Friday, February 26, 2010

In the Pipeline: New Throat Spray for Sleep Apnea

A recent Chicago Tribune article reports that researchers have identified genes to target when treating obstructive sleep apnea (OSA).

The study indicates that drugs may one day replace tonsillectomies for kids with sleep apnea.

The American Academy of Sleep Medicine estimates that two percent of children suffer from OSA.

According to the study, an estimated 80 percent of the almost 600,000 tonsillectomies performed each year are on children with OSA. The results were published online by the American Journal of Respiratory and Critical Care Medicine.

Many children with OSA have enlarged tonsils and adenoids.

The research compared tonsils that were removed from 18 children with OSA and 18 children with recurrent tonsil infections.

The researchers identified 47 genes that acted differently in children with OSA. They were able to block some of those genes from multiplying tonsil tissue.

A spray, pill or topical injection could be available in as few as seven years.

The research brings good news to parents who feel uneasy about their children having surgery. A medicine could lower the risks and complications accompanying treatment.

Untreated OSA can effect children’s development, thought processes and behavior. It can also lead to depression, bed-wetting, attention problems and heart disease.

Earlier this month, this blog reported on a Taiwanese study that examined how OSA affected children. In December, there was a post about new research indicating that urine tests may be able to detect sleep apnea in children.

Thursday, February 25, 2010

Keying Into the Mechanics of Oral Appliances

Today’s issue of the Tuscaloosa News included an interesting article on oral appliance therapy (OAT), detailing how dentists treat obstructive sleep apnea (OSA).

The piece explains that the word “apnea” comes from the Greek word meaning “without breath.” People with OSA can stop breathing for 10 to 30 seconds, sometimes for a minute or longer, hundreds of times a night. OSA occurs when the soft tissues in the back of the throat collapse, blocking the airway during sleep.

Many dentists learn how to treat this serious medical condition. Last week, this blog discussed how to find a dentist trained in OAT.

Dr. Bill Meriwether and Dr. Daniel Urban, both members of the AADSM, relayed how this therapy restores normal breathing.

“With the apnea appliance, the jaw is brought forward to open the airway,” Dr. Meriwether said.

The dental appliance is made from molds of a person’s mouth. Many appliances can be adjusted to eliminate or decrease side effects. For instance, some appliances use a small wrench to move the device into its proper position.

In 2005, the American Academy of Sleep Medicine released guidelines, recommending oral appliances for mild to moderate OSA patients who cannot tolerate or comply with CPAP, the standard treatment therapy.

Dr. Urban explained that while CPAP works almost 100 percent of the time and is the “gold standard” of OSA treatment, some people can’t or won’t wear the mask.

Dr. Meriwether added that oral appliances are less intrusive than CPAP and a good alternative for people whose condition would otherwise go untreated.

Dr. Meriwether has slept with several of the dental appliances to learn what his patients experience.

“It involves some adjustment, some adaptation,” he said. “It is a little bit like putting on contact lenses. If they are fitted well, most people adapt to them pretty readily.”

Wednesday, February 24, 2010

A Closer Look at Upper Airway Resistance Syndrome

Obstructive sleep apnea (OSA) and snoring have received growing attention in recent years. But what about their close relative - upper airway resistance syndrome (UARS)?

A sleep-related breathing disorder (SBD), UARS is midway between OSA and snoring. It is not quite as severe as OSA, but more serious than snoring.

All three of these conditions can cause the sound known as snoring. The sound comes from the soft tissues in a person’s throat vibrating against one another.

When snoring without OSA happens, the person’s airway partially closes. This smaller airway can cause loud snoring, but air continues to flow during sleep.

With OSA, the airway completely closes. These airway collapses can cause loud snoring and lead to serious health problems. OSA patients often experience fragmented sleep and have an increased risk for heart attack, stroke and diabetes.

In UARS, breathing problems throughout the night are not as severe as in OSA patients, but the condition can still be harmful. People with UARS suffer many of the same symptoms of OSA.

If you or someone you know snores loudly, feels excessively tired during the day, or experiences any of the signs of a SBD, a sleep study can determine which, if any, sleep disorder is present.

Like with OSA and snoring, dentists can treat UARS using oral appliance therapy.

Learn what Dr. Oz had to say about sleep apnea here.

Monday, February 22, 2010

Dr. Oz Demonstrates the Negative Effects of Bruxism

In November, Dr. Oz. ran a segment on the dangers of teeth grinding, or bruxism, and why it is important to treat this disorder.

Signs of bruxism include headaches, flat teeth and sore jaws.

Bruxism and sleep apnea often tie together. In November, this blog reported on a new study that found that a quarter of sleep apnea patients suffer from bruxism. People who have sleep apnea may want to ask their dentist or physician about bruxism and vice versa.

There are several ways the two conditions relate.

Bruxism can reflect anxiety or depression, both of which people with sleep apnea are at risk for.

Apnea can also cause daytime sleepiness, leading to high caffeine intake, which is associated with bruxism.

Dentists can help screen for bruxism and sleep apnea. If a person’s teeth look flat, it may be because of clenching or grinding during sleep. If they have large neck sizes, excess body weight, snore loudly, or feel excessively tired during the day, they may suffer from sleep apnea.

Both disorders can be diagnosed at an overnight sleep study.

Sleep apnea can be treated with an oral appliance. Click here for a list of dentists trained in dental sleep medicine.

This blog post from December further discusses how bruxism and sleep apnea relate.

Friday, February 19, 2010

One More hour of Sleep per Night Could Be Your Ticket to a Healthy Heart

ABC World News with Diane Sawyer reports that former President Clinton’s heart troubles may relate to getting too little sleep.

Former President Clinton’s lack of sleep reflects a national problem. The American Academy of Sleep Medicine (AASM) estimates that 70 million Americans suffer from one or more sleep disorders.

Poor sleep quality increases a person’s risk for heart attack, stroke and diabetes, among other serious diseases. Regardless of American’s on-the-go lifestyles, sleep should not be trivialized.

A recent study from the University of Chicago found that those who increased their sleep from six to seven hours per night had a 33 percent decreased chance of having clogged arteries.
Finding time for that extra hour of sleep can be challenging – especially if you suffer from insomnia.

An estimated 30 percent of adults have insomnia symptoms. Less than 10 percent experience chronic insomnia.

Sleep hygiene can make falling asleep easier. "You need to set aside the time for sleep. You need a few hours to unwind before. It takes time for the brain to wind down," Dr. Charles Czeisler told ABC.

Thursday, February 18, 2010

How Do I Know If My Dentist is Trained to Treat Sleep Apnea with Oral Appliance Therapy?

Many, but not all, dentists are trained in dental sleep medicine (DSM).

Members of the American Academy of Dental Sleep Medicine (AADSM) can receive training in DSM year-round. There are more than 1,800 members worldwide. Find a full list of members here. You can search the list to find a dentist in your area.

The AADSM offers members post-graduate courses, study clubs, an annual meeting, and a peer-reviewed journal to keep them up-to-date on the latest research. The American Dental Association approves these educational opportunities for continuing education credits. The Academy of General Dentistry also approves them for Mastership/Fellowship Credit.

AADSM members have the option to sit for an exam that recognizes excellence in dental sleep medicine. An independent board of examiners called the American Board of Dental Sleep Medicine (ABDSM) gives the exam. A full list of Diplomates is available here.

A dentist can be qualified in dental sleep medicine without being a Diplomate.

Oral appliance therapy is a relatively new area of dentistry. While oral appliance therapy has helped many sleep apnea patients, it is a good idea to make sure your dentist received training. Ask him or her if she is a member of the American Academy of Dental Sleep Medicine.

Sleep apnea is a serious medical condition. It should be diagnosed at a sleep center. Oral appliance therapy is an alternative to CPAP, the standard treatment option.

Wednesday, February 17, 2010

Sleepy Teens Twice As Likely to Have Car Crashes

A study in the Feb. 15 issue of the Journal of Clinical Sleep Medicine found that sleep problems and sleepiness increase the risk of motor vehicle accidents in teens.

Results indicated that adolescent drivers were twice as likely to have had a crash if they experienced sleepiness while driving or reported having bad sleep.

The 2004 study was conducted in Italy. It included 339 students. Students were between the ages of 18 and 21 years. Fifty-eight percent of them were male. All of them had licenses.

Eighty of the 339 students had already crashed at least once. Fifteen percent of them considered sleepiness to have been the main cause of the crash.

Fifty-six percent of students who had at least one previous crash reported driving while sleepy. In contrast, 35 percent of subjects who had not been in a crash reported driving while sleepy.

The students answered questions about lifestyle habits, sleep habits, sleep disorders symptoms and daytime sleepiness.

Researchers assessed the frequency and timing of car use. They also examined the number of accidents drivers experienced and the perceived causes. They considered the respondents’ way of dealing with drowsy driving.

Results showed that students suffered from chronic sleep deprivation. Additionally, 45 percent woke up at least once during the night with trouble falling asleep again. Forty percent complained of difficulties waking up in the morning. Nineteen percent reported bad sleep.

This pour-quality sleep affected their daytime wakefulness. Sixty-four percent of participants complained of excessive daytime sleepiness.

Men and smokers had an increased risk for accidents. The authors suggested that tobacco use could have been an indirect estimate of unhealthy lifestyle habits or method of counteracting sleepiness.

The researchers recommended combating sleepiness by pulling off the road and napping for 10 to 15 minutes. Opening a window, listing to music or drinking coffee are not effective.

Untreated sleep apnea is a major cause for motor vehicle accidents. Having sleep apnea can make a person 15 times more likely to be involved in a deadly motor vehicle accident.

In December, this blog reported on a study that found that being awake 17 straight hours produced impairment equal to a blood alcohol concentration (BAC) of .05. After 24 hours of not sleeping, the impairment rose to .10.

Read more about drowsy driving here.

Tuesday, February 16, 2010

Ghouls and Goblins: Severe OSA Decreases Nightmare Recall

Wish you could forget your nightmares? Many people do, but nightmares may indicate healthy sleep patterns.

UPI reports that a new study found that severe obstructive sleep apnea (OSA) decreased nightmare recall.

Nightmares are dreams that can cause anxiety, terror or distress. An estimated 50 to 85 percent of adults report having at least occasional nightmares.

The study, published in the Feb. 15 issue of the Journal of Clinical Sleep Medicine, found that severe OSA patients reported a significantly lower number of nightmares than otherwise healthy patients.

The study included 393 patients. Sixty-seven percent of the patients were male. Their mean age was 50.5.

Each patient took a sleep test. Their mean AHI was 34.9, indicating a high frequency of severe OSA. AHI, or apnea-hypopnea index, measures the number of times a person stops breathing per hour during sleep. An AHI of more than 30 represents severe OSA.

Participants also reported how frequently they remembered dreams and nightmares. “Frequent” dream and nightmare recall happened at least weekly.

Dream recall and nightmare recall were not associated. Of the participants, 52 percent reported frequent dream recall and 34 percent reported frequent nightmare recall.

Severe OSA had a more negative effect on nightmare recall than on dream recall. Results indicated that nightmare recall decreased as OSA severity increased.

Frequent nightmare recall was reported by more than 70 percent of control subjects and more than 43 percent of mild OSA patients. In contrast, frequent recall occurred in more than 29 percent of moderate OSA patients and more than 20 percent of severe OSA patients.

The researchers believe that OSA suppresses the cognitive experience of nightmares. OSA causes sleep fragmentation. This fragmentation can lead to less rapid eye movement (REM) sleep. Nightmares generally occur in REM sleep.

The researchers suggest that treatment will help OSA patients get more REM sleep. Treatment may raise the frequency of nightmare recall. While nightmares can be frightening, they indicate better sleep quality.

Oral appliance therapy and CPAP are two common treatment options.

Image by Yogesh Moorjania

Monday, February 15, 2010

Sleep Centers Work Hard to Make Falling Asleep Easy

Advances in medicine, treatment options, and public awareness have led more people to undergo sleep studies, according to a recent Boston Globe article.

More than 18 million Americans suffer from obstructive sleep apnea (OSA). This condition can be diagnosed with a sleep study at a sleep center.

Learn more about sleep studies here.

Many people worry they will not be able to sleep in a strange place. But sleep centers work hard to make their patients as comfortable as possible.

South Shore Sleep Diagnostics opened a state-of-the-art sleep center this weekend. It is accredited by the American Academy of Sleep Medicine (AASM).

Like sleep labs across the country, the new center aims to make its patients feel at-ease. With the amenities offered, patients might confuse the center for a hotel.

Each bedroom has a private bathroom and 50-inch flat-screen TV. The queen-sized beds are lined with feathers and covered in 1,000-thread-count Egyptian cotton bedding. The rooms have complimentary, non-alcoholic wet bars and patients enjoy coffee and pastries in the morning. The center even offers a shuttle service for seniors.

“We wanted to stay away from the institutional approach,’’ said Dr. Anit T. Patel, medical director at South Shore Sleep Diagnostics. “We realize it’s hard enough to sleep away from your own bed as it is.’’

Sleep specialists and technologists monitor patients’ health throughout the night from a nearby room. Electrodes track each patient’s breathing, brain waves, heart rate, and blood pressure.

There are more than 1,900 AASM-accredited sleep labs. AASM accreditation identifies sleep medicine providers who offer the highest quality of medical care for people with sleep problems. AASM-accreditation began in 1975.

Find a sleep center near you.

Image by Bluman

Friday, February 12, 2010

Signs of Sleep Apnea: Soft Palate Length May Aid OSA Screening Process

A study published online recently in the journal Sleep and Breathing found that the length of a person’s soft palate may help sleep specialists detect sleep apnea. The soft palate length as a percentage of the whole airway length may also give clues.

Sleep apnea can occur when the soft palate collapses, preventing airflow during sleep.

The study included 45 Japanese patients. Six women and 19 men had sleep apnea. Eight women and 12 males were controls.

Five of the controls complained of snoring and had a sleep study but did not have sleep apnea. The control participants who did not snore or experience daytime sleepiness did not have a sleep study. All of the sleep apnea patients underwent a sleep study. Each OSA patient experienced at least five arousals per hour.

The researchers used spiral CT scans to image each participant’s airway. They found that soft palate length increases with age in men and is smaller in women, after adjusting for OSA and body mass index (BMI) status.

The results also indicated that patients with OSA had longer soft palates in contrast to the control group, making it a possible tool for OSA screening.

Other common signs of OSA include excess body fat and a neck size larger than 16 inches in women or 17 inches in men. Loud snoring and excessive daytime sleepiness are also warning signs.

If you think you may be at risk for sleep apnea, visit a sleep center.

Many dentists know how to screen for and treat sleep apnea. Find-a-dentist in your area.

Thursday, February 11, 2010

Children with Sleep Apnea Face Health Issues

A new study published online in the journal Sleep and Breathing found that children suffering from severe sleep apnea might experience effects of this condition during the day.

The study occurred in Taiwan. It included 138 children. Eighty-five boys and 53 girls participated. They were six to 11 years of age.

The children’s parents filled out the Child Behavior Checklist (CBCL). The CBCL looks at eight behavior aspects, including somantic complaints and attention. Somantic complaints include unexplained medical problems like stomachaches and headaches.

CBCL questionnaires also look at anxiety, depression, withdrawal, social problems, thought problems, delinquent behavior and aggressiveness.

The children’s teachers also filled out Teachers Report Forms (TRF). TRF examine academics, adaptive functioning, and behavioral and emotional problems.

Each child took a sleep study to test for sleep apnea. Sleep apnea happens with the airway collapses, preventing airflow. The body wakes up to breathe, causing an arousal. This pattern can happen hundreds of times a night.

Children who woke up more than 15 times per hour were considered to have severe sleep apnea. Children who had one or less arousal from sleep per hour were controls.

Parents and teachers indicated that children with severe sleep apnea had more attention problems and somantic complaints during the day than the controls. They also had higher body mass indexes (BMI). A high BMI and excess body weight can worsen sleep apnea.

The results suggest that children with severe SDB may be predisposed to somatic complaints and attention problems. Sleep examination or medical intervention might be provided at an early age in these children.

Wednesday, February 10, 2010

New Study Suggests Oral Appliance Therapy Might Be Ideal Treatment for Military Recruits

A new study published online by Sleep and Breathing found that oral appliance therapy might be the ideal treatment for military recruits suffering from sleep apnea.

Periodic leg movements (PLM) involve bursts of muscle activity during sleep. These bursts can cause arousals like those caused by sleep apnea.

Researchers believe PLM and sleep apnea often coexist. However, sleep apnea can mask PLM. When sleep apnea treatment is effective, PLM may become apparent. PLM can worsen daytime sleepiness, so it is important for a sleep specialist to know when it is present.

Previous studies have shown that effective CPAP treatment can unmask PLM. This study shows that oral appliances can have the same effect.

Researchers at the Walter Reed Army Institute of Research conducted the study.

It involved 21 active military members who suffered from sleep apnea. Fifteen men and six women participated. They were 25 to 53 years of age.

A dentist trained in dental sleep medicine fit each service member with an oral appliance.

Each patient took a sleep study without an oral appliance. Ten patients had mild OSA. Five patients had moderate OSA. And six patients had severe OSA. Three of the 21 people had PLM during sleep.

Participants took another sleep study wearing an oral appliance. In the second sleep study, 11 of the 21 people experienced PLM. These results indicate that the oral appliances helped unmask hidden PLM.

Oral appliances are portable, non-invasive and do not require electricity.

The researchers suggest that oral appliances are effective and ideal for military recruits.

Sleep and Breathing is the official journal of the American Academy of Dental Sleep Medicine.

Tuesday, February 9, 2010

Dental Sleep Medicine Expands Into Higher Education

Dental sleep medicine (DSM) has come a long way since the AADSM’s start in 1991. Founded by eight dentists interested in treating obstructive sleep apnea (OSA), the Academy now provides training for more than 1,800 dentists via educational courses, peer-reviewed journals and study clubs.

Several universities have begun addressing the need for DSM education as well.

AADSM members Leopoldo Correa, BDS, and Noshir Mehta, DMD, MDS, MS, launched an innovative new DSM program at Tufts University in Boston, MA this past fall.

An article in the January/February issue of Sleep Review Magazine provides an overview of this exciting new program.

The curriculum caters to postgraduate dental students. These students have dental degrees and are doing advanced studies. They receive both classroom and clinical instruction.

Students learn how to screen patients for sleep apnea and interpret sleep studies. They learn how to fit and adjust oral appliances, and examine the pros and cons of different appliances.

There are more than 18 million Americans suffering from sleep apnea. Many of them do not know they have the disease. Dentists see their patients on a regular basis, so it is convenient for them to screen for sleep apnea. This screening ensures that more OSA patients get the treatment they need for a healthy life.

Dr. Correa explained that there are still not enough dentists trained in DSM to meet the patient demand. The course was designed to address that gap.

He explained why many dentists decide to learn DSM.

“Dental sleep medicine is a rapidly expanding field where the dentist has an immediate and direct effect on the overall health of the patient,” said Dr. Correa. “It is one of the growing number of examples where a medical and a dental practitioner can work together to benefit the patient more than either one alone.”

So far, the program has been well received. Tufts University will offer a new mini-residency program this April.

Image by: UBC Library Graphics

Monday, February 8, 2010

Sleep Apnea and Nighttime Urination

A recent study evaluated nocturia as a predictor of obstructive sleep apnea (OSA). Nocturia involves excessive urination at night. It can cause a person to wake up several times during the night to urinate.

Nocturia is a known symptom of sleep apnea. This study examined it as a potential screening tool. Snoring is already a common screening tool for OSA.

The study was published online by the journal Sleep and Breathing in October, 2009.

It involved more than one thousand adults who had sought help at a sleep disorders center. They were all older than 18 years of age.

Each person completed medical and sleep history questionnaires. They also took an overnight sleep study. Of the participants, 797 had sleep apnea, 777 reported snoring, and 839 reported nocturia.

Results show that self-reported nocturia can effectively predict OSA.

The researchers suggest that nocturia may be a useful screening tool for sleep apnea.

Research also shows that CPAP therapy for sleep apnea reduces awakenings to urinate.

Sleep and Breathing is the official journal of the American Academy of Dental Sleep Medicine.

Friday, February 5, 2010

Sleep Apnea – What a Headache!

Morning headaches are a common symptom of obstructive sleep apnea (OSA).

Past studies found that these headaches affect anywhere from 18 to 74 percent of OSA patients.

A study published last February in the journal Cephalalgia showed that morning headaches might trouble a third of OSA patients.

The study included 101 healthy individuals and 462 OSA patients.

An estimated nine percent of healthy participants reported morning headaches. In contrast, more than 33 percent of OSA patients suffered from headaches.

People with moderate and severe sleep apnea were most affected.

Morning headaches were more frequently reported by women and patients with a history of headaches.

The study did usher in good news, though.

CPAP treatment solved 90 percent of patient’s morning headache problems.

Continuous Positive Airway Pressure (CPAP) is the gold standard of OSA treatment. While safe and effective, 25 to 50 percent of OSA patients cannot tolerate or comply with CPAP.

Many people use oral appliance therapy as an alterative. Oral appliance therapy is performed by dentists trained in dental sleep medicine.

Thursday, February 4, 2010

Trimming Down By Catching Up on Your Zzz’s

One of the hardest parts of detecting obstructive sleep apnea (OSA) is that most people do not realize their brain forces them awake throughout the night to breathe.

These unconscious arousals can happen hundreds of times a night, voiding the benefits of restorative sleep, draining a person of energy, and putting them at risk for obesity, no matter how long they stay in bed.

A new study in the Feb. 1 issue of the journal SLEEP found that not getting enough sleep could lead to obesity.

The study examined people’s sleep habits and weight gain in Japan.

During health checkups in 2006 in 2007, 35,000 men and women reported their sleep habits. Their weights and heights were also recorded.

An estimated six percent of the men who were not obese in 2006 became obese in 2007.

The researchers found that weight gain and the development of obesity were higher in men who slept less than six hours. Men who slept five hours were more affected by weight gain than those who slept five to six hours.

Both men and women who slept seven hours had higher body mass indexes in 2007 than in 2006 compared to those who slept seven to eight hours per night.

Interestingly, the researchers found that sleeping more than nine hours was associated with increased weight gain. They suggested that a confounder such as OSA, may have affected the results.

Wednesday, February 3, 2010

Teaming Up Against Sleep Apnea: Physicians and Dentists Collaborate to Help Patients

An article in today’s Times Herald-Record highlights the teamwork many dentists and sleep physicians use to treat sleep apnea.

In a quest to help his wife sleep, 52 year-old John Franco set out to cure his snoring.

After taking a sleep test – he found out his snoring was actually a sign of sleep apnea.

Franco tried everything from CPAP to surgery to treat his apnea. Finally, Franco’s journey led him to an unlikely spot – the dentist chair.

Franco’s dentist, AADSM member Dr. Thomas Littner, told him about a dental device that might improve his snoring and his health.

Snoring and sleep apnea happen when a person’s airway partially or completely collapses during sleep. Dentists are not permitted to diagnose sleep apnea. But after a person takes a sleep test and gets diagnosed with sleep apnea, a dentist can fit that patient with an oral appliance. This appliance keeps the patient’s airway open so they can sleep better.

Dr. Littner fit Franco with a custom-made device.

"It's comfortable," Franco said. "It did take time to get used to it, but I like it. And most importantly, I don't snore. My wife said so."

Dr. Littner is an OSA patient himself. He became interested in dental sleep medicine when he started using an oral appliance to improve his own sleep. To learn oral appliance therapy, he took courses with the American Academy of Dental Sleep Medicine.

Dr. Littner is on staff at Orange Regional Medical Center where he works with Dr. Alan Schaffer to treat obstructive sleep apnea. Dr. Schaffer is a fellow of the American Academy of Sleep Medicine.

Dr. Schaffer explained how sleep medicine often requires a team of professionals to improve patients’ health.

"This whole field sets itself up as a multidisciplinary approach in medicine. It's an alternative to our C-PAP breathing apparatus that our center recommends for sleep apnea. But we have some patients (like Franco) who cannot tolerate the C-PAP, so we send them to Dr. Littner to be fitted with an oral device. We complement each other very nicely."

Tuesday, February 2, 2010

Sleep Apnea Patient Tells the Wall Street Journal How an Oral Appliance Restored His Health

Wall Street Journal reporter Kris Maher recently investigated how patients get treated for sleep apnea when they “balk” at the “bulky masks” involved in CPAP therapy.

CPAP device manufactures are working to improve CPAP compliance by making the designs more comfortable.

In the meantime, 25 to 50 percent of patients do not comply with or tolerate CPAP. So where do they go for treatment?

One option is the dentist’s office.

There are more than 1,800 dentists who treat sleep apnea with oral appliance therapy. These devices work best for patients with mild to moderate sleep apnea.

Thirty-five year-old Dave Morton used to wake up from sleep choking. After taking a sleep test, he was diagnosed with sleep apnea and started using a CPAP mask.

"I was very stressed and couldn't sleep," Mr. Morton recalled. "I never woke up feeling refreshed."

After two years of on-and-off CPAP use, Mr. Morton switched to a dental appliance, which reduced his sleep apnea significantly.

"I'm happier and healthier," he said. "I can tell my brain is working better again."

Dental devices can have side effects such as jaw pain or tooth movement. However, compared to the risks of untreated sleep apnea, such as heart attack, stroke and diabetes, many patients accept the tooth movement.

Learn more about oral appliances.

Monday, February 1, 2010

As Clear as Black and White: Study Shows that Severe OSA Patients Have Lower Concentration of Gray Matter

A study published today in the journal SLEEP found that men with severe obstructive sleep apnea (OSA) have significantly less concentrated gray matter in multiple brain areas than healthy men of the same age.

“Gray matter” refers to the cerebral cortex. It is where most of the brain’s information processing takes place.

The study suggests that the memory and cognitive impairment frequently observed in OSA patients may relate to changes in brain structure.

The study involved 36 males with severe OSA. It compared their brain structures to that of 31 healthy males of matched age. The men’s mean age was 44 years.

The participants each took a sleep study. The OSA patients had a mean apnea-hypopnea index (AHI) of 52. This number indicates they partially or completely stopped breathing more than 52 times per hour during sleep. An AHI of more than 30 constitutes severe OSA. These pauses can lead to severe drops in blood-oxygen concentration.

The researchers used an MRI technique to characterize structural differences between the men’s brains. They looked to see if gray matter concentrations or volumes differed in OSA patients and healthy men.

The researchers found that gray matter concentration decreased in OSA patients without significant changes in volume of the matter.

They noted that more research would help determine if this loss occurs because of OSA, or if preexisting abnormalities contribute to the development of the disorder.


The Official Blog of the American Academy of Dental Sleep Medicine (AADSM) is intended as an information source only. Content of this blog should not be used for self-diagnosis or treatment, and it is not a substitute for medical care, which should be provided by the appropriate health care professional. If you suspect you have a sleep-related breathing disorder, such as obstructive sleep apnea (OSA), you should consult your personal physician or visit an AASM-accredited sleep disorders center. The AADSM, and the American Academy of Sleep Medicine, as the managing agent of the AADSM, assume no liability for the information contained on the Official Blog of the AADSM or for its use.