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Prevalence of Sleep Disorders
It is estimated that one-third of the U.S. population suffers from sleep disorders. Approximately 40 million individuals are chronic sufferers, yet less than 10% have been diagnosed or sought treatment.
Regardless of the type of sleep disorder, the impact on individuals is considerable. Clinically, people suffering from sleep disorders have an increased likelihood of cardiovascular disease, hypertension and mortality. At the same time, these individuals experience reduced cognitive performance that lowers job performance, decreases their quality of life and makes them ten times more likely to be in an automobile accident. These individuals are more susceptible to work-related injuries, depression and family discord, too.
Economically, sleep disorders in the U.S. are estimated to cost $60 - $115 billion annually for medical and indirect expenses. Sleep studies and therapies alone cost an estimated $5 billion per year. Individuals with undiagnosed sleep disorders have also been documented as heavy users of medical services.
Seven types of sleep disorders occur most frequently in the U.S. We have many treatments that can improve the symptoms of those disorders but they may be permanent problems. The disorders that you are looking at are conditions where a nerve may have an irreversible injury peripherally or in the CNS (brain) or the last one in the bone. We use low level or cold laser treatments in combination with medications and our appliance therapy to reduce symptoms and improve quality of life. The combination of treatment in this way usually reduces or sometimes eliminates the dosage of medications and therefore the side effects (drowsiness, fatigue, constipation, dizziness, etc), which in itself improves quality of life.
- Sleep Apnea Syndrome, affecting an estimated 20 million individuals
- Chronic/Severe Insomnia, affecting an estimated 20 million individuals
- Circadian Rhythm Disorder, affecting an estimated 17 million individuals
- RLS/PLMD: Restless Leg Syndrome / Periodic Limb Movement Disorder, affecting an estimated 10 million individuals
- Parasomnia, affecting an estimated 3 million individuals
- Cheyne-Stokes, affecting an estimated 1.5 million individuals
- Narcolepsy, affecting an estimated 300,000 individuals
Obstructive Sleep Apnea (OSA)
Sleep apnea, known as obstructive sleep apnea (OSA), is more common in the U.S. than asthma or diabetes. Generally, the disorder strikes men more often than women and it progressively worsens with age and increased weight. Basically, during sleep, relaxed muscle activity leads to a closing of the throat and airway, which forces sufferers to take in a deep breath of air and awakens them. This cycle repeats throughout the night, preventing the individual from getting a restful, deep sleep.
Clinical signs and symptoms of OSA include:
- Intermittent snoring with pauses
- Awakenings with gasping or choking
- Gastro-esophageal reflux (GERD)
- Fragmented, non-refreshing, light sleep
- Excessive daytime sleepiness
- Poor memory and/or clouded intellect
- Irritability
- Morning headaches
- Decreased sex drive or impotence
Leading risk factors for OSA are obesity, increasing age, male gender, anatomic abnormalities of the upper airway, a family history of sleep apnea, alcohol or sedative use, smoking and hypertension.
What exactly happens to cause sleep apnea? The image below demonstrates the debilitating cycle of OSA.
Diagnosis & Treatments
The best way to diagnose OSA (or any sleep disorder) is to catch them when they are happening. That is why there are essentially two alternatives for diagnosing them: in a sleep lab or at home.
At Dr. Woodlief's office we use the latest diagnostic equipment for sleep disorders. One of the devices, which fits comfortably over the patient's hand, is worn for one night. The resulting data from that device reveals key information, including the number and length of periods that the patient's sleep was interrupted. We then use this data, combined with other diagnostic tools, to determine the appropriate treatment plan to correct the problem.
Treatment options for OSA fall into three major categories:
1. Lifestyle Changes. Many individuals can relieve the symptoms of OSA by increasing exercise and losing weight. Among other improvements, this reduces fat and increases muscle tone in the throat, which lessens any airway constriction. Lifestyle changes are recommended even in cases when they, alone, will not resolve the problem.
2. Medical Interventions. Many OSA sufferers experience improvements using an at-home sleep device that delivers Continuous Positive Airway Pressure (CPAP). The patient wears a mask to sleep that is attached to a hose and a pump, which supplies air at a stable pressure level to prevent the airway closure that leads to apnea. While effective, the machine can be noisy and cumbersome. In fact, 80% of patients are non-compliant after one year.
In the most severe cases, the only other medical intervention is surgery. This is an option of last resort. During the surgery, portions of the uvula and wall of the throat are removed and the jaw bone may be cut to create a wider airway passage.
3. Dental Orthotic. At Dr. Woodlief's office, we prefer to use non-invasive, customized and affordable dental orthodic appliances whenever possible to reposition the jaw, mouth and teeth in a way that helps prevent airway closure. In 2006, the Academy of Dental Sleep Medicine supported the use of orall appliances as first line treatment option for patients with mild to moderate obstructive sleep apnea and snoring. Dr. Woodlief, works with a number of specialized orthotics just for this purpose. These portable devices are placed into the patient's mouth and worn throughout the night. They are easy to clean and maintain and are noiseless. As a result, many patients prefer the dental orthodics over CPAP.
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