It is not very often that a long-term study can conclusively state that lack of sleep can harm you, but this study does reflect that and more. It has also concluded that treating OSA slashes your daytime sleepiness by 45%. This is remarkable. Now, because of studies like this, individuals or employers who count on themselves or their team to be awake and alert will now pay more attention to how serious OSA can be. Most insurance carriers cover the diagnosis of OSA (getting a sleep study), but some restrictions may apply.

The way to determine if OSA is present, and to what extent, is by doing a PSG (Polysomnograph) analysis. This is a fairly simple test and is often done at home initially. If the home test shows serious issues, then the MD does a more advanced test at their in-office facility. The PSG generates a value called the AHI (Apnea Hypopnea Index) that describes how many times the patient stops breathing for more than 10 seconds, along with the times that breathing is slowed. This is not an exact science, and some doctors argue that AHI is an antiquated technique to measure the problem, but for now, this is what they have. Here is a quick review of the meaning of the numbers and the severity:

• None/Minimal AHI = <5 recorded events per hour
• Mild AHI = ≥ 5, but < 15 recorded events per hour
• Moderate AHI = ≥ 15, but < 30 recorded events per hour
• Severe AHI = ≥ 30 recorded events per hour

Back to the infamous, or soon-to-be-infamous, study. The Wisconsin Cohort Study also looked at death rates and concluded that cardiovascular mortality accounted for 26% of deaths for people who did not have SDB (Sleep Disordered Breathing), and the death rate for severe SDB was 42%. This is substantial. For those who had OSA and did not wear a CPAP, the death rate was significantly higher than for those who wore their CPAP. In other words, if your sleep MD dictates that you need a CPAP, then you need a CPAP! If you are CPAP intolerant, then you should discuss this with your MD. The conversation may lead to an alternative suggested use of a dental appliance to help keep the airway as open as possible. Generally, this is a great alternative for patients.

The study concluded that premature death occurred in severe OSA patients. Additionally, the estimate of a 3-fold greater odds of cardiovascular mortality may be underestimated when compared to community controls and patients without SDB. The death rate amongst those who did not use CPAP was significantly higher than that of patients who were dedicated to wearing the CPAP. The bottom line is that although many patients typically do not like the CPAP, it is keeping them alive, and that is what counts.

If you have OSA or symptoms, get it checked! You will likely be saving your own life or the life of a loved one. To learn more about OSA treatments in Falls Church, Virginia? Dr. Jeffrey Brown and our team at Sleep & TMJ Therapy are here to help. Please call 703-821-1103 today to book a reservation.

The post Untreated OSA (Obstructive Sleep Apnea) Is More Serious Than We Thought first appeared on Sleep & TMJ Therapy.

AHI- Apnea-Hypopnea Index

The Apnea-Hypopnea Index (AHI) is a diagnostic tool used to assess the severity of sleep apnea, a sleep disorder characterized by pauses in breathing or periods of shallow breathing during sleep. The AHI measures the number of apnea (complete pauses in breathing) and hypopnea (partial reductions in breathing) episodes that occur per hour of sleep. It is calculated based on data collected during a sleep study, known as polysomnography.

Here’s how the AHI is categorized in terms of sleep apnea severity:

-0-5 is considered none to mild.
-5-15 is moderate.
-15+ is considered severe apnea.
-UAR: Upper Airway Resistance – blockage in the upper airway.
-MSLT- Multiple Sleep Latency Test – naps to see sleep efficiency.
-OSA: This is obstructive sleep apnea.
-PSG: Polysomnograph – the sleep apnea test.
-Multiple leads are placed over various muscles to see how they react while asleep.

Visible and Audio Symptoms for Adults and Children

If a spouse or parent sees or hears a person snoring, gasping or waking up a lot, then the HST, Home Sleep Test, is indicated to determine if apnea is present. Look for big circles under the eyes. Subjective symptoms include the following:

-Tiredness during the day and daytime drowsiness.
-Overwhelming urge to take naps.
-Difficulty falling or staying asleep.
-Unusual breathing patterns and movement patterns while falling or during sleep.

Epworth Sleepiness Scale Questionnaire

The Epworth Sleepiness Scale (ESS) is a questionnaire used to assess daytime sleepiness. It provides a measure of a person’s general level of daytime sleepiness or their average sleep propensity in daily life. The scale was introduced by Dr. Murray Johns in 1991 as a simple, self-administered questionnaire.

The ESS consists of eight questions, each asking the respondent to rate, on a scale from 0 to 3, their likelihood of dozing off or falling asleep in different common situations that vary in terms of their somnolence-inducing potential. The situations include passive activities such as sitting and reading, watching TV, sitting inactive in a public place, being a passenger in a car for an hour without a break, lying down to rest in the afternoon, sitting and talking to someone, sitting quietly after a lunch without alcohol, and being in a car while stopped for a few minutes in traffic.

-0-7 is unlikely abnormally sleepy.
-8-9 is the average daytime sleepiness.
-10-15 is excessively sleepy, depending on the situation.
-16-24 is continual, excessive sleepiness.

The Breathing Triangle?

The “Breathing Triangle” refers to three key areas of the face that are essential for optimal breathing: the two nostrils and the mouth. This concept is often discussed in the context of health and wellness, specifically in relation to sleep and breathing disorders such as obstructive sleep apnea (OSA). This involves both nostrils and the throat and the two points make up the inverted triangle. If the top of the triangle is blocked (the nostrils) then the breathing is compromised.

(MSLT) Multiple Sleep Latency Test

The Multiple Sleep Latency Test (MSLT) is a diagnostic tool used in sleep medicine to measure the speed at which a person falls asleep in quiet daytime situations. It is often used to diagnose narcolepsy and other disorders associated with excessive daytime sleepiness.

Your Sleep Visit

We take your vitals, note neck measurements, etc. At the initial visit, the vitals are the same as TMD: BP, Oxygenation, Pulse, Neck measurement, BMI, and pH. At each visit, the ROM (range of motion) is measured, discuss your symptoms, mostly subjective on how you feel you are sleeping with the appliance. If your spouse is present, we will ask if snoring still occurs.

At the 3-12 Month Markers From Delivery

At three months we run a new HST (home sleep test) and titer the appliance forward by 0.5mm and Dr. Jeffrey Brown will adjust the strap. The HST will be performed again six months after the last visit until no more apnea or snoring is reflected. The 12-month check after the last visit will be more of a review, then once each year thereafter with a new sleep test every 2-3 years.

As you can see, Dr. Brown and our team take your sleep health seriously. If you would like to read more, check out our Sleep Apnea Therapy page. If you would like to schedule an appointment, please call 703-821-1103 to speak with a friendly member of our team!

The post What You Should Know About Your Sleep Numbers first appeared on Sleep & TMJ Therapy.

If you snore or wake up gasping in the middle of the night, you really should consider having at least a HST-Home Sleep Test- done to see if you are in the range of sleep apnea. In most cases, you would do the home test to get the basic indicators to see if there is more of a problem than meets the eye. The test will reveal a number called the AHI-Apnea Hypopnea Index. If that number is between 0 and 5, there is a very low risk of apnea. If the number is over 15, then it is usually labeled as moderate to severe apnea. AHI refers to how many times you either stopped or slowed breathing each hour of the night.

The problem with sleep apnea is that your brain does not get enough oxidation to function properly. Often this can manifest as a morning headache. Other manifestations of apnea include cardiovascular disease, high blood pressure, stroke, diabetes and even some cancers. When the brain and body do not receive proper oxygen supply, systems in the body begin to shut down. This is when disease processes can set in and now you have to deal with daily meds for diabetes or high blood pressure. Many times, some of these meds prevent the good, deep sleep that we need for better health. Painkillers are notorious for allowing us to fall asleep, yet they prevent the deeper, restorative sleep that is critical to good health.

So, what are some of the warning signs that you might have sleep apnea? One clear sign of potential OSA (Obstructive Sleep Apnea) is waking up with a headache regularly. This oftentimes means that your brain is not getting enough oxygen and it lets you know by making your head hurt when you first wake up. This is serious stuff – deal with it. Other indicators include restless legs and even gasping for air in the middle of the night. Your brain jolts you into waking up so that you can breathe and get some oxygen into the body. Other signs include waking with a dry mouth or even a sore throat.

A really strong sign of OSA is excessive daytime sleepiness. Again, your body is warning you of a potential problem and you really need to listen. Another symptom is trouble focusing during the day. As you can see, OSA is a serious problem and it’s wise to deal with it. Get the proper help you need from someone who understands sleep apnea. Please call our team in Falls Church, Virginia to schedule a visit with Dr. Brown. Call 703-821-1103 today!

The post Do You Have Sleep Apnea? first appeared on Sleep & TMJ Therapy.

MFT refers to Myofunctional Therapy. This means that if you can learn how to stretch your tongue and strengthen the muscles of the face, then as you get a bit older these muscle groups will stay tauter and less droopy over time. This equates to less airway obstruction. Less fat tissue drooping into your throat means the airway will function better and your AHI (Apnea Hypopnea Index) can be lowered. While treating airway disorders, a sleep apnea test is usually performed. The AHI number will be determined. An AHI of lower than 5 is usually a good number, but when it creeps up to 10 and above, this means sleep apnea could be present. If sleep apnea is present, it needs to be dealt with.  Sleep apnea affects more than just your sleep.  Daytime drowsiness can lead to difficulty concentrating and irritability.

Before discussing MFT further, there are more abbreviations to understand.  The term OSA refers to Obstructive Sleep Apnea. OSA just means that you have sleep apnea, and the AHI is relatively high. It is always important to know your numbers regarding OSA and know why a higher number is a bad sign. So do your sleep test, determine what the AHI number is, and you will know how bad the OSA is. This will help you understand how to fix the problem and the severity of your sleep apnea.

Many people would help their own health if they exercised regularly. Imagine if you exercise your tongue, your cheeks, your neck, your forehead; this would allow all the muscles of the head and neck to work better and not be so flaccid. As we get older, all these muscles simply become saggier. The less-tone flabby muscles in the throat begin to close the throat. Did you know that your tongue can harbor tremendous amounts of fat tissue? This tissue is very difficult to get rid of because practically no one exercises the tongue the way it should!

The real problem with MFT, as mentioned previously, is that even when you really should do the exercises, most do not. They are too busy, don’t really care, or think it’s kind of a silly thing. But, when they learn that the muscular system of the throat is just like working the biceps, the traps, the thighs, they more or less ‘get it.’

Learn about MFT and how it might help you because it will help you stay healthier longer.  If you’d like a more natural approach to helping reduce your OSA, this is worth looking into!  There are online resources to help you learn where to look.

The post How MFT Can Help AHI, OSA, & Other Abbreviations first appeared on Sleep & TMJ Therapy.