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?

Could Sleep Apnea be Affecting Your Patient’s Dental Implants?

 

When our patients are missing teeth, many might turn to dental implants for a more permanent solution. And that’s great, but what if something is changing the permanence of those dental implants? In a study from the Journal of Oral Implantology, the impact of obstructive sleep apnea (OSA) on dental implants was investigated, and they found a connection. If we can treat our patients’ sleep apnea to prevent harming their dental implants, we can continue to help them smile for longer.  

The Study

Researchers looked at how OSA affects implant-borne prostheses, and the frequency with which a complication occurred was studied in 67 different patients. The researchers found a high instance of complications related to OSA, which means we need to pay closer attention to our patients’ oral health when they have dental implants and/or suffer from sleep apnea.

Of the 67 patients studied, about 16 experienced complications with their dental implants. In fact, 13 of those had OSA. Among the 16 patients with complications, there were 22 prostheses with a total of 30 issues, including:

  • Porcelain Fracture
  • Facture of the Screw/Implant
  • Loosening of the Screw
  • Decementation

The average time for a complication to occur in patients with sleep apnea is about 73 months post-implantation–that’s a long time. In fact, about 81% of patients with OSA experienced complications with their dental implants–that number is far too high.

What Options are Available?

As you know, the availability of oral appliance therapy is essential in helping our patients find relief from sleep apnea. And now, it seems it can help to prevent further harm to their dental implants. It is also important to keep an eye on sleep bruxism, or bruxism in general, because this will be a leading cause of damage to dental implants, too.

We’ve got a lot on our plates when it comes to treating obstructive sleep apnea and sleep bruxism in our patients, but now we need to be on the lookout for complications with dental implants. Are you ready to take charge of your patients’ health even more? Good. So am I.

Let’s keep an eye on sleep apnea, sleep bruxism and dental implants. If we can pay extra attention to these patients, we can continue to not only improve their sleep, but their oral health as well. If you have any questions, please do not hesitate to contact me further. In the meantime, continue to seek advanced education by attending one of my upcoming lectures!

There’s a New Guideline for Sleep Apnea Testing…

At the beginning of March we were introduced to a new set of guidelines for sleep apnea testing. The American Academy of Sleep Medicine (AASM) developed new guidelines with an expert task force of board-certified sleep medicine physicians. These guidelines were then published in the Journal of Clinical Sleep Medicine.

The Guidelines

Recommendations were based on a systematic literature review, meta-analyses, and assessment of the evidence using the Grading Recommendations Assessment, Development, and Evaluation (GRADE) method. These new guidelines also include circumstances in which an attended polysomnography in an accredited sleep center or home sleep testing should be done for suspected obstructive sleep apnea (OSA). It’s a lot to take in, but these guidelines were created to further help us dentists, and other physicians, better treat our patients.

In addition to new guidelines, there were also updated recommendations from previous practice parameters published in 2005 and 2007. For the foundation of high quality care when diagnosing OSA, two “good practice statements” were adopted:

  1. Diagnostic testing for OSA should be conducted along with a comprehensive sleep evaluation and adequate follow-up.
  2. Polysomnography is the standard diagnostic test for adults in which OSA is suspected based on a comprehensive sleep evaluation.

To further help clinicians in diagnosing OSA in adults, the following recommendations were also made:

  • Clinical tools, questionnaires and prediction algorithms should not be used to diagnose OSA in adults, in the absence of polysomnography or home sleep apnea testing.
  • Polysomnography, or home sleep apnea testing with an adequate device, should be used for the diagnosis of OSA in uncomplicated adult patients presenting with signs and symptoms that indicate an increased risk of moderate to severe OSA.
  • If a single home sleep apnea test is negative, inconclusive, or technically inadequate, polysomnography should be performed for the diagnosis of OSA.

And the list goes on, but it is important to understand these guidelines so we can better care for our patients.

Where do Dentists Come Into the Picture?

As you know, dentists don’t diagnose sleep apnea, but we can recommend our patients seek outside help. If your patient is displaying signs and symptoms of sleep apnea, it is important to be prepared. While you can’t diagnose them, you can recommend a doctor to visit for a proper diagnosis. You can also share your knowledge of the process so your patient doesn’t go into it blindly.

To review the guidelines and learn more about these new additions, you can read the article here.