Dr Gatti's Blog a Lawrence Dentist Reflections

Today more than ever, the idea of a good night’s sleep is a fleeting one. Scrimping on sleep causes more than midday drowsiness and saggy eyelids – it may raise your blood glucose levels and cause other medical complications that I have written about in previous blogs. We don’t really know why the body needs sleep, however we do know that sleep is a dynamic, complex activity. The hypothalamus tells the body when to sleep, wake up, change blood pressure, help the immune system and regulate hormones for digestion. Every organ of the body, including the hypothalamus depends on sleep to function properly. Lack of sleep interferes with your ability to produce insulin, increases your risk of diabetes, high blood pressure, depression, heart attack and stroke. Also, sleepless nights increase the level of stress hormones in your body, causing the body to store fat and make it more difficult to loose weight.

In the past I have talked about obstructive sleep apnea (OSA) and snoring causing sleep disruption for you and your bed partner. We have also discussed how these can be addressed with oral appliances. Now I would like to review some simple general rules to improve the overall quality of your sleep. I am talking about sleep hygiene. Bottom line is that your bed should not be an extension of your office or family room. The bed is meant for sleep and sex. I can give you some sound advice for sleep; as for sex, well…

Here are some sleep hygiene recommendations:

• Wind down for about 30 minutes prior to bedtime.
• Try to go to bed and wake up at the same time every day.
• Avoid exercising or eating within 2 hours of bedtime.
• Avoid caffeine after lunch.
• Limit alcohol intake.
• Don’t eat or watch TV in bed.
• Try relaxing breathing exercises when you get into bed.
• After an estimated 20-30 min. of not falling asleep, get out of bed. Then, do something relaxing, like listening to music or light reading until you are sleepy enough to return to bed. Do not get on the computer.
• Don’t set up camp on the couch or you will begin to associate sleep with the couch and not your bed.

These are fairly straight forward and simple; however, developing good sleep hygiene and a consistent routine is very important to sleep and that is not a laughing matter.

All through the house not a creature was stirring-except for someone snoring.

So many people snore that everyone thinks it is normal even if it is extremely disruptive. A good night of sleep is not only very important to your overall health, but to the health of all the people in your home. A poor night of sleep affects your ability to function effectively throughout the day. It is estimated that 30% of adults snore on a regular basis and up to 50% snore occasionally. Living with a snorer can strain even the best relationship.

If you are kept awake night after night by a bed-partner’s snoring, you are not getting the sleep you need. The effect of the noise on a sleeping partner of a snorer can raise blood pressure in direct relation to the intensity of the noise. High blood pressure is a known risk factor for stroke, heart disease, kidney disease and dementia. What seems to be simple snoring could also be related to the more serious condition of Obstructive Sleep Apnea. Snoring and/or obstructive sleep apnea are serious medical problems. Improperly treated obstructive sleep apnea can be a serious threat to you health. Many couples are resorting to separate bedrooms or even a second master suite, which is not only expensive, but extreme when there is qualified, affordable and effective help available.

Dr. Gatti is a qualified dentist in the area of sleep-disordered breathing and will work with your physician to optimize your health or the health of a loved one. The dentist you choose to treat your problem with sleep disordered breathing must be properly educated and have adequate experience. Did you know that legally, any dentist can fabricate an appliance for the treatment of snoring and/or sleep apnea? However, that does not mean that every dentist has the necessary experience and training to provide proper therapy. Because no special qualifications are required it is your responsibility to choose your dentist wisely.

A qualified sleep-disorders dentist should have:

• Appropriate knowledge of sleep medicine
• Adequate training in oral appliance therapy
• Years of experience with many different appliance types
• Solid relationships with local sleep labs and sleep physicians
• Current knowledge of emerging trends
• Ability to derive maximum insurance benefits for you
• A team approach with other professionals
• A proven follow-up system in insure healthy results long-term
• In-depth knowledge of oral appliance research

If you have any concerns about our qualifications, please ask. We will be happy to discuss them with you.

Sleep apnea cognition and brain function

I recently attended a seminar on the impact of sleep apnea on cognition and brain function. Hard to believe, but it was rather fascinating and shed light on how important it is to treat sleep apnea at an early stage.

Generally when looking at an overnight sleep study to areas are evaluated; one being the sleep fragmentation (the number of times you awaken) and the other being recurrent hypoxia (the desaturation of oxygen in the blood.) These two factors lead to excessive daytime sleepiness, depression, attention and concentration problems, cardiovascular and an entire host of medical complications.

During this seminar the focus was trying to identify specific cognitive domains that improve with treatment and which ones did not improve. In general, treatment of sleep apnea improved attention and fatigue in most studies and consistently did not improve psychomotor functioning. So, fatigue is improved, however complex thinking and problem solving did not improve. The theory is that sleep deprivation can directly impact cognitive and brain function permanently.

As with all things, there are varying degrees of severity. Bottom line, it is not just about feeling tired, it is about treating the disease before long term, irreversible damage is done. Once again, obstructive sleep apnea is a serious player and should be evaluated and dealt with as soon as possible.