SLEEP-BREATHING Disorders Can Impact Immunity
Jul 30, 2020 09:21PM
By Susan Welch
Susan M. Welch
I own a general dental practice in Fort Walton Beach, and I specialize in sleep-breathing and TMJ (temporomandibular joint) disorders. Two of the most common problems I treat are snoring and obstructive sleep apnea (OSA), a condition that causes a sleeping person to stop breathing for longer than 10 seconds. Because a good night’s sleep is critical for supporting the immune system, snoring and OSA can reduce our ability to fight infections of any kind.
After getting many questions from patients concerned about their health and wellness in the age of COVID, I sat down to write about this important topic. All the information that follows is supported by data and research. For brevity’s sake, I won’t include it here, but it’s easy to find by typing key words into your search engine.
I get this question the most: “How do I know if I snore?”
The best person to ask is your bed partner or a family member who sleeps nearby. I often hear patients say, “My snoring doesn’t bother me.” However, it’s common knowledge that snoring disrupts others’ sleep and is therefore detrimental to them.
I often refer to snoring as a “second-hand” sleep breathing disorder: Lack of sleep for anyone leads to daytime sleepiness, brain fog, irritability, depression, poor pain management and other physical and emotional issues. Heck, more accidents are caused by people falling asleep while driving than by drunk driving.
Here’s a question several of my patients have asked recently: “Doc, with this COVID virus, should I still be wearing my CPAP?”
I wasn’t sure of the answer, so I reached out to one of our local sleep medicine physicians, Dr. Jason Boole. He told me it is OK to keep using a CPAP, as long as you continue to follow the standard instructions for cleaning the tubing and facial or nasal coverings. So if you have OSA and you use a CPAP to support your airway at nighttime, please don’t stop.
Untreated OSA is associated with high blood pressure (one of the earliest indicators of OSA); depression and anxiety; weight gain; type 2 diabetes; memory loss or difficulty with recall; hormonal imbalances; and erectile dysfunction, to name just a few conditions. In children, lack of sleep leads to daytime hyperactivity (often disguised as ADD or ADHD) and has been associated with issues like allergies, poor learning skills and delayed growth issues (children secrete human growth hormone when they sleep). In teenagers, lack of sleep has been associated with poor test scores, attention issues in class, and behavior and emotional issues. Quality sleep is clearly important to everyone’s health and wellness.
I’m also asked, “Is there an alternative to CPAP for treating sleep apnea?”
If a patient has sleep apnea, a medical provider can recommend a certain type of nighttime appliance as an alternative to CPAP. While CPAP is considered the gold standard for treating sleep apnea, not everyone can tolerate or wear one, and traveling with a CPAP can be cumbersome as well. In those instances, an oral appliance known as a mandibular advancement device (MAD) can be an effective option. Some patients may benefit from combination therapy, utilizing the CPAP and MAD together, which allows for a lower, more tolerable pressure setting on the CPAP device.
Here’s another relevant question for supporting health and immunity: “How are TMJ disorders related to sleep breathing disorders?”
TMJ patients from around the area are referred to my practice by oral surgeons, ear-nose-throat (ENT) physicians, the emergency room and my dental colleagues. Our interview and examination of a TMJ patient may indicate the need for a home sleep-study test or a polysomnogram (which is done in lab setting), to rule out a sleep-breathing disorder that may be contributing the patient’s TMJ pain, head and neck pain, and overall feeling of un-wellness. Once we understand the root cause, we can customize the right nighttime appliance to address the problem. It’s truly amazing how much better a pain patient will feel with a consistent good night’s sleep.
A customized oral appliance supports the airways and jaw joints to allow a better night’s sleep and improve overall health and well-being. For patients with a sleep-breathing condition, the right appliance can play a crucial role in keeping the immune system strong.
Susan M. Welch, DDS, FAGD, is a general dentist with more than 12 years’ experience educating and treating patients with snoring, sleep apnea and TMJ disorders. She is a diplomat of the American Board of Dental Sleep Medicine, the American Board of Craniofacial Dental Sleep Medicine and the American Board of Craniofacial Pain, and a fellow of the American Academy of Craniofacial Pain and Sleep Medicine. She and her team at Wright Parkway Dental Center have treated local patients and their families for more than 15 years, taking a holistic approach to oral health care. Wright Parkway Dental Center, located at 106 Wright Parkway SW, Fort Walton Beach, FL, is currently accepting new patients. For more information, visit WrightParkwayDentalCenter.com .