Welcome everyone to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health…OPTIMAL HEALTH.
The best, most effective way to improve your overall well-being is to keep an eye on the five pillars of health: Stress; Nutrition; Exercise; Sleep; and Emotional/Mental/Spiritual well-being. If those are in balance, your body will perform at its best. If one is out of whack, your body will let you know!
In the past year, my body has let me know I have a problem with SLEEP. Even after 7-8 hours of sleep, I was still tired in the morning. Thanks to my OURA ring, I started looking closer at the number of breathing interruptions I had during the night, which led to a home sleep study, which led to a diagnosis of SLEEP APNEA.
This is an important podcast. The Centers for Disease Control and Prevention (CDC) found that 3 in 4 adults have sleep disorder symptoms. The American Academy of Sleep Medicine (AASM) estimates that as many as 80% of people with OSA (Obstructive Sleep Apnea) are undiagnosed. I hope this grabs your attention. It did mine, so much so that I invited Dr. Whitt Moss, one of Tennessee’s rare board certified sleep dentists, to join me in unpacking the ins and outs of this prevalent disorder. Check it out here.
PODCAST NOTES
Sleep apnea is highly prevalent and significantly underdiagnosed. It involves repeated interruptions in breathing during sleep, which can cause dips in oxygen levels. These interruptions can lead to major health problems such as hypertension, cardiovascular disease, metabolic dysfunction (i.e.,insulin resistance), and neurocognitive impairment. Additionally, it can cause daytime fatigue, arrhythmias, and even sudden death.
There are two primary forms of sleep apnea: obstructive sleep apnea (OSA) and central sleep apnea (CSA). OSA occurs when the airway is physically blocked, commonly due to relaxed throat muscles. Central sleep apnea (CSA) is less common and is often linked to heart failure or neurological conditions, where the brain fails to send appropriate signals to control breathing.
There is a common misconception that sleep apnea affects only obese individuals, chronic alcoholics, or those who consistently snore. However, this condition can strike even those who don’t exhibit these obvious risk factors.
Initial diagnosis often involves questionnaires like the Berlin Questionnaire and discussions with the patient and their sleep partner. Definitive diagnosis is made through sleep tests, which can be conducted at home or in a sleep lab. Home sleep studies, involving simpler devices, are becoming more common due to patient comfort and convenience. Note: Sleep labs offer the gold standard and more detailed analysis.
Continuous Positive Airway Pressure (CPAP) machines serve as the gold standard treatment, but are often met with poor long term compliance due to discomfort. Alternative treatments include oral appliances designed by dentists, surgical options (less favored nowadays), and newer interventions like Inspire (a nerve stimulator that prevents airway collapse). Oral appliances, in particular, show higher compliance, especially among those who can’t tolerate CPAP.
Dentists can play a pivotal role in diagnosing and managing sleep apnea. Board Certified sleep dentists like Dr. Moss can identify anatomical markers during dental exams that suggest sleep apnea and offer treatments, such as personalized oral devices. Dentists are often in a better position than general physicians to notice signs like large tongues, mandibular tori, and evidence of teeth grinding.
Effective treatment of sleep apnea can lead to significant improvements in life quality, including reduced daytime sleepiness, better cognitive functioning, improved mood, and better management of comorbid conditions (i.e., high blood pressure). Using monitoring devices like the Oura Ring or Whoop Band can help track improvements in sleep quality and other health markers.
New studies have shown that these GLP-1 medications (especially Zepbound) can help with sleep apnea. These types of medications remove fat from the upper airways creating more room to breathe. When I first started using these medications on my patients, I noticed they lose facial and neck fat first. This may explain why it works so well in this area. Stay tuned.
Hormones, particularly estrogen, play a role in the prevalence of sleep apnea. Postmenopausal women see a spike in sleep apnea cases, highlighting the protective role of estrogen. Consequently, bioidentical hormone replacement therapy could offer benefits in preventing and managing sleep apnea. Also, noteworthy is the relationship between low testosterone levels in men and sleep apnea. If a man has Low T, you need to check for sleep apnea, also.
Sleep apnea is a critical topic that’s been flying under the radar for far too long. Recognizing and treating sleep apnea can make a huge difference in your overall health. For me, it has been a game changer. Sleep apnea is underdiagnosed and easy to treat. If you live with someone, know someone, or you are that someone that needs help getting good sleep, please contact one of our offices (performancemedicine.net), or Dr. Whitt Moss at Bateman Dentistry (423-246-9231). Your body will thank you.
Stay educated. Stay healthy.
Till next week.
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