year-old boy. Again we need to consider sleep disorders as well as more traditional diagnoses.
All of these children needed overnight clinic testing – not profitable and therefore not frequently done. In our “health and wellness’ society, sleep disorders in children and adolescents is a topic that has been, and remains, neglected in both public health education and professional training, this must change. With awareness and demand, this can and will change giving us a better, healthier and safer society.
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We need to share knowledge together to correct these misunderstandings and ignorance, because healthy sleep is important. Our time asleep, accounts for about a third of our lives (or at least it should do)!
Again – Good sleep is crucial to good health and longevity.
I hope that you find this website of value, and if you do, please tell your family and friends to drop in, and if you feel it can be improved please let me know how I can improve it for you.
Please click below for your free guide to a better sleep – thank you.
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Dr. Stephen Bray 2019
For those dentists and hygienists who want to ‘practically and effectively’ help their patients more easily from their own offices, I encourage you to join our network to improve access to this vital service. Thank you.