Temporomandibular Disorder–TMD–is a disorder that affects the jaw joints and the muscles controlling jaw movement. Some common symptoms (but not all) often include jaw pain, difficulty chewing, neck pain, and ear pain and can also include a clicking or locking of the jaw. These symptoms can vary in intensity and may sometimes lead to chronic discomfort.

Sleep Apnea is a condition characterized by sleep breathing being disrupted. Some symptoms mostly reported are loud snoring, fatigue, unable to concentrate, morning headaches and of course irritability. Typically, this is because the soft tissue (collagen) is not tight and most cases the tongue has extra fat cells. Both of these causes blocked the airway when lying down.

Both Sleep Apnea and TMD are often overlooked or misdiagnosed, making awareness crucial for effective management. Effective diagnosis usually involves a combination of medical history, physical examination, sleep test (at home or in-lab) and advanced diagnostic tools like MRI and a CBCT X-ray of the joints. Recognizing the signs and seeking professional help are key steps in managing these disorders. If you are looking for studies, there are clear links between OSA and TMD.

Both Sleep Apnea and TMD share several risk factors that can exacerbate symptoms. If the discs in the jaw joints are displaced, this will greatly contribute to TMD as well as OSA. Oftentimes, genetics are involved, and a family history of OSA and/or TMD is common. People experiencing symptoms of either condition should seek medical evaluation to prevent long-term complications. Understanding the underlying mechanisms of these conditions can help in recognizing the need for timely and appropriate treatment.

Another important factor is age; the likelihood of developing Sleep Apnea and TMD increases as one gets older. Being overweight is another significant risk factor for Sleep Apnea, as excess fat can obstruct the airway. This excess weight can also put additional stress on the jaw muscles, contributing to TMD symptoms.

Technological advancements are making significant strides in the diagnosis and treatment of both OSA and TMD. For Obstructive Sleep Apnea, the use of devices like Continuous Positive Airway Pressure (CPAP) machines has been revolutionary. These machines ensure that airways remain open during sleep by providing a constant flow of air through a mask. For those who cannot tolerate the mask, a custom-fitted dental appliance can be made to allow the airway to stay open by repositioning the jaw and tongue. Another noninvasive treatment is laser therapy. This can reduce the fat cells found in the tongue and tighten up the tissue in the back of the throat.

On the TMD front, appliance therapy is a great treatment. The focus is to drop the jaw joint down to allow for the disc to migrate back into the correct anatomical position on top of the jaw. This type of treatment also focuses on realignment of the cranium which in most cases helps greatly.  Appliance therapy like the Gelb orthotic and the amazing ALF have come to the forefront in TMD treatment, and coincidentally, helps with OSA.

Another option in conjunction or stand-alone treatment is laser therapy. This is being increasingly utilized to treat jaw pain and inflammation. Laser treatments can reduce pain and promote healing by stimulating blood flow and tissue repair. Another treatment in conjunction with appliance therapy is Botox injections. This typically is used to help calm the pain associated with TMD. These injections are given primarily to the masseter muscles.  This calms the muscles by temporarily paralyzing and then reduces the tension. Another type of treatment that helps is TMJ massage therapy. This adjunctive service focuses on the muscles of the head and neck. The massage results in less muscle tension, improves blood circulation and enhances the jaw’s working function of opening, chewing, speaking and yawning.

Additionally, advancements in imaging techniques, such as digital X-rays (bone views) and MRIs (soft tissue views) provide detailed views of the jaw joint and surrounding structures and tissues. This allows healthcare providers to make more accurate diagnoses and tailor treatments to individual needs.

Most of all, be sure to talk to a well-educated healthcare professional who understands your needs and can analyze the situation correctly. Are you struggling with TMJ issues and want to learn more about TMJ treatments in Falls Church, Virginia? Dr. Jeffrey Brown and our team at Sleep & TMJ Therapy can help you find the relief you need! Call 703-821-1103 today to schedule your consultation.

The post The Connection Between Sleep Apnea and TMJ Disorder first appeared on Sleep & TMJ Therapy.

Snoring might seem like an ordinary part of sleep, but in children, it can sometimes signal underlying health concerns that warrant closer inspection. While occasional snoring is not uncommon and often harmless, frequent snoring in kids could indicate various issues that need to be addressed.

Understanding what to look for can help parents determine if their child’s snoring requires further investigation or professional advice. It is crucial to pay attention to the nature and frequency of the snoring, as well as any other accompanying symptoms. Some children may snore due to temporary conditions like a cold or allergies, but others might have more persistent issues that need medical evaluation.

Parents should be mindful of not just the snoring sounds but also any signs of disrupted sleep patterns. If your child appears restless, wakes up frequently or shows signs of breathing difficulties during sleep, these could be important indicators. Snoring accompanied by pauses in breathing, gasping or choking sounds can be particularly concerning and may suggest a more serious underlying problem.

Addressing snoring in children early on can prevent potential complications and contribute to better overall health and well-being. By staying observant and proactive, parents can help ensure their children get the restful, uninterrupted sleep they need for healthy growth and development.

At Sleep and TMJ Therapy, we consult with parents regarding the sleep issues with their children. It is important to note that we will often work with an ENT or specialist in sleep medicine to be sure their child is receiving the best treatment possible. Part of the determination in treatment involves examining the temporomandibular joints, the Mallampati score, addressing any asymmetries and looking at posture as well. These are just a few of the things we look at. It is important that you take a team approach to your child’s treatment — the dentist, the MD, the sleep doctor and possibly the myofunctional therapist.

Signs of Snoring in Children

Identifying snoring in children requires observing specific behaviors during their sleep. One of the most noticeable signs is noisy breathing, where you may hear consistent loud snoring sounds emanating from your child’s room. Pay close attention to whether these sounds are regular or if they vary in intensity.

Another key sign is pauses in breathing. These interruptions might be brief, but they are significant and could suggest a more serious sleep-related issue. If your child frequently stops breathing for a few seconds and then resumes with a gasp or choking sound, it is essential to take note.

Restlessness during sleep is another indicator. If your child is constantly moving, tossing or turning, it could be a sign that they are not getting restful sleep. This restlessness may be accompanied by frequent awakenings throughout the night.

Observe your child’s sleeping position. Some children who snore may sleep in unusual positions to try to alleviate the discomfort caused by airway obstruction. They might sleep with their neck extended or in a sitting position to improve airflow.

Morning headaches can also be a sign. If your child frequently complains of headaches upon waking, it might be linked to poor oxygen levels during sleep due to snoring. Additionally, excessive daytime sleepiness can be an indicator. If your child seems unusually tired during the day or has trouble staying awake in school, it could be related to disrupted sleep caused by snoring.

Another aspect to consider is your child’s behavior and mood. Persistent snoring and poor sleep can lead to irritability, mood swings and difficulty concentrating. If you notice these changes in behavior, it could be linked to their sleep quality.

Monitor for any signs of mouth breathing during the day. Children who breathe through their mouth rather than their nose are more likely to snore at night. This habit can also lead to other issues like dry mouth or sore throat upon waking.

Facial asymmetry is another sign that can be associated with snoring in children. If you notice any irregularities in your child’s facial structure, it might be related to chronic mouth breathing and airway obstruction, both of which can contribute to snoring.

Lastly, consider if your child has frequent colds or allergies. These can cause nasal congestion and make it harder for them to breathe through their nose, leading to increased snoring. Keeping an eye on these signs can help you identify if your child’s snoring needs further medical evaluation.

In so many of the child cases, the ALF appliance can help with opening the airway. The ALF will increase the vertical inside the oral cavity and also can begin to widen the arches to some extent to allow for more room for the tongue.

Potential Causes of Snoring

Snoring in children can stem from a variety of causes. One common cause is enlarged tonsils or adenoids, which can obstruct the airway and lead to noisy breathing during sleep. Additionally, allergies or colds can contribute to nasal congestion, making it more difficult for air to pass smoothly and increasing the likelihood of snoring. Other factors include weight issues and environmental influences. Studies indicate that children who are overweight are at a higher risk of snoring. Allergies can exacerbate the problem; when flare-ups occur, they can lead to inflammation in the nose and throat, increasing snoring risks. Exposure to environmental tobacco smoke is another contributing factor that has been linked with a higher risk of snoring in children.

In the past, parents would often say, “My child snores…it’s so cute!” but it really is not. Snoring causes damage to the throat and can lead to other health problems. The dentist is often the one who can help with this with a referral to a practice like us or talk with your child’s pediatrician.

Health Concerns Related to Snoring

Persistent snoring in children can impact their overall health significantly. One primary concern is the potential effect on sleep quality, which can lead to various cognitive and behavioral issues. Recent research indicates that habitual snoring is associated with cognitive impairment and behavior issues.

In some instances, snoring might be a sign of Obstructive Sleep Apnea (OSA), a disorder where the airway becomes blocked during sleep, leading to breathing interruptions. This condition can result in more serious health consequences. OSA in children has been connected to impaired brain development, reduced academic performance, cardiovascular issues such as high blood pressure, altered metabolism and behavioral problems.

Cognitive development is particularly vulnerable to poor sleep quality caused by persistent snoring. Children who do not get adequate, restful sleep may struggle with attention, memory and learning. These cognitive deficits can lead to difficulties in school, affecting their academic performance and long-term educational outcomes. Furthermore, the lack of proper sleep can exacerbate behavioral problems, including hyperactivity, irritability and difficulty concentrating.

Another health concern related to snoring in children is the risk of cardiovascular issues. Chronic snoring and sleep apnea can strain the heart and blood vessels, potentially leading to high blood pressure and other cardiovascular problems. Early intervention is crucial to mitigate these risks and ensure a healthy cardiovascular system as the child grows.

Metabolic issues are also linked to sleep disturbances caused by snoring. Disrupted sleep can affect hormones that regulate appetite and metabolism, potentially leading to weight gain and other metabolic disorders. This is particularly concerning given that obesity can further exacerbate snoring, creating a vicious cycle that can be challenging to break.

Behavioral and mood disorders are another significant concern. Children with disrupted sleep may experience mood swings, anxiety and depression. These emotional challenges can affect their relationships with family and peers, as well as their overall quality of life. Addressing snoring and improving sleep quality can help alleviate these behavioral and mood issues, promoting better emotional health.

In addition to cognitive and behavioral issues, children who snore frequently may also face developmental delays. Sleep is essential for growth and development and interrupted sleep can hinder these processes. Ensuring that children get sufficient, high-quality sleep is vital for their physical and cognitive development.

Finally, persistent snoring can also impact a child’s immune system. Poor sleep quality can weaken the immune response, making children more susceptible to infections and illnesses. A strong immune system is crucial for overall health and well-being, particularly in growing children. Addressing snoring can help improve sleep quality and, consequently, enhance the immune function.

When to Seek Medical Advice

Parents should be attentive to certain red flags when it comes to their child’s snoring. If the snoring is accompanied by frequent interruptions in breathing, such as pauses, gasps or choking sounds, it is essential to seek medical advice. These symptoms could indicate Obstructive Sleep Apnea (OSA) or other sleep-related disorders that require professional evaluation and treatment.

Daytime symptoms are also important to consider. If your child exhibits excessive daytime sleepiness, irritability or difficulty concentrating, these could be signs of inadequate sleep quality due to snoring. Persistent morning headaches or complaints of a sore throat and dry mouth upon waking are additional indicators that medical advice should be sought. These symptoms often suggest that the snoring is affecting the child’s overall sleep and health.

Another sign to watch for is unusual sleep positions. Children who sleep in positions that seem intended to open their airway, such as with their neck extended or in a sitting position, might be experiencing discomfort due to snoring. This compensatory behavior is a significant indicator of possible airway obstruction.

Behavioral changes are equally important. If you notice your child has become more irritable, experiences mood swings or shows signs of hyperactivity, it could be linked to poor sleep quality caused by snoring. These behavioral changes can impact their social interactions and performance in school.

Monitoring for facial asymmetry is also crucial. If you observe any irregularities in your child’s facial structure, it might be due to chronic mouth breathing and airway obstruction. These physical changes can develop over time and might be related to persistent snoring and its underlying causes.

It is also essential to consider any underlying health conditions that might contribute to snoring. For instance, if your child has frequent colds or allergies that lead to nasal congestion and you notice an increase in snoring during these periods, discussing these patterns with a healthcare provider is important. They might suggest treatments to alleviate congestion and improve airflow, thereby reducing snoring.

Weight is another factor that can contribute to snoring. If your child is overweight, this can increase the risk of snoring due to excess tissue around the throat that can obstruct the airway. A healthcare professional can offer guidance on weight management strategies to help mitigate this risk.

Finally, environmental factors should not be overlooked. Exposure to tobacco smoke, even secondhand, can contribute to snoring by irritating the airways. If your child is regularly exposed to smoke and has persistent snoring, it is important to discuss this with your doctor as well. They can provide advice on minimizing exposure and managing any related respiratory issues.

By being vigilant and proactive about these signs, parents can ensure their children receive the appropriate medical evaluation and care to address snoring and any associated health concerns.

Tips for Parents

Parents can play a vital role in managing and potentially reducing their child’s snoring by making a few adjustments at home. One effective approach is to maintain a regular sleep schedule. Ensuring that your child goes to bed and wakes up at the same time every day can promote better sleep hygiene and overall sleep quality.

Creating a comfortable sleep environment is also important. Make sure your child’s bedroom is cool, quiet and dark. Using a humidifier can help keep the air moist, which might alleviate some breathing issues that contribute to snoring.

Elevating your child’s head during sleep can improve airflow and reduce snoring. You can achieve this by slightly raising the head of their bed or using an extra pillow. However, make sure the elevation is not too high as it might cause neck strain.

Encouraging your child to sleep on their side instead of their back can also make a difference. Back sleeping can cause the tongue and soft tissues to fall back, blocking the airway and leading to snoring. Side sleeping can help keep the airway open. For some of our patients, there is a pillow called Medcline (found on Amazon, of course) that actually forces the person to sleep on their side and slightly elevated — this is a good sleeping position.

Addressing nasal congestion is another crucial step. Using saline nasal sprays or a nasal rinse can help clear nasal passages, making it easier for your child to breathe through their nose. Over-the-counter nasal strips can also be useful in keeping nasal passages open during sleep. In our office, we promote the ‘Mute’ nasal dilator that greatly opens the nasal passages to promote much better nasal breathing. This is very important to the formation of nitric oxide in the sinuses.

If allergies are a trigger, managing them effectively can reduce snoring. This might include using air purifiers, washing bedding frequently and keeping pets out of the bedroom. Allergy medications, as recommended by a healthcare provider, can also help.

A healthy diet and regular physical activity can contribute to better sleep and reduced snoring. Encourage your child to eat a balanced diet rich in fruits, vegetables and whole grains and to engage in regular exercise. This can help maintain a healthy weight, which is important as excess weight can contribute to airway obstruction and snoring.

For children who suffer from frequent colds or allergies, it is important to manage these conditions proactively. Ensure they are taking any prescribed medications as directed and consult with a healthcare provider for additional strategies to minimize symptoms.

Lastly, if your child is exposed to tobacco smoke, take steps to minimize this exposure. Not only does tobacco smoke irritate the airways, but it can also contribute to snoring and other respiratory issues.

By implementing these strategies, you can help your child achieve better sleep and reduce the occurrence of snoring, contributing to their overall health and well-being. Be sure to see a highly trained medical/dental professional who understands sleep-disordered breathing and how to treat this condition.

If your child is dealing with TMJ issues and you want to learn more about TMJ treatments in Falls Church, Virginia,  Dr. Jeffrey Brown and our team at Sleep & TMJ Therapy are prepared to help. Please call 703-821-1103 with your questions or to schedule a consultation with Dr. Brown. Your child deserves a good night’s sleep!

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Understanding Obstructive Sleep Apnea

Obstructive sleep apnea is a prevalent condition characterized by repeated interruptions in breathing during sleep due to blocked airways. These interruptions can lead to fragmented sleep and reduced oxygen levels in the blood, causing a variety of health problems. In addition, the structure of your jaw, cranium or neck can contribute to this problem as well as excessive body weight. OSA is a big deal. Alarmingly, a 2019 study funded by ResMed found that as many as 936 million adults worldwide suffer from mild to severe OSA. This statistic highlights the widespread nature of this disorder and underscores the importance of understanding its effects and seeking proper treatment.

As you go through your sleep cycles (4 or 5 times per night), it is interrupted by your soft tissue within the mouth settling down and blocking the airway. This blocks or limits the air getting through. The brain detects this. The continual triggering of waking up by your brain is needed for survival but causes disruption to your sleep. Your muscles are tightened within your neck and your head. This creates the airway to open up. Now, your sleep cycle has been disrupted. Your sleep cycle will resume once your blood oxygen levels increase back to normal. This disruption usually happens during stage three of sleep or the REM sleep stage.

The Link Between Obstructive Sleep Apnea and Cardiovascular Disease

The connection between obstructive sleep apnea and cardiovascular disease is well-documented. OSA can contribute to high blood pressure, heart attacks and strokes, primarily due to the stress that frequent breathing interruptions place on the heart. These interruptions cause a decrease in blood oxygen levels, leading the heart to work harder to pump oxygen throughout the body. Over time, this strain can result in significant cardiovascular problems. The repetitive cycle of reduced oxygen levels and abrupt awakenings can lead to an overactive sympathetic nervous system, which further exacerbates hypertension and cardiovascular strain. Additionally, individuals with OSA are at a higher risk of developing arrhythmias, which are irregular heartbeats that can lead to more severe heart conditions. The cumulative effect of these cardiovascular stresses emphasizes the importance of managing OSA to protect heart health.

The Impact of Obstructive Sleep Apnea on Daily Life

Living with obstructive sleep apnea can significantly disrupt daily life, leading to chronic fatigue, mood swings and difficulty concentrating. Frequent awakenings throughout the night result in fragmented sleep, preventing the body from achieving the deep, restorative rest it needs. This constant tiredness can make even simple daily tasks feel overwhelming, affecting productivity at work and diminishing the quality of interactions with family and friends.

One of the most troubling aspects of OSA is its impact on cognitive functions. Sufferers often experience memory lapses, slower reaction times and poor focus, which can hinder their ability to perform well in both personal and professional settings. These cognitive issues are especially concerning in situations that require sustained attention, such as driving. The risk of accidents increases as drowsiness impairs judgment and reaction speed.

Additionally, the sleep deprivation caused by OSA can lead to irritability and mood disorders, such as depression and anxiety. The emotional toll of constantly feeling exhausted and unwell can strain personal relationships, creating tension and misunderstandings. Partners of those with OSA may also suffer from disrupted sleep due to the noise of snoring and frequent awakenings, further affecting the household’s overall well-being.

Furthermore, the physical discomfort associated with untreated OSA can lead to a vicious cycle of poor sleep and health issues. Those suffering from the condition may develop habits that further exacerbate the problem, such as relying on caffeine or sugar for energy, which can lead to weight gain and worsen sleep apnea symptoms. This can perpetuate a cycle of declining health and increasing sleep difficulties.

Overall, the day-to-day impact of obstructive sleep apnea extends far beyond mere inconvenience, affecting various aspects of life and health. Addressing the condition is crucial not only for improving sleep quality but also for enhancing overall quality of life.

Risks of Untreated Obstructive Sleep Apnea

Untreated obstructive sleep apnea (OSA) poses severe risks that extend far beyond daily inconveniences. One of the most alarming concerns is the heightened risk of cardiovascular complications. As previously discussed, the stress placed on the heart due to frequent interruptions in breathing can lead to conditions such as high blood pressure, heart attacks and strokes. This constant strain on the cardiovascular system significantly increases the likelihood of severe heart-related events, which can be fatal.

Another critical risk associated with untreated OSA is the potential for developing metabolic disorders. For instance, sleep apnea has been linked to insulin resistance, a precursor to diabetes. The disrupted sleep patterns and reduced oxygen levels in the blood can interfere with the body’s ability to use insulin effectively, raising blood sugar levels and increasing the risk of type 2 diabetes.

Additionally, research indicates a potential connection between sleep apnea and cancer. Studies suggest that the intermittent lack of oxygen (hypoxia) experienced by individuals with OSA may promote tumor growth and spread. Although the exact mechanisms are still being investigated, this association underscores the seriousness of untreated sleep apnea.

Cognitive and psychological impacts are also significant. Chronic sleep deprivation caused by OSA can lead to memory problems, poor focus and mood disorders such as depression and anxiety. These issues can severely affect daily functioning and overall mental health, leading to a diminished quality of life.

The risks are not confined to the individual alone. Partners of those with OSA often experience disrupted sleep due to the noise of snoring and frequent awakenings, which can affect their health and well-being as well.

Research indicates that people with severe OSA have an increased risk of death due to any reason. This sobering fact underscores the importance of diagnosing and treating OSA to prevent long-term health complications and improve overall life expectancy.

Treatment Options for Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) has several effective treatment options that can help mitigate its symptoms and improve overall health. One of the most widely used treatments is continuous positive airway pressure (CPAP) therapy. This involves wearing a mask connected to a machine that delivers a steady stream of air, keeping the airways open during sleep. While CPAP therapy is highly effective, some individuals may find it uncomfortable or challenging to use consistently.

For those who struggle with CPAP, alternative treatments are available. Oral appliances are custom-fitted devices that adjust the position of the jaw and tongue to help keep the airways open. These devices are often preferred for their comfort and ease of use, making them a viable option for many OSA sufferers. Within our practice, the sleep patient will have checks at three, six and 12 months from delivery. In addition, another sleep study will be conducted to determine the efficacy of the appliance’s usage. As an adjunctive service, and a more conservative approach than surgery is to use laser therapy to reduce the tongue volume and open up the palatal area. It is kind of like doing a facelift of the palate but without the surgery. It is simple, effective and minimal in cost and pain levels.

In more severe cases, surgical interventions may be necessary. Procedures such as uvulopalatopharyngoplasty (UPPP), which removes excess tissue from the throat, or the insertion of implants to support the soft palate, can help reduce airway obstruction. More advanced surgical options include maxillomandibular advancement (MMA), which repositions the upper and lower jaw to enlarge the airway. These surgical procedures are last ditch efforts and only for desperate cases in my humble opinion.

Emerging treatments, such as hypoglossal nerve stimulation, offer another option for those with moderate to severe OSA. This treatment involves a surgically implanted device that stimulates the nerve controlling the tongue, preventing it from collapsing backward and obstructing the airway. Again, this is a surgical approach and should be used only in extreme cases.

Patients must work closely with their healthcare provider to determine the most appropriate treatment plan, as individual needs and responses to treatment can vary significantly.

Preventative Measures and Lifestyle Changes

Managing obstructive sleep apnea often requires not only medical treatments but also significant lifestyle changes. Weight management is a key factor; shedding excess pounds can greatly alleviate OSA symptoms. A combination of regular exercise and a balanced diet can facilitate weight loss and improve overall health, potentially reducing airway obstruction during sleep.

Positional therapy can also be beneficial. Sleeping on one’s side rather than on the back can prevent the tongue and soft tissues from collapsing and blocking the airway. Special pillows and devices are available to help maintain this sleeping position throughout the night.

It’s important to avoid substances that relax the throat muscles, such as alcohol and sedatives. These substances can exacerbate OSA symptoms by making it easier for the airway to collapse during sleep. Quitting smoking is also advised, as it can reduce inflammation and swelling in the airway, making it easier to breathe.

Establishing a regular sleep schedule can help in maintaining good sleep hygiene. Going to bed and waking up at the same time every day, even on weekends, can regulate the body’s internal clock and improve the quality of sleep. Creating a restful sleep environment, free from noise and light disruptions, can also contribute to better sleep quality.

In some cases, raising the head of the bed by a few inches may help prevent airway collapse and reduce snoring. This can be easily achieved by using an adjustable bed frame or placing sturdy objects under the legs at the head of the bed.

Incorporating these lifestyle changes can significantly improve the symptoms of obstructive sleep apnea and enhance overall well-being. Working closely with healthcare providers ensures that these measures complement medical treatments for the best possible outcomes.

Seeking Help? Call To Learn More!

At Sleep & TMJ Therapy, Dr. Jeffrey Brown and our team are here to help you get proper care if you struggle with sleep disorders in Falls Church, Virginia. Please call us at 703-821-1103 to learn more or schedule a consultation.

The post The Serious Health Risks of Obstructive Sleep Apnea first appeared on Sleep & TMJ Therapy.