Leading UK sleep expert says that we must raise awareness of sleep apnoea

A leading Cambridge sleep expert has said more people need to be aware of sleep apnoea after new research shows just a small minority of women go to the doctor with sleep issues. As you are aware from a recent article, almost half of British women say they are not getting enough sleep and don’t feel well rested when they wake up. It also found despite the extent of their sleep problems, only a minority of women visit their GP about sleep issues such as difficulty sleeping and snoring.

Woman can not sleep because of the snoring of her husband

Dr Ian Smith, director of Papworth Hospital’s Respiratory Support and Sleep Centre and assistant medical director, said women and men are quite biologically different – and this is hard-wired into our sleep patterns.

“Women are more likely to be early risers (Larks) and need to get to bed early while more men are late to bed (Owls),” he said.

The impact of sleep deprivation on appearance is much more prominent in women than men with 31 per cent of women admitting that sleeping problems have caused them to put on weight and 33 per cent said it made their skin look less healthy. Women are also more prone to insomnia.

The male upper airway is more likely to narrow during sleep and this makes snoring and sleep apnoea (pauses in breathing) more common in men.

“As a consequence, about twice as many men have obstructive sleep apnoea compared to women, but about six times as many men are referred to sleep clinics for sleep apnoea and the women who are referred have often had symptoms for longer.”

“Snoring, poor sleep and sleepiness may indicate sleep apnoea which is for some a serious condition,” said Dr Smith. “People who have repeated pauses in their breathing at night are often sleepy in the day which leads to a six fold increase in the risk of car crashes. It can also cause high blood pressure with a risk of strokes and heart attacks.

Anyone with snoring and daytime sleepiness should take action in some way as soon as possible. Screening for sleep apnoea is very simple and the treatment can be extremely effective. People started on treatment usually feel transformed with much more energy in the daytime and we know that the risks of car crashes and high blood pressure are pretty much reversed.

“Some drivers may be wary of coming forward if they have heard that sleep apnoea can affect your driving licence. This is true for untreated, sleepy people but usually we can get treatment started in just a few weeks and we can prioritise professional drivers whose work may be at risk.”

Papworth Hospital is a major heart and lung hospital in Cambridgeshire, England. It is the UK’s largest specialist cardiothoracic hospital, and the country’s main heart and lung transplant centre, and was home to the first successful heart transplant in the UK and one of the world’s first beating-heart transplants. As a result of their extensive research into the success of custom-made oral appliances, they made two key recommendations in 2014 that were published in The Lancet:

  • SleepPro Custom should be offered as first line treatment for mild OSA and any form of snoring
  • SleepPro Custom should be offered as an alternative to CPAP for the treatment of moderate OSA

SleepPro Custom is the only “evidence based mandibular advancement device “ that is available in the UK at a price within reach of the average person’s pocket, and is ideal for this serious respiratory problem.

The SleepPro Custom, and the accompanying anti-microbial version, the Custom AM, is made to an individuals’ dental impression to guarantee the best possible fit available, along with extra comfort. It is a product that has been developed in Britain, is fully recommended by the NHS, and will be made and supplied from the company’s specialist UK laboratories.

‘Most people with sleep apnoea snore, but not all those people who snore have sleep apnoea,’ explains Tim Quinnell, a consultant at the Respiratory Support and Sleep Centre at Papworth Hospital.

Snoring might not be life-threatening immediately, but its longer-term effects can be devastating. If you snore heavily, or suspect that you or your partner may suffer from sleep apnoea you should act immediately to prevent it.

John Redfern


The latest research shows many women suffer in silence

Nearly HALF of women are constantly exhausted – and it could be due to a serious medical condition, experts warn in an article based on new UK Government research that was published this week.

Women have sleeping problems but suffer in silence

The YouGov survey of 4,100 British adults found that 46 per cent of women have trouble sleeping, compared with 36 per cent of men.

  • The study found that nearly half of women are sleep deprived but suffer in silence – only one in four tell their doctor.
  • Lack of sleep could be caused by obstructive sleep apnoea (OSA) – a sleep disorder that causes snoring and highly dangerous pauses in breathing – but often goes undiagnosed.
  • Poor sleep also increases risk of type 2 diabetes for middle-aged women and other new research confirms this.
  • Women are also more likely to wake during the night, with 36 per cent of women reporting this problem compared with 23 per cent of men.
  • Six in ten women said they become irritable during the day because of lack of sleep, while less than half of men do.

Many women do not seek medical advice because they believe it is merely a side effect of growing older. Experts however warn that not getting enough sleep can be a sign of a serious underlying medical condition, although pregnancy or the menopause can often be a factor too.

Sleep is known to be a particular problem for women as they approach the menopause.  Changes in hormone levels can lead to hot flushes, night sweats and mood changes – each of making sleeping harder. Pregnancy and the menopause increase a woman’s risk of suffering from OSA.

Professor John Stradling, a sleep expert at Oxford University, said: ‘Often women think that feeling exhausted is just part of modern life when in fact it could be something more serious. Remaining untreated leaves women at risk of reduced quality of life and serious health conditions.’

He added: ‘Many women are not aware that they may have sleep apnoea, meaning that they are missing out on the medical advice or treatment that they need. The sooner their sleep issues are addressed by a sleep expert, the better.’

Bill Johnston, chairman of the Sleep Apnoea Trust Association, which commissioned the survey, said it was easy to blame poor sleep on a change in the seasons, especially in winter. ‘For many it is, but for others, sleep issues could be a sign of sleep apnoea,’ he said.

‘The overall lack of awareness around sleep apnoea symptoms and its impact on a person’s health may mean that many are suffering in silence so it is important that we work with healthcare professionals to uncover this missing group and help minimise the impact of sleep problems on their lives.

An estimated 1.9 million women in Britain are thought to be going through the menopause at any one time. Some 80 per cent of these women are thought to experience symptoms, which typically last for about four years.  For about one in ten, however, symptoms last much longer, in some cases continuing for 12 years.

If left untreated it could lead to more serious health problems such as stroke or heart attack. Some 1.5 million adults in Britain are thought to suffer with sleep apnoea, but do nothing although treatment is simple and inexpensive. As well as snoring and insomnia, symptoms include restless legs, fatigue, depression, headaches and muscle pain.

No woman likes to think that she snores, because of the stigma that is attached to it, but at the end of the day the statistics show that women who snore account for 40% of all snorers.

A range of high quality approved mouthpieces that help to prevent serious health problems caused by heavy snoring and obstructive sleep apnoea is now available. These are 98% effective in tests, NHS Approved, comfortable, unobtrusive, and bring a great night’s sleep.

SleepPro Woman has been specially produced for this group and is the ideal starter mouthpiece. If symptoms continue or are accompanied by gasping for breath in the night they should consider a custom-fitted appliance called SleepPro Custom – the NHS No. 1 recommendation for both snoring and obstructive sleep apnoea.

Acting now and investing in a mouthpiece that will stop your snoring could improve your day beyond recognition, and maybe even save your life.

John Redfern


New Health Crisis – time to Stop Snoring and control OSA It will reduce blood pressure problems and prevent Diabetes

Poor diabetes care in England is leading to avoidable deaths, record rates of complications and huge costs to the NHS, which although spending 10% of its budget on diabetes, most goes on managing complications not preventing them. However this is a worldwide problem and not one to be found just in Britain.

Diabetes in the Press

Snoring raises blood pressure and causes diabetes

Despite constant campaigning, it is only now being strongly recommended that Governments and Health Services act to curb a huge health crisis related to all these inter-related factors. However these facts are not new and were published as headlines well over a year ago – and there were other strong indicators before that.

Research has shown that disturbed sleep contributes to overeating and weight gain, which raises blood pressure, which causes diabetes, and that oxygen deprivation can also cause the onset of raised blood pressure and Diabetes. Anyone with night-time breathing issues like snoring or sleep apnea often has high blood sugar and is almost twice as likely to develop type 2 diabetes, according to a recent study of 6,000 US adults.

Recent figures show that the number of adults in England with diabetes has risen to more than 3 million, and was going up by almost 5% every year. Diabetes UK says the disease is the fastest growing health threat of our times and current care models are not working to get on top of the problem.

The number of people with diabetes is increasing, as is the number of patients who develop complications.

People with sleep apnea were nearly twice as likely as normal sleepers to develop diabetes, and snorers were 27 per cent more likely. Those with daytime sleepiness were also about 50 per cent more likely than those without that symptom to develop diabetes.

The research clearly showed that the more disturbed-breathing symptoms people had during sleep, the greater their diabetes risk. Snoring is a main contributor to many health problems and is at the core of them all. Research has constantly proved it.

MPs have criticised the Department of Health and the NHS in England for being “too slow” to act in preventing and treating diabetes.

A report by the Public Accounts Committee says variations in the care of both type 1 and 2 diabetes mean the annual cost to the health service will continue to rise and not only is the number of people with diabetes increasing, but also the number of patients who develop complications.

For people aged 16 and over the bill currently stands at £5.5bn a year. Most of the £5.5bn-a-year cost is spent on complications from diabetes, such as heart and kidney disease, blindness and nerve damage, leading to amputations. All these things can be reduced by catching the disease early, and managing blood glucose, blood pressure and cholesterol, and also by preventing snoring.

It isn’t difficult to understand that depriving the brain of a continuous oxygen supply is highly dangerous and can eventually be fatal. Constant research studies at leading hospitals and Universities throughout the world prove the links time and time again, but little is done. We still fail to act – and that includes National Governments, their Health Ministries, and also ourselves.

It is well known that in all countries that most known cases of heavy snoring and obstructive sleep apnea (OSA) remain ignored and untreated, although some are better documented than others. Not only that, but treatment is no longer complicated – in fact it’s simple and can be self-administered in an easy, inexpensive way – and without prescription.

All developed nations have now approved the stop snoring mouthpiece as the best way to tackle and prevent both heavy snoring, and mild to moderate OSA, but if Governments don’t act soon then the crisis will develop even more.

For a small cost you can protect yourself from all these problems. You now have to ask yourself what is the value of your good health, and maybe even your life. It’s time for you to do something about it – either for yourself, for your partner, or for both of you.

John Redfern


Obstructive sleep apnoea linked to increased risk of stroke and cancer

Many recent medical studies conducted worldwide, and connected with sleep, have reached very similar conclusions; that regularly disturbed or ‘fragmented’ sleep puts people at greater risk of stroke, impaired thinking and memory, and even cancer.

Apnoea and stroke a concern

This is particularly so in those over 60 where those who had fragmented sleep were more likely to have hardened blood vessels, or oxygen starved tissue in the brain. This has been proved to increase the risk of developing arteriosclerosis, a potentially serious condition where the arteries become clogged up by fatty substances known as plaques.

Results showed that amongst the many hundreds of individuals monitored, that 29% had already experienced a stroke, and 61% had signs of moderate to severe damage to blood vessels in the brain.

Researchers found that greater sleep fragmentation was associated with 27 per cent higher odds of having severe arteriosclerosis. Moreover, for each additional two arousals during one hour of sleep, researchers reported a 30 per cent increase in the odds that subjects had visible signs of oxygen deprivation in their brain.Stroke

A primary cause of disturbed sleep is obstructive sleep apnoea, usually called OSA, where the individual suffers from disturbed sleep, but often do not realize that they’re waking many times, and even gasping for breath. Mild to moderate OSA is very common, and often ignored and untreated. Severe OSA is critical for those who are suffering and must be treated.

One of the main studies was published in the Journal of Clinical Sleep Medicine – a long study that was carried out over a twenty year period.

Results of the study show that people with moderate to severe obstructive sleep apnoea were four times more likely to die early, nearly four times more likely to have a stroke, three times more likely to die from cancer, and 2.5 times more likely to develop cancer. These figures are after the results were adjusted for potential confounding factors such as body mass index, smoking status, total cholesterol and blood pressure.

Obstructive sleep apnoea is dangerous and needs urgent treatment.

The British Lung Foundation (BLF) comments extensively on this and recommends key areas of treatment that will help manage the symptoms of OSA and which may occasionally correct the problem.  This includes lifestyle changes but they add that often, additional treatment beyond lifestyle changes is needed for moderate to severe OSA.

Mild to moderate sleep apnoea can be treated by simply using a mandibular adjustment device – often called a splint, oral appliance, or simply a mouthpiece. These are recommended strongly by the BLF. This device, also called an oral device, is worn over your teeth as you sleep. It brings your lower jaw forward, helping to keep your airway open. This treatment can be used without prescription if you have mild to moderate OSA and will help to control it, perhaps even correcting any harm that has been done previously.

The BLF also discuss surgery and CPAP treatment for extremely severe cases, but this can be avoided if a specially made, highly efficient mouthpiece is worn early enough.

Papworth Hospital is a major heart and lung hospital in Cambridgeshire, England. It is the UK’s largest specialist cardiothoracic hospital, and the country’s main heart and lung transplant centre, and was home to the first successful heart transplant in the UK and one of the world’s first beating-heart transplants. As a result of their extensive research into the success of custom-made oral appliances, they made two key recommendations in 2014 that were published in The Lancet:stroke

  • SleepPro Custom should be offered as first line treatment for mild OSA and any form of snoring
  • SleepPro Custom should be offered as an alternative to CPAP for the treatment of moderate OSA

Other NHS approved appliances are available for snoring at any level.
The details of these studies are available to read on the SleepPro website

Contact [email protected] for further information

John Redfern


New evidence on why snoring can be dangerous for your health

A new study suggests that although your snoring may sound like a car revving, it could indicate that the cells in your veins are breaking down.Snoring and sleep Apnea

Scientists have long known that obstructive sleep apnea, a disorder that often causes snoring, can increase your risk of cardiovascular diseases, but they didn’t know exactly why. Now, a team of doctors at Columbia University has pinpointed a defined chain of events that explains how this damage might occur, and found that some commonly prescribed anti-cholesterol drugs may help to prevent it. 

The research team at Columbia wanted to figure out how it was that interrupted breathing was affecting the cells that line blood vessels, which is often where cardiovascular damage begins. They extracted these cells from the arms of 76 patients with obstructive sleep apnea and a further 52 others who didn’t have the sleep disorder.

They found that those with sleep apnea had a much higher level of a protein called CD59. This butterfly-shaped protein guards cells from attack by the body’s own immune system. However, on closer inspection, the researchers discovered that the CD59 of people with sleep apnea had been pulled inside the cell, instead of guarding the cell’s surface, leaving the cell vulnerable to attacks from the immune system. 

These damaged cells, in turn, would be more likely to obstruct blood flow — the first such cellular explanation of how obstructive sleep apnea may cause so many serious heart problems.

But one group of snorers didn’t have these abnormal CD59 effects. Five of the sleep apnea patients who happened to be taking statins – drugs that lower cholesterol – had cells that looked just as healthy as the cells of people without sleep apnea. That suggests that statins could help protect apnea patients from cardiovascular trouble.

“This is a great start to try to understand the damage that sleep apnea does, particularly when left untreated as is so very often the case” said Dr. Shalini Paruthi, a sleep medicine expert at Saint Louis University.

Paruthi added that this damage to blood vessels is just one of the risks posed by sleep apnea.  “We often run into the myth that snoring’s OK,” she said. “But it’s not OK. It might be the sign of something very dangerous.”

Untreated obstructive sleep apnea increases the risk of heart disease, stroke, high blood pressure and diabetes, as well as memory and thinking trouble.

Another new study states that more half of those diagnosed with sleep apnea fail to stick with the standard treatment for the condition, which traditionally has been the CPAP mask, and most people aren’t given additional options, even when they can’t tolerate the treatment.

Obstructive sleep apnea probably affects between 5% and 7% of the U.S. population, the researchers said. The condition is usually diagnosed during a sleep study that measures how many times someone stops breathing (apnea) or has shallow breathing with a drop in blood oxygen (hypopnea) for at least 10 seconds during each hour of sleep.

The study authors reviewed the medical records of just over 600 people. All of them had been diagnosed with obstructive sleep apnea and were immediately prescribed CPAP but just 42% began using it regularly as directed. Only about a third of those remaining, who weren’t using CPAP, were referred for an alternative to help them manage their sleep apnea.

Dr. Michael Thorpy, director of the Sleep-Wake Disorders Center at Montefiore Medical Center in New York City, said this reflects the difficulty of having patients use CPAP. “It is not an easy treatment for a lot of patients to sleep with a machine at night, and it requires some work and effort to get patients to become compliant,” he said.

Respiratory therapists or other providers can help patients with alternatives if a patient is having trouble with CPAP, said study author Dr. Alan Kominsky, Assistant Professor of Surgery at Cleveland Clinic in Ohio. “For some, CPAP is the only appropriate treatment, but others may have additional options, including dental devices or surgery”, Kominsky said.

Oral devices are by far the best for those with mild to moderate sleep apnea/snoring, and will prevent and control this dangerous condition”.

 

John Redfern


Poor Quality Sleep is costing Business time and money

Employees’ sleep problems are probably costing British business a great deal of time and money as poor-quality sleep can affect workers’ mood and judgment and it can also result in serious health problems. Ask yourself if you lost a day or two of work last year because of poor-quality sleep the night before? If that’s the case you’re far from alone, according to new results from the World Sleep Survey.

Tired office worker suffering from poor quality sleep

The study, which was conducted by researchers at the University of Oxford found that full-time employees lose an average of seven days of work per year due to poor-quality sleep and those who report that their sleep is of “less than average” quality lose more than 13 days. More than 20,000 people participated in the survey. The financial cost of that to the UK is huge.

Earlier research from 2011 prompted employers to take a closer look at sleep. Researchers from Harvard University had interviewed more than 7,000 people by phone, and found that insomnia/poor quality sleep results in the loss of 11 days of work per year. As a nation, that represented a total loss of $63.2 billion.

Poor-quality sleep can result can affect mood and judgment, and result in serious health problems. In the USA, the Centres for Disease Control and Prevention recently declared insufficient sleep a “public health epidemic,” with some 18 million people in the U.S. reporting that sleep troubles impacted their job performance.

Sleep experts are not surprised that exhausted employees are skipping work. When you don’t sleep well, you’ll experience a serious degree of cognitive impairment. Some people simply don’t allot enough time for a good night’s rest; others aren’t able to sleep well due to medical conditions, like insomnia or sleep apnoea.

For those who have persistent sleep troubles, it is recommended that they either pay a visit to a doctor or if they persistently snore heavily, or at least try using an oral appliance to reduce the problem and prevent it. Some 72% of those who participated in the World Sleep Survey said they had not consulted a physician about their sleep troubles.

People who average less than seven hours sleep per night are at increased risk of problems, such as high blood pressure, depression and anxiety. This occurs even in people who don’t feel tired during the day. Others may have sleep apnoea but be totally unaware although their partner may realise by identifying the symptoms of heavy snoring, appearing to wake often throughout the night and gasping for breath.

Figures published by the AA attribute as many as 20% of accidents, many involving death, to poor quality sleep by a driver who then dozes at the wheel.

It is now more widely accepted as a major problem and some companies are trying to help their employees become more aware of the difficulties it causes. Historically, employer wellness programs have focused on fitness and healthy eating. But that’s now beginning to change.

Some companies are developing programs to assess and treat employees with sleep apnoea, a common disorder that disrupts sleep and often goes undiagnosed. More than 5% of UK male adults have sleep apnoea and there are lower but increasing figures for women, often due to weight gain. The real figures may be even higher as most cases are undiagnosed.

Large US companies, like Google and Goldman Sachs, have brought in sleep experts to disseminate information about sleep disorders. Johnson & Johnson offers its employees a digital coaching program that is designed to reduce insomnia, and involves relaxation videos. Corporate wellness companies even offer coaches to teach employees about healthy habits for getting a good night’s rest.

One of the key recommendations for improving sleep by stopping heavy snoring, and controlling sleep apnoea, is by the use of a medically approved mouthpiece that is worn at night, and is much like a sports gumshield that we are all familiar with. In this case it protects in a different way by moving the jaw forward slightly, and in doing so it keeps the throat open so that breathing continues normally. Results from the specialist NHS sleep researchers at Papworth Hospital tested a selection of typical oral appliances, and based on the results recommended SleepPro Custom as the first mouthpiece to use to prevent snoring and control sleep apnoea.

The subsequent result of using these simple and inexpensive oral appliances will improve worker efficiency and safety in many ways, as well as improving their attendance record, and benefit their general well-being both in the long and the short term.

 

John Redfern


Sleep apnoea sufferers face a 17% higher risk of pneumonia

People with sleep apnoea may be at much greater risk for developing pneumonia, according to a new study. And the more severe the sleep apnoea, the greater the risk, the research suggests.

SleepPro and apnoea

The sleep disorder causes the upper airway to become blocked, cutting off the supply of oxygen during sleep. The researchers said this increases the risk for aspiration, or inhaling contents or fluid from the throat into the lungs. This can put people at much greater risk of developing pneumonia.

The researchers found that patients with untreated sleep apnoea have a 17% greater risk of developing pneumonia than those without the sleep disorder. Untreated sleep apnoea doesn’t just raise the risk of pneumonia – it’s also unfriendly to the heart.

The 11-year study involved over 34,000 patients and almost 7,000 of these participants had sleep apnoea, and about 27,000 did not. The researchers found that more than 9%of the sleep apnoea group at some stage developed pneumonia, compared to just over 7% of those without the sleep disorder. In addition the risk was significantly higher among patients who were using continuous positive airway pressure (CPAP) therapy, always previously considered as the gold standard for treating sleep apnoea.

Pneumonia can affect anyone, and it often occurs during the autumn and winter months. If you catch it, pneumonia can be serious and highly life threatening.  It is caused by infection from bacteria, viruses or fungi, which irritate the lungs. This irritation causes the tiny air sacs in your lungs to become inflamed and swell up with fluid. Pneumonia could have dramatic longer-term effects on your life; stopping you from carrying out simple daily activities that are often taken for granted.

  • Up to 1 in every 100 UK adults develop pneumonia each year and over 172,000 adult hospital admissions are due to pneumonia – 1 in 5 of them occurring in people aged under 65.
  • If you have a heart condition and have pneumonia, you are over four times more likely to have a heart attack or stroke.
  • More than 50,000 UK adults die of pneumonia each year and it is one of the most common causes of death due to infection in both men and women.

Sleep apnea is a chronic sleep disorder that affects approximately 20 million North Americans, many still undiagnosed because there isn’t a simple test that can diagnose the condition. With cases of sleep apnoea, breathing repeatedly starts and stops throughout the sleep cycle. The interruption in breathing can last seconds to minutes, and normal breathing usually resumes with a loud snort or choking sound.

According to the American Heart Association (AHA), treating sleep apnoea may protect your heart from harmful changes that contribute to heart disease. An AHA study found six months of treatment reversed abnormal heart changes related to sleep apnoea in study participants.

Sleep apnoea is most commonly treated with continuous positive airway pressure (CPAP), or a custom-fitted oral appliance that eliminates snoring while keeping the airways open to promote healthy breathing. According to a study published in the Canadian Medical Association Journal, it can help promote a healthy respiratory system too.

People with sleep apnea often snore loudly, and are tired, even after a full night’s sleep because their sleep cycle is so frequently interrupted. Unfortunately they are rarely aware of this and it is best if their partner observes to see who snores heavily and note if these interruptions happen.

OSA is the more common type and happens when the muscles in the throat relax during sleep, resulting in the collapse or blockage of the airway. It can affect anyone, but is more common in obese individuals.

Treatment is both vital and simple, and most people who have mild to moderate sleep apnoea can control the effects by using a tailor-made oral appliance – a mouthpiece that simply adjusts the position of the lower jaw and in doing so keeps the airway open. No more snoring – and no health danger of the types described earlier.

Don’t ignore it – make 2016 a great year for good sleep and good health.

 

John Redfern


Bruxism and Teeth Grinding is a major problem – and growing fast

A recent medical report has indicated that about one in four people with obstructive sleep apnoea (OSA) suffer from teeth grinding, particularly nocturnal bruxism, and it is more common in men. Evidence shows that stress and anxiety play significant roles in this growing problem.

Bruxism SleepPro has the answer

Figures produced by British dentists say teeth clenching and grinding is on the rise. In fact, they report a 30% increase in bruxism over the last 5 years. Many dentists blame stress and the inability to cope with it. They say that whist we sleep, a lot of our worries – even if they are only in our subconscious mind – can lead to clenching and teeth grinding.

Bruxism however is not confined solely to OSA sufferers and some studies have suggested that as many as 10% of the total population may be affected. This figure may be significantly higher as many cases of bruxism, just like sleep apnoea, are not reported.

Colgate, a leader in the toothpaste industry, recently posted on their blog the top three ways to treat Bruxism, also known as teeth grinding. The three highlighted solutions were to talk to your dentist about jaw alignment, get a mouth guard and to let go of negative stress.

The article goes on to state that “stress, anxiety, smoking, heavy alcohol, caffeine, depression and sleep disorders are all possible causes of teeth grinding according to the Bruxism Association”.

The Bruxism Association also explains that the most common symptom of teeth grinding is a headache. Other symptoms may include muscle aches, enlargement of facial muscles, discomfort of the jaw and stiffness in one’s neck or shoulders.

Sufferers of bruxism may experience eroded enamel, making teeth vulnerable to tooth sensitivity. Although Colgate offers special toothpaste for sensitive teeth, they hope to educate readers so that their teeth do not become eroded.

One of the easiest solutions recommended by the Colgate article to eliminate Bruxism is the use of a mouth guard, also known as a night guard that is specifically used to prevent teeth grinding. When purchasing a night guard for teeth grinding, their recommendation is that it is important to get one that can be moulded for your specific teeth.

Although a relationship has been established between bruxism, sleep apnoea, and stress, many dentists are also noticing that teeth grinding is a problem among people who have narrow arch width, especially in the upper jaw. Dentists say correcting the arch has been known to help with both grinding and the recurrent risk of sleep apnoea. Studies out of the University of Montreal indicate that a narrow arch is a “primary risk factor” for bruxism in children and adults.

Grinding teeth can lead to enamel erosion, which in turn can lead to cavities, so it is something that dentists are always looking for when people come in for regular check-ups. Grinding and clenching teeth can happen unconsciously and cause a range of problems.

The signs and symptoms of bruxism can be subtle and may include:

  • Audible grinding or clenching at night, usually noticed by a partner
  • Flattened, worn or chipped teeth* Sensitive teeth – especially to hot or cold food
  • Facial pain or headaches in the temple region
  • Increased yellowing of teeth as the enamel is worn away
  • Sore or tight jaw muscles
  • Earache – even though the ear is not affected, jaw problems can present with ear symptoms.

Doctors and dentists don’t fully understand why some people are “bruxers” and others aren’t, but if you suffer this way then take you should take the right steps immediately with a customised night guard before the problem gets worse  – and also gets much more expensive.

John Redfern


Do you think you have sleep apnea? It varies in form and there are four main types of treatment.

Good sleep is critical to good health. But what if someone stops breathing for short pauses in the middle of the night, breathes shallowly, snorts, snores, gasps for air, or breathes infrequently?  This is known as sleep apnoea and it could be contributing to a great number of health issues. Those disruptions through the night may last from 30 seconds to several minutes and may occur hundreds of times. This results in a lack of oxygen to all tissues, but this particularly includes the brain.

Apnea and snoring

It can be tricky to diagnose, as there is no blood test for it. What’s needed is for someone to be sleeping in the same room to notice the snoring, gasping, snorting, and pauses through the night, in order to raise concern.

It occurs in two types, which differ in how serious they are, although both have major implications for health if untreated. Obstructive sleep apnoea is the most common form, with central sleep apnoea being less common.

Someone with obstructive sleep apnoea has an airway that becomes partially or fully blocked during sleep due to either excess weight, large tonsils compressing the area, or simply to anatomical defects.  Central sleep apnoea on the other hand occurs when the part of the brain that handles breathing does not correctly communicate with the muscle required for breathing, resulting in pauses or infrequent breaths while sleeping. A combination of the two can occur but is not common,

In all cases the body receives less oxygen than it needs, and it responds by releasing the hormones involved with stress such as cortisol and adrenaline.

The increase in these hormones coupled with a lack of oxygen can put a person with sleep apnoea at higher risk for high blood pressure, heart attack, stroke, irregular heartbeats, and heart failure. These people often also wake up with a headache, are very tired, and experience brain fog through the day, due to this lack of oxygen and quality sleep.

Some people have sleep apnoea in a mild or even moderate form that might be quite subtle, in that their snoring or pauses doesn’t wake up others, yet they themselves wake feeling tired and unrested without knowing why. Others with more severe sleep apnoea are often told that their snoring sounds like a freight train, or their own gasping for air wakes them up, such that they feel like they were choking.

Doctors and researchers have described the recent continuous growth of sleep apnoea as an epidemic. It is well established in men, but is showing rapid increases amongst women and it is estimated to affect somewhere between 25% and 30% of adults, but often undiagnosed and untreated.

The key telltale sign is snoring. Sufferers may also gasp for air and choke briefly whilst sleeping, but have no recall of it when waking up. They will usually feel sleepy during the day, be tired, and as a result often irritable too.

CPAP

Historically the main treatment for moderate to severe sleep apnoea has always been to keep the airway open via a mask. The CPAP mask and machine (continuous positive airway pressure) has been around since the early 1980’s and this is highly effective – but there are problems.

Patients often reject it for various reasons that include discomfort, dry mouth, noise disturbance, claustrophobia, and of course it doesn’t travel well.

Surgery

This may involve removal of the adenoids or excess flesh, or be one of the recent pacemaker type of implants that place a generator in the upper chest which has an electrical stimulation lead to the neck to keep the airways open. This is usually only for those severe cases that reject CPAP.

Positional Therapy

Most sleep apnoea patients suffer worst when they lie on their back causing the tongue to fall back and obstructing the airway. The old method was a tennis ball sewn into the back of the pyjama jacket but special pillows are now available, both for users of oral appliances and CPAP users too.

Dental Appliance Therapy

Often called an Oral Appliance or mouthpiece, this treatment makes use of something called an M.A.D. (mandibular adjustment device) – a simple well fitting gum shield that is comfortable to wear and highly effective. They work by moving the jaw forward slightly, which then opens the airway; breathing is smooth and continuous, and snoring stops immediately.

This is by far the most popular and the easiest to use. It’s comfortable to wear, shapes itself to your dental profile and has proved effective in 98% of cases. It has the added advantage of being easy to take wherever you go – either away on business, or on the family holiday.

Quality mouthpieces are now highly recommended by the NHS for all who snore, and also for cases of mild to moderate sleep apnoea and they are now even proposed as a replacement for CPAP intolerance.

 

John Redfern