Sleep may seem simple, but the mechanism behind it is complex and requires all body systems to be in harmony with one another. Sleep disorders are therefore not uncommon.
Everyone experiences some difficulties with their sleep at one time or anaother, but for those who are affected by it or feel there is something wrong, further investiagtion can help enormously.
So, there are many disorders of sleep. some common, some rare (some in between), we can assist in screening, triage and diagnosing some of the conditions. Some problems are easily solved (when you know what the problem is), some may take a little longer or need some help along the way.
We can assist in collaborative care too as it’s important to have a base of knowledge which covers the patients wants and needs, not just selling people what you have to offer.
There are many factors that affect sleep and determining what is “at work” and therefore a diagnosis is the first step toward healthy sleep and all the benefits that go with it.
Sleep impacts many things, for instance;
Good sleep is crucial to good health and longevity. It has been shown that those with good quality sleep of the right duration is associated with longer life, also less illness and an improved quality of life.
Infants can have obstructive sleep apnea – A small percentage of infants who die from sudden infant death syndrome (SIDS) have apnea symptoms prior to death. But infant sleep apnea has not been established as a risk factor for SIDS.
Children – Good sleep is absolutely crucial for children of all ages – failure to achieve this will affect the child and their future. Providing this quality of sleep will simply change your child’s life, forever – nothing less
Adolescents and young adults – are notorious for not getting enough sleep. The average amount of sleep that teenagers get is between 7 and 7 ¼ hours. However, they need between 9 and 9 ½ hours (studies show that most teenagers need exactly 9 ¼ hours of sleep). Teenagers do not get enough sleep!
Adults – Sleep is crucial. Dangers to others from those sleep deprived are well documented. CLICK BELOW
Sleep needs change – how, when and what should we do?
Sometimes its not sleep that gets our attention but a disease, illness or dysfunction that is related or associated with poor sleep. As usual, treatment should be directed toward the cause not the symptoms.
Then again there are problems that affect sleep (and start a vicious cycle). Anyone who has ever had a bad back, sore shoulder or hip knows that sleep will be affected. Poor sleep increases pain.
The dental connection
What about the dental aspects .If you’re a patient, why should you see a dentist if you don’t sleep well?
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.
Sleep is simple but with complex mechanisms. Our normal circadian rhythm controls our sleep throughout internal messages but requires all the body is “on board” with it!
Personally – Stephen Bray
“Well, apart from a general concern for others, my father died of a massive heart attack – a complication of his obstructive sleep apnea (OSA) and heavy snoring – I believe his death was both associated and avoidable.
To aid her sleep, my mother was prescribed a barbiturate for over 20 years (without any clinical follow-up), not surprisingly she became reliant on them to sleep.
My own obstructive sleep apnea (OSA) and snoring 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 to get treated.
On a separate note, I once experienced a serious surgical emergency and close shave with death as I lost my airway forcing me to experience just how important an open airway is!
During the 20 years of practice in the area of sleep, I have seen much frustration in patients, I’ve seen their associated illness and even their deaths, sometimes unnecessarily so. One hopes that as public and medical awareness and demand increases, so will the quality of the service that we all deserve.” SB
We’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. As dentists we are able to screen and suspect, but the diagnosis must be made by a physician.
Even physicians may be unaware of the connection between heavy snoring and stroke however.
Young women may have OSA too – but with different symptoms.
Young women may have OSA, yet are not infrequently told categorically that it simply isn’t possible for them to have it because they ate not male, middle aged, over weight and snore.
Hundreds of patients are unnecessarily taking medicines to aid sleep.
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 had at some time.
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.
Many dentists too, remain genuinely unaware of the impact sleep disorders have on their patients, and indeed the effect of it on the dental work they’ve just performed for them.
Jack and I work together to provide support for dentists new to the field – some 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 value to the patient is the 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.
SAM. 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 – 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”.
PETER – 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.
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- please call our office if you feel we may be of value in the improvement of your sleep.
IF YOU FEEL WE MIGHT BE ABLE TO HELP YOU – PLEASE CLICK BELOW
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.