Lymphatic System’s Connection with Migraines and Sleep

In a study posted by the Washington Post, scientists studied lymphatic vessels for more than two decades. For more than 300 years it was accepted that the lymphatic vessels stopped at the brain. However, this recent study by scientists found new answers. Utilizing mice with glowing lymphatic systems, Kari Alitalo found that the heads of the mice glowed, which showed a link between the lymphatic system and the head. This is where migraines and sleep come into play.

A Migraine Connection

Harvard University researchers found that glymphatic flow (is a functional waste clearance pathway for the vertebrate central nervous system (CNS)) significantly decreases in the period just before a migraine. The intense pain of migraines is caused by inflamed nerves in the tissue that surrounds the brain. As a result of faulty clearance of molecular waste from the brain, it can trigger inflammation in these pain fibers, which leads to disturbingly painful headaches.

Sleep’s Role

Another link with the glymphatic flow is sleep–the system appears to process twice as much fluid during sleep as it does during the time awake. In this situation, the lymphatic system removed more of the protein when the mice were asleep than when they were awake. As suggested, over time sleep dysfunction may also contribute to Alzheimer’s and even brain illnesses. While you are sleeping, you clean your brain, so when you can’t sleep, your brain suffers–you need that time for housekeeping.

Sleep position is also important. When a person sleeps in an upright position, waste is not removed properly. Sleeping on your stomach is also not effective with the back being somewhat better. When laying on your side, it appears to show much better results. Sleep might not be the only way to improve glymphatic flow, but it is one of the better ways.

We need to continue to take these advancements and improve our services to our patients. With a connection between the lymphatic system, migraines and sleep, we can keep offering our patients the care they need to remain healthy and happy. Let’s take these advancements and work toward an improved understanding of the migraine and sleep connection with the lymphatic system.

Obstructive Sleep Apnea Disrupts Cognition in Parkinson’s Disease

Another interesting article and topic is how obstructive sleep apnea (OSA) disrupts cognition in Parkinson’s Disease patients. It seems that the more research being completed, the more we continue to see a link between other diseases. Sleep apnea in patients with Parkinson’s disease is linked to higher levels of sleepiness and lower cognitive function scores according to results published in Neurology.

What is the Connection?

Cognitive dysfunction is one of the non-motor symptoms of Parkinson’s disease associated with lower quality of life. Dementia also occurs in about 30% of patients with PD, reaching as high as 80% in patients with advanced age and disease. These cognitive and psychomotor impairments can also be linked with obstructive sleep apnea.

It’s interesting to think about this new connection and how it might affect our patients. While we might not interact with a large group of people with Parkinson’s disease, it is still important to know and understand this connection. For instance, sleep problems can be an early sign of Parkinson’s disease. This is even before motor symptoms have begun. Some common sleep problems for Parkinson’s patients include:

  • Insomnia
  • Excessive daytime sleepiness
  • Nightmares
  • Sleep attacks
  • REM sleep behavior disorder
  • Periodic leg movement disorder
  • Restless leg syndrome
  • Sleep apnea
  • Nocturia

Each of these conditions can lead to further complications, mainly sleep apnea. And, as you know, sleep apnea has been linked to insomnia, excessive daytime sleepiness, nocturia and restless leg syndrome. By being aware of these connections, we can continue to help our patients even more.

Skipping Sleep Only to Catch Up Tomorrow Is Bad for Cognition

When our patients skip out on sleep and then try to catch up in the following days with longer bouts of sleep, it is tied to worse cognition–both in attention and creativity–in young adults. The more varied a person’s sleep patterns are, the worse their cognition declined across the week. In these instances, it makes learning and completing tasks quite difficult.

For this reason, we want to ensure our young adult patients are getting the appropriate amount of rest and screened for sleep apnea. Whether a person is completing a project, studying for school, or binge-watching their favorite show on Netflix, losing sleep and then trying to catch-up on sleep is never a good idea.

The Negative Effect of Skipping Sleep and Catching Up

Irregular sleep patterns have a negative effect on a person’s ability to focus for planning, making decisions, correcting errors, and remaining attentive while driving. Erratic sleep can also have a significant impact on creativity, meaning it is harder to think on your toes for various projects. Creativity is often described as a person’s ability to see a link between things that might seem unrelated at first, but then are able to create a link.

In addition to a lag in creativity, many young adults will experience a drop in their working memory, which enables them to hold memories for a short time while also completing a separate task. Sleep significantly improves creativity and memory, which is why it is important for us to ensure our patients are getting the sleep they need to complete daily tasks without issues.

Offer Treatment Options

If you notice your patients are experiencing signs of sleep deficiency or they mention how they crammed for an exam and lost sleep, but it’s ok because they will sleep this weekend, make sure you provide proper education. Inform those patients of the need for regular sleep every day and not just some days. Additionally, screen your patients for sleep apnea–there is a chance some patients might also be suffering from sleep apnea. When this is the case, no matter how much sleep they get, they will continue to struggle with their daily tasks. Be aware and look out for common symptoms so you can help your patients lead healthy, happy lives.

Let’s look deeper into cognition with young adults, so we can continue to provide the best care possible. What are ways you might look for signs and symptoms in your patients? Share your ideas and let’s see how we can continue to help!

Truckers for a Cause Help Raise Awareness

We’ve previously discussed sleep apnea and its prevalence in truck drivers, so you’re already aware of the high risk of accidents there. While we continue to educate and raise awareness for sleep apnea, we’ve got a little extra help – Truckers for a Cause. I think it’s great! The more awareness for sleep apnea, the better!

What is Tuckers for a Cause?

Bob Stanton is a cofounder of Truckers for a Cause, and is a truck driver. Truckers for a Cause is dedicated to educating truckers about the dangers of sleep apnea. In their words, “people helping people with sleep apnea”. This is a great cause and one that should never be taken lightly. If you are aware of a truck driver in your life, or a patient that might be a truck driver, direct them to this group for further help and guidance.

While at a conference on fatigue research, Stanton outlined several challenges truckers face in treating sleep apnea with the use of a CPAP machine in-cab. This is where dentists can step in. We understand that the use of a CPAP machine while on the road can be difficult and bulky, which is why an oral appliance might be a great alternative–truck drivers can get the rest they need, while treating their sleep apnea. It’s a win-win situation.

Sleep Apnea Regulations

According to Title 49 of the Code of Federal Regulations, section 391.41(b)(5), it states:

“A person is physically qualified to drive a commercial motor vehicle if that person: Has no established medical history or clinical diagnosis of a respiratory dysfunction likely to interfere with ability to control and drive a commercial motor vehicle safely.

Since a driver must be alert at all times, any change in his or her mental state is in direct conflict with highway safety. Even the slightest impairment in respiratory function under emergency conditions (when greater oxygen supply is necessary for performance) may be detrimental to safe driving. There are many conditions that interfere with oxygen exchange and may result in incapacitation, including emphysema, chronic asthma, carcinoma, tuberculosis, chronic bronchitis and sleep apnea.”

It’s interesting to look into this topic further because truck drivers who suffer from sleep apnea can directly affect other drivers on the road. This is why so many regulators have taken a strict stance on testing for sleep apnea in truck drivers.

Let’s take charge of this new insight and new partner in sleep apnea care. What steps do you think we should take to further educate truck drivers on the importance of sleep apnea treatment and how oral appliance therapy can help?