Dr. Mogell Dental Blog

Boca Raton Cosmetic Dentist

Morning Headaches - Could Sleep Apnea Be The Cause?

Thursday, November 07, 2013

In my last post I talked about morning headaches and teeth grinding. Another common cause, that is usually not diagnosed, is obstructive sleep apnea. There is some research that is beginning to suggest that the two might actually be linked in some cases.

Obstructive sleep apnea is a sleep breathing disorder. During sleep, the soft tissues of the mouth and throat relax and fall back, blocking the airway. The sleeper actually stops breathing. This occurs many, many times throughout the night with the sleeper briefly waking to begin breathing again. Search YouTube for videos of patients with sleep apnea, it is frightening to watch.

Left untreated, sleep apnea has been linked to heart attack, stroke, diabetes, depression and weight gain.

The signs of sleep apnea include snoring, gasping during sleep, weight gain, a large neck size and extreme daytime sleepiness. Patients may wake with headaches or sore throats.

Sleep apnea can only be diagnosed by a physician but it can be treated by a dentist who is trained in dental sleep medicine.

I'm proud to say that I am only one of three dentists in Florida who are board certified by the American Board of Dental Sleep Medicine. I work closely with area sleep physicians to ensure that their patients who are unable to use CPAP machines are effectively treated with oral appliance therapy.

Sleeping with an oral appliance is a simple and comfortable way to treat obstructive sleep apnea.

Find out more about obstructive sleep apnea and oral appliances by contacting our office at 561-394-9000 today.

Labels: obstructive sleep apnea, teeth grinding, TMJ

yourdentalblog

Morning Headaches - We Can Help

Do you feel like you wake up every single morning with a headache? You aren't alone.

Two of the most common reasons for these morning headaches are teeth clenching during sleep and obstructive sleep apnea. Fortunately, we treat both disorders at our Boca Raton office. I'll talk about teeth clenching in this post and sleep apnea in the next.

Grinding or clenching your teeth is called bruxism. Many people grind their teeth and don't even realize it. A few grind throughout the day but the vast majority of teeth grinding occurs while we are asleep. Unless a bed partner complains about the grinding noises next to them all night, or teeth begin to crack and break, a night grinder will be unaware.

Bruxism not only damages teeth (I have seen cases where teeth have been worn down to almost nothing), but it also leads to painful TMJ symptoms, including headaches. The TMJ, temporomandibular joint, is your jaw joint and is one of the most complicated joints in the human body. Add to this the unbelievable strength of the jaw muscles and it is easy to see how the joint can become inflamed or damaged.

Night time grinding can't really be "cured" but we can stop further damage and put an end to the headache and muscle pain. By completing a full TMJ workup we can find the optimal "happy place" for your jaw and create an orthotic device that is worn during sleep. This orthotic will keep your jaw in the optimal position and prevent damage to the teeth.

Grinding may be caused by stress but in some cases it appears to be a symptom of obstructive sleep apnea! More about that in my next post.

Please contact 561-394-9000 today to schedule your TMJ consultation. You don't need to live with constant headache pain. The diagnosis and treatment of TMJ dysfunction has been an integral part of my practice for over 20 years.

Labels: obstructive sleep apnea, TMJ

yourdentalblog

Pregnancy, Sleep Apnea and Diabetes - A Common Theme

Wednesday, October 23, 2013

Pregnancy comes with it's share of challenges, including sleep disorders and gestational diabetes. New research shows that pregnant women with obstructive sleep apnea were much more likely to develop gestational diabetes than those without a sleep breathing disorder.

The article, published in The Journal of Clinical Endocrinology & Metabolism, looked at a small group of pregnant women. Some of the women had gestational diabetes, some did not, and a control group of 15 non-pregnant, non-diabetic women. The researchers found that, no surprise, pregnant women had more sleep disturbances than non-pregnant women.

But the researchers also found that obstructive sleep apnea was more prevalent in the pregnant women with gestational diabetes than those pregnant women without diabetes, 73% to 27%. Because obesity is a large risk factor for obstructive sleep apnea the researchers adjusted for this variable and they were able to accurately predict which pregnant women would probably develop gestational diabetes based on their obstructive sleep apnea.

A healthy pregnancy is important for healthy babies (and moms). If you are thinking of becoming pregnant or if you are pregnant and overweight you should be checked for obstructive sleep apnea. Please contact us at 561-394-9000 today. Healthy teeth and gums and healthy sleep are all essential for a healthy pregnancy!

Labels: obstructive sleep apnea

yourdentalblog

Sleep Apnea and Anxiety

Wednesday, September 18, 2013

Anxiety and sleep apnea have been linked in a number of studies. In 2012, a European study found that more than half of sleep apnea patients also "had some degree of depression and anxiety."

It is important to note that it has not been proven that sleep problems cause anxiety or that anxiety causes sleep problems. A University of California - Berkeley researcher said "It's been hard to tease out whether sleep loss is simply a byproduct of anxiety, or whether sleep disruption causes anxiety." I believe that this "chicken or egg" conundrum will be found to go both directions - depending on the patient.

The connection between anxiety and sleep disorders intrigued University of California- Berkeley researchers. They are trying to discover whether treating one condition will influence the other. Their goal is to find the connection between lack of sleep and the increase in brain activity that contributes to excessive worrying and anxiety. Their study concluded that experiencing sleep deprivation increased "anticipatory anxiety".

Dr. Matthew Walker said "These finding help us realize that those people who are anxious by nature are the same people who will suffer the greatest harm from sleep deprivation." He continued, "By restoring good quality sleep in people suffering from anxiety, we may be able to help ameliorate their excessive worry."

CPAP Raising Your Anxiety Levels?

About half of sleep apnea patients find they cannot tolerate sleeping with the machine all night or even use it at all. A custom oral appliance from a dentist trained to treat sleep disorders can successfully treat mild to serious sleep apnea without the hoses or masks.

Our patients find sleeping with an oral appliance comfortable and highly effective. Visit our Boca Raton office for full service dental and sleep apnea treatment or ask about sleep apnea treatment in our Jupiter, Port St. Lucie or Vero Beach locations. Call us at 1-800-343-SLEEP to schedule your consultation.

Labels: anxiety, obstructive sleep apnea

yourdentalblog

TMJ and Sleep Apnea

Monday, June 24, 2013

Sleep apnea has many serious health consequences and now we can add the pain of TMJ disorder to the list.

Researchers from the University of North Carolina at Chapel Hill School of Dentistry looked at data for over 2500 people between the ages of 18 and 44. The study participants were examined for TMJ issues and also were evaluated for obstructive sleep apnea.

The finding of this study support the link between sleep apnea and TMJ problems.They found that patients who did not have TMJ symptoms before developing sleep apnea were much more likely to develop TMJ symptoms. "Men and women with two or more signs/symptoms of OSA had a 73% greater incidence of first-onset TMD, in relative terms, than those with fewer signs/symptoms," explained the study authors. They also concluded that chronic TMJ problems were three times as common among adults with a likelihood of having sleep apnea.

A very important part of searching for a dentist that can treat your sleep apnea using an oral appliance is making sure that the dentist has also had extensive training and experience in treating TMJ disorders.

Find out more by contacting Dr. Kenneth A. Mogell at 561-394-9000 today.

Labels: obstructive sleep apnea, TMJ

yourdentalblog

Sleep, Breathing and Silent Stroke

Friday, February 03, 2012

Most people have never heard of them but there are these sneaky things called "silent strokes". Silent strokes do the same type of tissue damage in the brain but there are no outward symptoms like you have with a regular stroke.

Research presented at the American Stroke Association's International Stroke Conference made a link between silent stroke and sleep apnea.The researchers evaluated stroke patients for sleep breathing disorders and they found 91% of the study population had sleep apnea. The researchers also performed brain scans on the patients and found that those with sleep apnea were more likely to have silent strokes. Having more than five episodes of apnea per night was linked to the silent strokes and the worse the case of sleep apnea, the more likely the patient experienced silent strokes.

This important research underscores the need to treat sleep breathing disorders such as obstructive sleep apnea. However, there are two problems healthcare providers face when it comes to these patients.

First, most people who have sleep apnea do not know it. Patients are usually diagnosed only when a bed partner complains about the snoring and gasping or their daytime sleepiness forces them to seek a medical opinion.

Secondly, once a diagnosis is made the first line of treatment is usually CPAP. While CPAP is a lifesaving therapy about half of patients find it impossible to sleep with a CPAP machine. They find the masks uncomfortable, the machine annoying and refuse to continue the therapy.

For mild to moderate sleep apnea a wonderful alternative for these patients is an oral appliance. An oral appliance is a small device that looks like a mouthguard. The appliance is created by a dentist who has special training in the field of dental sleep medicine. The appliance is designed to place the jaw in a position that enables the airway to stay open all night long - no more stoppages of breathing.

To find out if you may suffer from sleep apnea or if you have been diagnosed and cannot tolerate your CPAP please contact Dr. Kenneth Mogell in Boca Raton, FL at 561-487-5595.

Labels: obstructive sleep apnea

Kenneth A. Mogell, D.M.D.

Untreated OSA Causes Health Problems

Wednesday, January 04, 2012

Many patients who suffer from OSA leave their condition untreated which is a dangerous choice.OSA stands for obstructive sleep apnea and sufferers stop breathing many times each night because their airways collapse and they stop breathing during sleep. Signs of OSA include excessive daytime sleepiness, loud snoring and gasping during sleep. It has been estimated that almost 90% of people who suffer from this disease have not been diagnosed.

Researchers in India found that OSA patients were three times more likely to suffer from obesity, hypertension, diabetes and a condition called hyperlipidemia. People who hae hyperlipidemia have high cholesterol and triglyceride levels. The results of the study strongly suggest that sleep disordered breathing such as OSA is strongly associated with metabolic syndrome.

Weight loss has been shown to lessen the severity of OSA but we all know how difficult it is and how long it takes. When OSA is diagnosed the first therapy offered to patients is typically CPAP. Many patients find sleeping with the device difficult and abandon the machine and treatment of their OSA.

A highly effective treatment that is not as well known is oral appliance therapy from a dentist who is specially trained in Dental Sleep Medicine. An oral appliance is a small mouthpiece worn during sleep that allows the airway to remain open. Oral appliances reduce or eliminate snoring and apnea events allowing a full night of restful sleep.

To schedule your consultation to see if oral appliance therapy is right for you please contact Dr. Kenneth Mogell at 561-394-9000 today. Your health depends on getting a good night's sleep.

Labels: obstructive sleep apnea

Kenneth A. Mogell, D.M.D.

Can Sleep Apnea Be Helped By Mediterranean Diet?

Tuesday, November 15, 2011

Eating a Mediterranean diet and exercising can improve some sleep apnea symptoms according to researchers. The Mediterranean diet emphasizes fruits, vegetables, fish and healthy fats such as olive oil. The study published in European Respiratory Journal looked at the impact of the Mediterranean diet on obese sleep apnea patients as compared to patients on a weight loss diet.

Obstructive sleep apnea is one of the most common sleep breathing disorders and becomes more prevalent as weight increases. Approximately 20-40% of obese patients suffer from obstructive sleep apnea and weight loss is an essential part of the treatment. Obstructive sleep apnea causes frequent stoppages of breathing during sleep. Sleep is fragmented causing excessive daytime drowsiness and other health complications.

Researchers in Greece studied 40 obese sleep apnea patients. 20 were placed on the Mediterranean diet and the other 20 were given a prudent weight-loss diet. Both groups were encouraged to walk at least 30 minutes each day. Both groups also received CPAP therapy.

The results showed that the group following the Mediterranean diet had a reduced number of apnoeas during REM stage sleep and were more likely to adhere to the lower calorie diet. While the study showed an improvement for this one stage of sleep it did not show an overall improvement in the severity of the condition. The authors feel that further studies with more patients are needed.

If you experience daytime sleepiness, weight gain and have been told you snore loudly you may suffer from obstructive sleep apnea. For more information about this disorder, diagnosis and treatment in the Palm Beach or Broward County areas please contact Boca Raton Dental Sleep Medicine at 561-394-9000.

Labels: obstructive sleep apnea

Kenneth A. Mogell, D.M.D.

Mental Illness Treatment Should Include Sleep Apnea Screening

Tuesday, November 08, 2011

An article in the Palm Beach Post today stated that 11% of Americans older than 12 take an antidepressant. These drugs are prescribed for reasons other than mental health issues but that is still an astounding number. The symptoms of obstructive sleep apnea can sometimes mimic those of mental illness - lethargy, irritability, forgetfulness. When those suffering from depression or another form of mental illness also have obstructive sleep apnea it can make the mental illness worse and possibly contribute to manic episodes. Unfortunately, screening for sleep disorders in psychiatric patients is rarely done.

A new study from the University of Utah suggests that using a simple questionnaire to screen patients may be helpful. "Sleep problems are so integral to psychiatric problems, we wanted to make sure that along with psychiatric disorders we were treating obstructive sleep apnea too," said Dr. Vanita Jain. Because many medications used in treating psychiatric conditions are also respiratory depressants it is especially important for these patients to be screened.

The questions asked included: Do you snore loudly? Do you often feel tired, fatigued or sleepy during the day? Has anyone observed you stop breathing during your sleep? Do you have high blood pressure? Are you over 50 years of age? Are you male? Other questions include a large neck circumference and high body mass index (BMI).

If you answer yes to several of these questions you may be suffering from obstructive sleep apnea or another sleep breathing disorder. To schedule your consultation please contact Boca Raton Dental Sleep Medicine today at 561-394-9000. We will discuss testing for a correct diagnosis, treatment options available and medical insurance coverage..

Labels: depression, obstructive sleep apnea

Kenneth A. Mogell, D.M.D.

Acid Reflux and Obstructive Sleep Apnea

Tuesday, October 04, 2011

Acid reflux is a common complaint among patients who suffer from obstructive sleep apnea. It seems that choosing oral appliance therapy to treat your obstructive sleep apnea may also reduce the symptoms of acid reflux disease.

A small study looked at dental patients who wanted oral appliances to treat their obstructive sleep apnea. After a sleep study the patients answered questions about acid reflux symptoms. After the patients had been wearing their oral appliances they were asked the same questions. Researchers found that wearing the oral appliance reduced the acid reflux symptoms for both men and women. It is unclear exactly why the oral appliance seemed to help the acid reflux symptoms.

If you are experiencing any of the symptoms of obstructive sleep apnea including acid reflux, snoring, excessive daytime sleepiness and weight gain please contact Kenneth A. Mogell DMD at 561-394-9000 today to schedule your consultation.

Labels: acid reflux, obstructive sleep apnea

Kenneth A. Mogell, D.M.D.