There are so many issues involved with SDB that it would take pages to explain, so in this short blog, we will review some of the major players in the equation.

The symptoms of SDB include morning headaches, night terrors, teeth grinding, polyuria (lots of bathroom visits at night), mood changes (irritability during the day), cognitive difficulties, restless sleep, gasping/snorting while asleep, and periods of outright cessation of breathing. As you can see, SDB is a very serious matter and needs to be addressed.

Let’s start with how to measure SDB. To get somewhat of a handle on the problem, a fairly simple test called the PSG (Polysomnogram) can be done. The PSG produces a number that allows an assessment of how serious sleep apnea might be. It’s sort of similar to getting a blood pressure number. For sleep apnea, if the number goes above 5-15, the apnea is considered to be moderate. Anything over 15 is generally considered severe apnea and needs to be addressed right away. A CPAP is usually the first course of treatment, and if a patient cannot handle wearing the CPAP, a dental sleep appliance usually works quite well.

As part of a good sleep analysis, the Vitamin D3 level should be analyzed carefully. The reason for this is that D3 is not really a vitamin, it is actually a hormone that regulates your sleep. If the D3 number is around 30 ng/ml or below, you are running really low and should address the problem. The proper number for good healing and good sleep is around 60-80 ng/ml. If you maintain a very low D3 level over time, eventually your body stops the ability to process D3 and you will have lots of problems with sleep later in life.

Snoring is another SDB issue that is very common in our society. Snoring is created by a harsh sound that occurs when the tissue is vibrating as you breath. This can turn into a chronic problem causing a vibration of the carotid artery, and this can cause damage to the artery to the point where your body sends plaque to fill in the damaged areas. If a plaque loosens and goes to your heart, then a cardiovascular event, even death, can occur. Snoring can be caused by a condition having fat deposition in the throat and tongue, nasal congestion, deviated septum, or even enlarged tonsils and adenoids. These factors can lead to snoring and prevent a good night’s sleep.

Another important aspect of good sleep is a very much ignored thing called sleep hygiene. That’s right; how clean, how good is your sleep pattern? What this means is that if you can program your body into going to bed at a regular time each night, your body will get used to that pattern and sleep more effectively and efficiently. Good sleep can be prevented by other factors such as:

-Sleep Disturbance: This is mostly caused by stress, insomnia and even excessive screen time.

-Poor Diet: Food is obviously a very important part of fuel for our body. With a poor diet, nutritional deficiencies become present, like the vitamins and minerals your body needs.

-Dehydration: This affects the function of your body’s organs and blood volume. The effect makes you feel tired.

-Psychological: This could be stress from work or a traumatic event causing a considerable degree of uneasiness leading to your mental health and exhaustion.

As you can see, when sleep is poor, you will be tired. It’s as simple as that.

If you are experiencing any of these symptoms, Dr. Jeffrey Brown and our team are here to help. We offer sleep apnea therapy in Falls Church, VA. Please give us a call if you would like to learn more, or to schedule a consultation. Just call our office at 703-821-1103. Better sleep awaits you!

The post Why am I Always Tired? first appeared on Sleep & TMJ Therapy.

Sleep apnea is a condition with multiple symptoms and even more treatment options. When a person sleeps at night, they should stay asleep all night with minimal movement and there should be no snoring. Unfortunately, many people these days snore and have little control over this. Snoring can be a symptom of obesity or might be present in even the slimmest people – there is no true rhyme or reason here. The best way to diagnose the problem is to do a sleep study – a polysomnogram. This requires wearing all sorts of wires across the head and neck for a two-night study in most cases. Then a board-certified sleep MD reads the results. Without getting too technical, the measurement achieved is called the AHI – Apnea Hypopnea Index. If the AHI is quite high, then the usual first measure is to wear a CPAP – continuous positive airway pressure – to force the air into the lungs. For some people, it really works well,  yet for others, it just cannot be tolerated.

Depending on who the doctor is,  the next level of treatment is usually a dentist-fabricated device that opens the jaw and brings it more forward – just like if you did CPR on a person. The dental sleep device is a very good way to help open the airway in most mild to moderate apnea cases. Sometimes the device is used along with the CPAP to allow the machine to use less pressure to get the air into the lungs.

There are many other techniques to help sleep apnea cases – they involve surgery to cut away the palatal area – often referred to as UPPP (Uvula Palatal Pharyngeal Plasty) or even balloon plasty to just temporarily open the airway. Another surgery is called MMA -Maxillary Mandibular Advancement. This effectively brings the upper and lower jaws forward permanently. Beware of these surgeries as they might disrupt the TM joints. Other techniques include various medications that serve many different purposes.

Recently, HNS (Hypoglossal Nerve Stimulation) has been developed. This involves putting, for lack of a better word, an electrical ‘shock’ wire into the hypoglossal nerve in the tongue, then running a wire down the inside of the neck to a battery pack under the skin just below the collar bone. As with any surgical procedure to do an implanted device, there are risks associated with the procedure. Once the therapy is turned on, what happens next is when the patient has an apneic event, the sensor detects this and sends a ‘shock’ and in turn the tongue begins jutting forward to open the throat. Some people seem to tolerate this technique fairly well, others not so much. Some patients may experience discomfort from the stimulation, notice tongue abrasion, experience mouth dryness, or experience discomfort from the presence of the device. Overall, this is a relatively simple technique. The question brought up there is some concern that after a year or two the tongue may no longer be responsive to the shock wire.

Overall, there are many treatments for sleep apnea and no one system of therapy is right for every patient.  Based on the AHI, the most non-invasive treatment, a dental sleep appliance,  does still work and is highly recommended.

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