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?

Meet the Sleep Team

No matter where you are located, there is a sleep team near you. Each sleep team is ready to help with your patients’ sleep problems. As a dental sleep medicine specialist, you play an integral role in the treatment of your patients. However, you do still need a sleep team to help you along the way. Let’s get to know the other members of a sleep team.woman-sleeping-skin-625km112013

Board Certified Sleep Medicine Physician

A board certified sleep medicine physician has the necessary skills to diagnose and treat sleep disorders. If you suspect your patient might be suffering from a sleep disorder, the first person you should contact is your local sleep medicine physician. Each sleep medicine specialist has received special training that can prevent serious life-threatening diseases and improve your quality of life.

The Sleep Technologist

A sleep technologist will assist in the evaluation and follow-up care of patients with sleep disorders—they interact directly with the patients. They will assist the sleep medicine physician with diagnostic tests, including in-lab sleep studies, multiple sleep latency testing (MSLT) and the maintenance of wakefulness testing (MWT). A sleep technologist will also score sleep tests prior to the physician’s interpretation, while also assisting patients with their home sleep tests.

Advance Practice Nurse/Physician Assistant

Nurses and physicians assist the sleep medicine physician in providing care for your sleep patients. Their roles will vary by state, but both typically practice within the scope of practice as defined by a state licensing board.

Sleep Surgeon

Also known as an otolaryngologist, a sleep surgeon has a specific interest in treating snoring and obstructive sleep apnea. Sleep surgeons work closely with a board certified sleep physician to provide proper care for patients who cannot tolerate CPAP therapy. The sleep surgeon can discuss with your patient each surgery option available.

Behavioral Sleep Medicine Specialist

Mental health professionals that have training in behavioral sleep medicine can work with patients to address the behavioral, psychological and physiological factors that might be interfering with their sleep. A behavioral sleep medicine specialist will use cognitive-behavioral therapy to attempt to eliminate habits, behaviors and environmental disruptions that stand in the way of optimal rest.

As a dental sleep medicine specialist, you maintain the ability to recognize a sleeping problem before it worsens, while also being able to provide effective treatment for your patients. Dr. Mayoor Patel is available to help you learn more about your role as a dental sleep medicine specialist and how you can successfully treat your patients.

Give Your Patients the Gift of a Better Night’s Sleep

Let’s face it, snoring is not attractive, nor is it fun. When a person or their partner snores, it can significantly interrupt their night’s sleep, causing tense relationships. To help your patients give the gift of a better night’s sleep, it is important for your dental office to begin continuing education in the area of dental sleep medicine. Currently, it has been shown that 40% of the American population snores while as many as 16% has diagnosable sleep apnea. With more than 80% of sleep breathing disorders going undiagnosed, your practice can take the next step toward helping your patients and their family members get a better night’s sleep.

What to do

The first thing you should do is to educate yourself on the practice and particulars of dental sleep medicine today. By taking an introductory course on Dental Sleep Medicine you can get a robust introduction to the field of dental sleep medicine. There are several organizations that offer courses and annual meetings to meet the continuing education needs for integrating dental sleep medicine into your practice.

Next, it is important to create a relationship with your local sleep physician. While this may be out of your comfort zone, it is an essential part of gaining the resources you need to give your patients the gift of a better night’s sleep. Sleep physicians are the medical providers who diagnose sleep-disordered breathing and are responsible for the overall care of the patient. As an effective and successful dentist, you will work very closely with your patients’ sleep physician to provide optimal care.

Begin Now

Within your dental practice you can begin to integrate dental sleep therapies. You can do this by creating sleep-focused conversations with your patients. This can be as simple as adding a question to your hygienist’s initial consultation with the patient, such as Do you, or anyone in your family, snore? By adding this simple question, you can help uncover a large population that is in need of care and may not even realize it.

Obstructive sleep apnea (OSA) is heritable and can often be found in children of snoring parents, so taking charge now is important in their overall health. Asking a simple question at a patient’s appointment can be all you need to offer a successful treatment plan so they can get a better night’s sleep! Your patients’ families will be thanking you for this gift that keeps on giving!

Working with a Sleep Physician

Another important relationship to hold and maintain is with a sleep physician. Sleep medicine in the dental office provides knowledge and understanding of sleep physiology and the life-threatening consequences of sleep-disordered breathing. Many at-risk patients are candidates for oral appliance therapy, and many patients who are suffering from sleep apnea can be treated by your dental practice working in an interdisciplinary relationship with a sleep physician.

The Sleep Physician’s Role

While you can provide your patients with oral appliance therapy, it is important to be aware that the first step in treatment is diagnosis. In order to properly diagnose your patients, a sleep physician is needed. A sleep physician is available to provide proper diagnosis of sleep apnea in patients. For this reason, it is important to establish a relationship with your local sleep physician. With each patient that displays signs of a sleep breathing disorder, you can send them to your local sleep physician for referral. Through a visit with the sleep physician, your patient will be monitored, tested and diagnosed. From there you can treat your patient with oral appliance therapy when appropriate.

Create a Bond

First, it is important to introduce your dental sleep medicine practice to your local sleep physician. This allows your local sleep physician to be aware of the services you provide, which helps in building a relationship for proper diagnosis and treatment planning. To create this working relationship, it is important that you give physicians and their staff confidence that your practice will provide exceptional care for their patients by speaking their language and sending standard medical SOAP format narratives that document your patients’ treatment—it demonstrates to physicians that your practice has established proper protocols.

Introducing yourself to your local sleep physician is a good way to establish a solid relationship because you are informing them that you are screening your dental patients for sleep apnea, and will be referring to them for an evaluation and diagnosis. The sleep physician will also play a large role in a follow-up sleep study after a patient has begun oral appliance therapy. Your local sleep physician will help to make sure the treatment is working, or provide treatment adjustments as needed.

Contact Dr. Mayoor Patel for more information on how you can establish a proper relationship with your local sleep physician and why it is so important for treating your patients.