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.

One of our success stories that really stands out is the daughter of one of my friends. The friend and my wife go way back – about 20 years – and that friend sent her daughter to see me earlier this year. She told me that her daughter was in so much pain that when she came home at night, she could do little more than curl up in a ball and cry herself to sleep. This young woman had already been to dozens of doctors over the years and could not function much longer with so much head and neck pain. She was even thinking that life was not worth it. We were able to figure things out pretty quickly and within a month she was feeling better than she had in years. This is how debilitating TMJ disorders can be and how remarkable it is when they are fixed.

Of course, there are failures – unfortunately, most of those are with the people who have been in really bad shape for too many years. The goal is always to avoid surgery but sometimes no matter what we do (appliance therapy, massages, laser treatments, etc.) we cannot get the disc back in place or it is already perforated. The analogy that I tell patients is that they should imagine their car having an oil leak, loud muffler, brake fluid leak, smoke-belching, etc. and the mechanic trying to fix it all to restore your car. This is just too much for any mechanic to totally fix. All you can do is hope for the best. In most cases, there can be some degree of improvement. This is how TMJ treatment can be at times. You hope for the best in a bad situation. In almost all cases, however, improvement is seen, and I am thankful and grateful for that.

As we close out 2023, I am grateful for the support of our friends, families and team members who have made all of our efforts so successful. My core team members are well aware of how much I appreciate their hard work and going beyond what is expected of them. We are now in a position to further spread the word about what we can do to help people improve their lives. Our office will be expanding as many of you have already seen when you visit. We will have a bit more space to be able to prepare the treatment rooms in advance of your visit to make sure our ‘on-timeness’ is really top-notch!

So, we end this wonderful year with good friends and family all around us. May you all have a most excellent 2024 and God Bless.

Dr. Jeff Brown

The post The End of Another Year is Here first appeared on Sleep & TMJ Therapy.

Diagnosis of the problem is paramount. A really well-done MRI is critical in determining the path of treatment, and many times getting good imaging is quite difficult. So here is the first ‘delay’ in fixing the problem, getting an appointment for a well done and well-read MRI. It can take several weeks to get that appointment and quite honestly some people just do not want to wait. I can’t blame them either. Let’s get it done now!

The next delay is just getting an appointment at the office to discuss all the issues. This is where we look at the bone from the CBCT X-ray and the soft tissue from the MRI. In most cases, people want their insurance to pay at least something and that in turn creates the next delay. Next on our list is the fact that with TMJ appliances, they are custom-made. This takes time. They are not something sitting on the shelf, ready to put in the mouth. It takes weeks to make them since they are custom made for each person.

Now let’s get to the next big delay. You have to wear the devices for 12-18 months to give the discs a chance to move back into the proper position. That’s right folks, it takes that long, especially if the discs have been displaced for several years. The discs don’t just fall back into place instantly. It will take time and patience. Of course, some are not willing to devote such time (and patience) to their health, so they do not do anything. That is OK as not everyone is experiencing the same level of pain or discomfort. When it gets really bad, the patient will pursue treatment but generally now the problem is harder to fix, costs more, and takes more time. This is like most things in life.

Finally, the biggest time consumer of all – finishing after the discs are back in place. In most cases, orthodontic work is needed to grow the teeth taller to protect and support the TM joints (the jaw joints). Orthodontics can take 1 ½ -3 years, easily! So here you are, having spent all this time on appliances only to realize it’s going to take another couple of years. You are basically dedicating up to 4-5 years of your life toward fixing a TMJ problem. This is why we always tell our patients phase one is appliance therapy and phase two is finishing. Thus, the question has been answered. Now you know why TMJ treatment can take so long!

The post The Case of: “Why Does This Take So Long?” first appeared on Sleep & TMJ Therapy.

Before each patient comes in for an adjustment or consult, my team and I take the time to study whatever records or X-rays in advance of their appointment each morning, so we are properly prepared. This takes a lot of effort some days. Not only is it important to prepare in advance, but we must also figure out the next steps for our patients; is it time for a new MRI, time for braces, time for crowns, is surgery indicated? This properly prepares me for when I walk into that operatory to see the next patient, I’m armed with the information I need for their personalized treatment.

On days like today, May 12, 2022, our schedule has taken a huge hit due to an uptick in Covid cases in the area. I kind of like these days now and then because I can write my blogs (this is number 3 today!) and review X-rays and MRIs in preparation for the coming days. There are so many weeks that we have no cancellations at all and so I must make time for the MRIs and X-rays on the weekend. That is not much fun, but it’s what I must do to prepare and get ready to explain to the patient what is going on. So, on the rare days like today, I can get caught up and be ready for the patients tomorrow.

Another little tidbit that goes on behind the scenes is that we are constantly trying to ‘get the word out there’ about what we do. I have many times been asked to put an office in Florida or California, but we would need another doctor to cover the main office in order to do that. We are working on that, but it takes time, lots of time. So now, to spread the word, I write these blogs and just recently started doing some video blogs.

As you can see, we keep busy around here. There is always something new and exciting happening. All of this is to help you, our patient, feel better. Thank you for putting your trust in our office. We love doing what we do!

The post The Case of What Happens Behind the Scenes at Sleep and TMJ Therapy first appeared on Sleep & TMJ Therapy.