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?

Join us in New York for our First Annual Dental Sleep Continuum

We are excited to announce our first annual Dental Sleep Continuum in New York City starting this July!

What is the dental sleep continuum?

I will be joined by Dr. Bennett and Dr. Gelb for the first annual Dental Sleep Continuum in conjunction with Nierman Practice Management. This continuum offers practicing dentists a comprehensive program aimed at providing hands on clinical experience in all aspects of oral appliance therapy (OAT). Through this continuum, dentists will gain expertise in successfully treating obstructive sleep apnea and disruptive snoring.

This 3-session, 6-day program is ideal for those just beginning to implement dental sleep medicine, as well as anyone that wants to expand their knowledge and increase their experience in providing oral appliance therapy to more patients in their dental practice.

3 weekends of lectures and hands on learning

Nationally known experts in the field of dental sleep medicine will lead the sessions. At completion of the 3-session course, you will leave with the knowledge to properly evaluate patients for sleep disordered breathing problems, as well as how to screen for temporomandibular joint disorders.

We will take a look at several different oral appliances and you will have the opportunity to make three different custom-made devices specifically for you. It will help you gain a better understanding of how to create these appliances. The lab breakout sessions will help participants:

  • Learn standard patient examination techniques.
  • Be proficient in taking impressions and bite relationships for different appliances.
  • With the proper fitting of the oral appliances.
  • Make adjustments to the appliances.
  • Properly manage potential side effects.

This course will provide 48 hours of CE credit, along with a solid foundation for participants in studying for Dental Sleep Medicine board exams. Register now and we look forward to seeing you in New York beginning in July! Please contact me if you have any questions.

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.