Patients who snore might suffer from nerve and muscle damage in palate

According to Umeå University in Sweden, people who snore might have extensive tissue damage in the nerves and muscles of the soft palate. As a result, this can create problems for patients when swallowing. It can also contribute to the development of sleep apnea. Treatment options often include early intervention to stop snoring, which can have benefits in healing or preventing the development of sleep apnea.

Development of sleep apnea remains unclear

It is still unclear why some people develop sleep apnea. Some factors that might contribute are obesity, a small throat, neurological diseases and hormonal disorders. However, even if the patient doesn’t have any of those factors they might have sleep apnea. Rresearch has also shown that tissue damage in the soft palate is also an important contributor to the development of sleep apnea and disturbances in swallowing function. Farhan Shah, PhD, a student at the department of integrative medical biology at Umeå University, says that the nerve muscle injuries appear to contribute to the collapse of the upper airway during sleep. The nerve and muscle damage might be the result of recurrent snoring vibrations that the tissues are exposed to.

His dissertation looked at eight patients who snore and 14 with both snoring and sleep apnea compared to 18 non-snoring people. The patients were studied overnight. Tissue samples from their soft palate were also analyzed to detect muscle and nerve lesions. Results showed that snorers and sleep apnea patients had extensive damage to both nerves and muscles. This is related to the degree of swallowing disorders and severity of sleep apnea.

Research is needed on muscle damage

This is good information for us to know, but there is still so more to observe and research. This knowledge can help us to gain a better understanding of the various connections.

This research is also a step in the right direction and we need to look at treatment of sleep apnea. Will treatment help to prevent nerve and muscle damage? Could it prevent or cure further deterioration in patients who snore and/or have sleep apnea?

June is National Aphasia Awareness Month

The month of June is National Aphasia Awareness Month. This means, as dental sleep medicine specialists, we need to make sure our patients are staying on top of their health by treating sleep apnea and other symptoms in prevention of stroke. As you know, stroke is the number five cause of death and the leading cause of disability in the U.S. And a stroke can have a variety of communication effects, one of which is aphasia. Stroke is the most common cause of aphasia, which is a language disorder that affects the ability to communicate.

Raise Awareness for Aphasia

Let’s use June to help increase public education around this language disorder and to recognize the numerous people who are currently living with or caring for people with aphasia. The American Heart Association/American Stroke Association continues to increase awareness for aphasia by sharing communication tips, the effects of having aphasia, assistive devices for those with aphasia and more.

The Connection with Sleep Apnea

Heart disease is the leading cause of death for men and women. But what you may not realize is that sleep apnea can lead to heart attacks, which can cause people to die in the middle of the night due to low oxygen or the stress of waking up frequently during sleep.

The relationship between sleep apnea, hypertension, stroke and heart disease is very strong. It is vital that everyone understand this connection to further prevent the development of aphasia as well. Sleep apnea can be easily treated to prevent stroke, aphasia and other comorbidities. It is more important than ever to receive continuing education to further improve your patients’ well-being and health.

When patients receive up-to-date health care, you are taking preventative steps, but we still have a ways to go. Start today by educating your patients on the risks of untreated sleep apnea, stroke and aphasia.

Patient adherence rate to sleep study referrals

Let’s talk about patient adherence. I think this is an area that we often overlook and really don’t pay too close attention to, but it is so important to better understand this. Patients become non-adherent for a variety of reasons and it is our job to make sure we know why this is happening so we can improve outcomes.

A study from 2017 looked at the facilitators and barriers to referral compliance among dental patients at risk for obstructive sleep apnea. The goal of this study was to determine the adherence rate to dentist referrals for sleep apnea evaluation. It also looked at the barriers and facilitators to referral compliance.

What the study found

Researchers looked at a sample of 1,099 patients that were given the STOP-Bang questionnaire. Based on the results from this questionnaire, those with elevated risk were referred for a sleep evaluation. After the referral, an interview was completed over the phone to determine if those patients followed through with the recommendation to determine compliance.

The study found that of the almost 1,100 patients screened, 224 (20 percent) were determined to be at-risk for obstructive sleep apnea. However, only 41 of those with an increased risk actually adhered to the referral recommendation. So only 18 percent actually followed through with what was recommended. That isn’t good.

It was found that the most common facilitators to compliance were increased awareness about OSA and dentist recommendation. The most common barriers to compliance were misconceptions about OSA and work responsibilities.

What can we do?

With only a small percentage of patients adherent to the recommendation of their dentist to see a sleep specialist, we need to do something. As dentists we should provide increased awareness about OSA, so that our patients better understand the importance of treatment for the improvement of their health and well-being. By providing better education, our patients can understand just how serious of a condition OSA really is. As far as work responsibilities go, we can look into home sleep testing and inform them that they can work with the sleep specialist to find the best solution.

Continue to educate your patients and staff so that you can not only improve your patients’ health but their adherence as well.

Tell your patients driving while drowsy is dangerous

Driving while drowsy means our patients are about eight times more likely to cause an accident. These federal estimates were found in a study by the AAA Foundation for Traffic Safety. In their study, they used in-vehicle camera footage of thousands of drivers that agreed to participate. After reviewing the cameras and results, the study found that drivers are falling asleep at the wheel at an alarming rate. It’s more than we thought.

With more than 700 crashes examined in the study, about 9.5 percent were caused by a drowsy driver. Drowsiness also played a role in almost 11 percent of accidents that caused serious property damage. This means we need to educate our patients more than ever before about the detrimental effects of sleep apnea not only on their health, but their surroundings.

Encourage patients to get more sleep

If a patient just isn’t sleeping, tell them to get more sleep. The AAA Foundation recommends getting at least seven hours of sleep a night before driving. While that sounds like a great idea, it isn’t always going to happen. In fact, about 35 percent of U.S. drivers actually sleep less than seven hours a night according to the Centers for Disease Control and Prevention.

And if you sleep for just four or five hours, it can quadruple your risk for an accident. However, if the patient has sleep apnea, that might be a different story when it comes to getting enough sleep each night.

Provide treatment for sleep apnea

Part of the issue is that many of patients need a lifestyle change to be able to sleep more, while others suffer from sleep apnea and don’t even realize it. Sleep apnea can make our patients feel sleepy enough to be drowsy drivers. Even if they stop the car and take a short nap, odds are they will still feel tired.

Patients that suffer from sleep apnea and are often found driving can experience altered senses that are commonly used to drive safely. It will often be difficult for them to focus their eyes, remain alert and to react quickly during various driving situations.

To combat this, it is important to not only educate our patients on the risk of untreated sleep apnea, but to also be able to identify signs and symptoms so we can recommend proper treatment or a sleep physician for diagnosis.  

What are you doing to help your patients get the sleep they need to function daily?