CPAP to Low Adherence
The rate of CPAP adherence remains persistently low over twenty years worth of reported data. No clinically significant improvement in CPAP adherence was seen even in recent years despite efforts toward behavioral intervention and patient coaching. This low rate of adherence is problematic, and calls into question the concept of CPAP as gold-standard of therapy for OSA.
Role of Dentist in Sleep Disordered Breathing
This brief reviewed clinical practice guidelines from the American Academy of Sleep Medicine/American Academy of Dental Sleep Medicine, which found that patient adherence with oral appliances was better than that for CPAP and that oral appliances have fewer adverse effects that result in discontinuation of therapy, compared with CPAP.
Sleep Deprivation & Obesity
Individuals who regularly slept less than 7 hours per night were more likely to have higher average body mass indexes and develop obesity than those who slept more. Studies showed that experimental sleep restriction was associated with increased levels of ghrelin, salt retention, and inflammatory markers as well as decreased levels of leptin and insulin sensitivity.
Sleep Apnea & Cardiovascular Disease
When apneas occur over the night the sympathetic nervous system (fight or flight) is activated and it results in consequences such as hypertension, diabetes, and abnormal cholesterol. All of which are risk factors for cardiovascular morbidity. It seems like a good idea for patients with a suspicion of sleep apnea be properly evaluated and treated.
CPAP vs. Oral Appliance Therapy with PTSD Patients
Although CPAP is more effective than oral appliance therapy at improving sleep apnea, both treatment options had comparable benefits for veterans with PTSD in relation to PTSD severity and health-related quality of life. oral appliance therapy offers a viable alternative for veterans with OSA and PTSD who are not able to use CPAP.
Sleep Apnea & Co-morbidities
Comorbidities (the presence of two or more chronic diseases) are frequent in Obstructive Sleep Apnea (OSA) patients, and OSA appears as a potential trigger for worse prognosis by worsening chronic organ damage, justifying the hypothesis of a dangerous liaison between OSA and comorbidities.
Sleep Apnea Severity & All-Cause Mortality
Moderate-to-severe sleep apnea is independently associated with a large increased risk of all-cause mortality, incident stroke, and cancer incidence and mortality in this community-based sample.
Sleep Apnea Screening & PTSD Prevalence
Screening of younger veterans with PTSD for Obstructive Sleep Apnea (OSA) should be standard care, and over night sleep studies and OSA interventions should be readily available to younger veterans.
Sleep Apnea & Stroke Mortality
Obstructive sleep apnea (OSA) significantly increases the risk of stroke or death from any cause, and the increase is independent of other risk factors, such as high blood pressure or hypertension.
Sleep Fragmentation & Chronic Pain
The long term findings suggest that efforts to prevent and treat chronic pain may be well served to target sleep disturbance as a point of primary prevention and intervention. Large, long term, cohort studies with basic assessments of sleep and pain generally support a relationship between sleep disturbance (e.g., insomnia symptoms) and clinical pain reports. However, several long term studies convincingly show that insomnia symptoms significantly increase the risk of developing future chronic pain disorders in previously pain-free individuals, whereas existing pain is not a strong predictor of new cases of insomnia.
Sleep Apnea & Bruxism (Clenching or Grinding)
Dentists have to understand the role of personalized medicine when they try to find an explanation to patients with complex clinical complications, as many biological and psychosocial factors may interplay in causing various disorders and diseases. The recognition of sleep problems can provide a new clinical dimension for prosthodontists in understanding and managing orodental complications related to occlusal loads on the tooth and orofacial structures as well as in broadening the field of SB as another interdisciplinary area linking dentistry to sleep medicine.
Home Sleep Testing & Excessive Daytime Sleepiness
Ideally after other, more common conditions (eg. OSA) are ruled out, the results of PSG and MSLT, including findings such as SOREMPSs, may be used to diagnose narcolepsy, based on the established criteria. While a Type-3 or -4 HSAT, with or without sleep surrogates may be used to screen for OSA, these testing devices are not useful evaluation or diagnosis of suspected narcolepsy.
Sleep Disorders & Depression
There is therefore a need for more successful management of sleep disturbance in depression, in order to improve quality of life in these patients and reduce an important factor in depressive relapse and recurrence.
Sleep Apnea & Alzheimer's Disease
It is hoped that the high occurrence of OSA in AD patients suggested by our meta-analyses might alert clinicians to importance of screening patients with AD for co-morbidities such as OSA.
Sleep Apnea & Diabetes
Among people with Obstructive Sleep Apnea (OSA), and controlling for other variables, initial OSA severity and its consequences on the body predicted risk for having diabetes.