by Vicki Cohn DDS, D. ABDSM, is the Clinical Director of Sleep Apnea Dentists of New England.
Continuous positive airway pressure (CPAP) is the first line of treatment for obstructive sleep apnea (OSA) but some people have difficulty tolerating it. CPAP can be uncomfortable, and it can dry out the mouth and cause nasal congestion. Fortunately, oral appliance therapy can be a successful alternative to CPAP for some people.
What is an oral appliance?
A custom-made oral appliance is a small device that fits over the teeth and is worn while you sleep. A mandibular advancement device (MAD) is the primary oral appliance for treating OSA. Insurance may cover oral appliance therapy using the same criteria as CPAP. Be aware that some insurance companies require you to try CPAP before covering oral appliance therapy.
When is oral appliance therapy a good option?
Oral appliance therapy can be an option for those with mild to moderate OSA and those who cannot tolerate or do not want to try CPAP. It is possible to go right from diagnosis to oral appliance therapy skipping CPAP altogether if you and your doctor determine it is an appropriate choice. All oral appliance therapy requires a prescription from a treating physician who will diagnose OSA and refer you to a dental sleep provider. The success of oral appliance therapy may improve when made by a dentist with dental sleep training. Some people may find CPAP easier to tolerate with an oral appliance or when they can alternate between therapies.
How does it treat OSA?
OSA is characterized by three major areas of collapse in the airway tube— high/upper: behind the soft palate to the top of the tongue; middle: where the tongue can fall back; and low: at the level of the epiglottis (this is rarer). Most people with OSA collapse in at least two places, but currently, there is no way to know in which of the three areas the collapse occurs.
A trained dental sleep medicine provider can make a MAD which will hold the jaw and tongue in a forward position during sleep, expanding the upper airway. This targets two of the three possible areas of airway collapse. The good news is that this helps the majority of patients who try it. CPAP targets all three areas of possible collapse, so it helps to open the entire airway, but it can be more challenging to use. Studies have shown that for mild to moderate OSA, the effectiveness of MAD is similar to CPAP. One reason may be that MAD compliance is higher.
How will my dentist determine if it is working?
There is some trial and error in finding the right jaw position to improve OSA. Your dentist may start by bringing the jaw forward until there is symptomatic relief. After a few months, a sleep study may be done, and any necessary adjustments will be made. Once the appliance is fit to the optimal position, dental visits will likely continue yearly to check the fit and integrity of the appliance.
While CPAP and oral appliances are the most widely used treatments for OSA, other treatments are available if these don’t work for you. It may be as simple as changing the position of your sleep or weight loss, or as intensive as surgery. If you suspect you suffer from sleep apnea, consult a sleep specialist.
Recent findings reveal that the initial hours of sleep play a crucial role in weakening neuron connections, paving the way for new learning the following day.
Summary: A study by University College London, published in Nature, shows that during the first half of sleep, the brain reduces connections made between neurons while awake, supporting the Synaptic Homeostasis Hypothesis. This “reset” prepares the brain for new learning. Using zebrafish with optically translucent genes for easy imaging of synapses, researchers found that sleep helps manage the strength of neuron connections based on prior wakefulness. The study raises questions about the second half of sleep, suggesting it might serve other brain functions like waste clearance or cell repair.
Key Takeaways:
The first half of sleep is crucial for weakening the connections between neurons that are formed during wakefulness, helping to reset the brain for new learning the next day.
The study utilized optically translucent zebrafish, allowing researchers to visually track how synapses in the brain were altered during different sleep-wake cycles.
While the first half of sleep focuses on synaptic weakening, the function of the second half remains less understood, with theories suggesting it may involve brain waste clearance or cell repair.
During sleep, the brain weakens the new connections between neurons that had been forged while awake—but only during the first half of a night’s sleep, according to a new study in fish by University College London scientists.
The researchers say their findings, published in Nature, provide insight into the role of sleep but still leave an open question about what function the latter half of a night’s sleep serves. The researchers say the study supports the Synaptic Homeostasis Hypothesis, a key theory on the purpose of sleep which proposes that sleeping acts as a reset for the brain.
“When we are awake, the connections between brain cells get stronger and more complex. If this activity were to continue unabated, it would be energetically unsustainable. Too many active connections between brain cells could prevent new connections from being made the following day,” says lead author professor Jason Rihel, PhD, in a release. “While the function of sleep remains mysterious, it may be serving as an ‘offline’ period when those connections can be weakened across the brain, in preparation for us to learn new things the following day.”
Study Shows Sleep’s Impact on Brain
For the study, the scientists used optically translucent zebrafish, with genes enabling synapses to be easily imaged. The research team monitored the fish over several sleep-wake cycles.
The researchers found that brain cells gain more connections during waking hours and then lose them during sleep. They found that this was dependent on how much sleep pressure (need for sleep) the animal had built up before being allowed to rest; if the scientists deprived the fish from sleeping for a few extra hours, the connections continued to increase until the animal was able to sleep.
“If the patterns we observed hold true in humans, our findings suggest that this remodeling of synapses might be less effective during a mid-day nap when sleep pressure is still low, rather than at night when we really need the sleep,” says Rihel in a release.
Neural Rearrangement Peaks in Early Sleep
The researchers also found that these rearrangements of connections between neurons mostly happened in the first half of the animal’s nightly sleep. This mirrors the pattern of slow-wave activity, which is part of the sleep cycle that is strongest at the beginning of the night.
“Our findings add weight to the theory that sleep serves to dampen connections within the brain, preparing for more learning and new connections again the next day,” says first author Anya Suppermpool, PhD, in a release. “But our study doesn’t tell us anything about what happens in the second half of the night. There are other theories around sleep being a time for clearance of waste in the brain, or repair for damaged cells—perhaps other functions kick in for the second half of the night.”
Have you ever noticed how a well-maintained classic car can turn heads and exude a timeless charm? Its age has become subjective. Just like a vintage automobile that has been meticulously cared for, feeling young is not merely a superficial notion — it is intrinsically connected to tangible health benefits.
Subjective age, the internal gauge that measures how old we perceive ourselves to be, transcends the realm of simple self-perception.
Much like how a classic car’s performance and longevity are tied to its upkeep, research has revealed that individuals who feel younger than their chronological age tend to enjoy longer lifespans, superior mental and physical well-being, and a host of positive psychological attributes.
These findings have led experts to propose the integration of subjective age as a biophysical indicator of aging, serving as a vital component of comprehensive health assessments.
Sleep-age connection
Researchers at Stockholm University have discovered that sleep affects how old you feel. The study, published in the scientific journal Proceedings of the Royal Society B, reveals that feeling sleepy can make you feel ten years older.
Leonie Balter, a researcher at the Department of Psychology, Stockholm University, explains, “Given that sleep is essential for brain function and overall well-being, we decided to test whether sleep holds any secrets to preserving a youthful sense of age.”
Power of a good night’s sleep
In the first study, 429 individuals aged 18 to 70 were asked how old they felt, how many days in the past month they had not gotten enough sleep, and how sleepy they were.
The results showed that for each night with insufficient sleep in the past month, participants felt on average 0.23 years older.
To further investigate the causal relationship between sleep and subjective age, the researchers conducted a second study involving 186 participants aged 18 to 46.
Participants restricted their sleep for two nights, with only four hours in bed each night, and another time slept sufficiently for two nights, with nine hours in bed each night.
The findings were striking. After sleep restriction, participants felt on average 4.4 years older compared to when having enjoyed sufficient sleep.
Staying young at heart by safeguarding your sleep
The effects of sleep on subjective age appeared to be related to how sleepy they felt. Feeling extremely alert was related to feeling 4 years younger than one’s actual age, while extreme sleepiness was related to feeling 6 years older than one’s actual age.
“This means that going from feeling alert to sleepy added a striking 10 years to how old one felt,” says Leonie Balter.
Previous studies have shown that feeling younger than one’s actual age is associated with longer, healthier lives. There is even support for subjective age to predict actual brain age, with those feeling younger having younger brains.
The implications of this study are clear. “Safeguarding our sleep is crucial for maintaining a youthful feeling. This, in turn, may promote a more active lifestyle and encourage behaviours that promote health, as both feeling young and alert are important for our motivation to be active,” states Leonie Balter.
Unlocking the secrets of age by sleeping
In a world where we are constantly searching for the fountain of youth, it turns out that the secret to feeling young again might be as simple as getting a good night’s sleep.
By prioritizing our sleep and ensuring that we get enough rest each night, we can not only feel more alert and energized but also maintain a youthful sense of age.
So, the next time you find yourself longing for the vitality of your younger years, remember that the key to unlocking that feeling might just be a few extra hours of shut-eye.
More about subjective age
As discussed above, subjective age refers to how old an individual feels, regardless of their chronological age. It is a personal perception that can be influenced by various factors, such as physical health, mental well-being, and life experiences.
People often report feeling younger or older than their actual age, and this subjective age can have significant implications for their overall health and quality of life.
Benefits of feeling younger
Numerous studies have shown that feeling younger than one’s chronological age is associated with a range of positive outcomes.
Individuals who feel younger tend to have better physical and mental health, higher levels of life satisfaction, and a more positive outlook on life.
They are also more likely to engage in healthy behaviors, such as regular exercise and maintaining a balanced diet.
Impact of subjective age on longevity
Research suggests that subjective age may even predict longevity. A study published in the Journal of the American Medical Association found that individuals who felt younger than their actual age had a lower risk of mortality compared to those who felt older.
This finding highlights the potential importance of subjective age as a biophysical marker of aging and its relevance in health assessments.
Factors influencing subjective age
Several factors can influence an individual’s subjective age, including:
Physical health: Chronic illnesses, disabilities, and poor physical functioning can make people feel older than their chronological age.
Mental health: Depression, anxiety, and stress can contribute to feeling older, while positive emotions and a sense of purpose can help individuals feel younger.
Social connections: Strong social support and engaging in meaningful relationships can promote a youthful sense of age.
Life experiences: Major life events, such as retirement, the loss of a loved one, or becoming a grandparent, can impact how old an individual feels.
Harnessing the power of subjective aging
In summary, subjective age is a fascinating concept that has garnered increasing attention from researchers and healthcare professionals alike.
By understanding the factors that influence subjective age and its potential implications for health and well-being, we can develop strategies to promote a more youthful mindset and improve overall quality of life.
Encouragingly, recent research on the link between sleep and subjective age suggests that we may have more control over how old we feel than previously thought.
Comments Off on Sleep deprivation: A cause of high blood pressure?
by SadofNE
Is it true that sleep deprivation can cause high blood pressure?
Answer From Francisco Lopez-Jimenez, M.D.
Possibly. Sleep experts recommend that adults get 7 to 8 hours of sleep each night. Getting less than six hours of sleep is known to be bad for overall health. Stress, jet lag, shift work and other sleep disturbances make it more likely to develop heart disease and risk factors for heart disease, including obesity and diabetes. A regular lack of sleep may lead to high blood pressure (hypertension) in children and adults.
The less you sleep, the higher your blood pressure may go. People who sleep six hours or less may have steeper increases in blood pressure. If you already have high blood pressure, not sleeping well may make your blood pressure worse.
It’s thought that sleep helps the body control hormones needed to control stress and metabolism. Over time, a lack of sleep could cause swings in hormones. Hormone changes can lead to high blood pressure and other risk factors for heart disease.
Don’t try to make up for a lack of sleep with a lot of sleep. Too much sleep — although not as bad as too little sleep — can lead to high blood sugar and weight gain, which can affect heart health. Talk to your health care provider for tips on getting better sleep, especially if you have high blood pressure.
One possible, treatable cause of lack of sleep contributing to high blood pressure is obstructive sleep apnea. This sleep disorder causes breathing to repeatedly stop and start during sleep. Talk with your care provider if you feel tired even after a full night’s sleep, especially if you snore. Obstructive sleep apnea may be the cause. Obstructive sleep apnea can increase the risk of high blood pressure and other heart problems.
A cross-sectional study utilizing self-reports from Chinese college students correlated mobile phone use with insomnia, bolstering previous research that made similar conclusions.
A study recently published in Frontiers Public Healthreinforced the known correlation between mobile phone addiction and insomnia, while additionally suggesting that increasing one’s physical activity could mitigate this negative impact.
Man Endlessly Scrolling in Bed | image credit: Louis-Photo – stock.adobe.com
During the COVID-19 pandemic, the use of social media was seen as a benefit both for providing social support during large-scale isolation and disseminating information on public health. However, as the authors of the current study mentioned, the negative consequences associated with mobile phone use—such as its documented influence on insomnia—should not be ignored. The authors added that investigations into the effects of mobile phone use during the pandemic have largely focused on the mental health of adolescents while the outcomes related to insomnia have been unknown.
To address this gap in knowledge, researchers conducted a study to investigate what underlying factors influence the relationship between insomnia and mobile phone addiction in college students, considering the mediating role of social anxiety and the moderating role of physical activity. This study was conducted in China, which endured the first outbreak of COVID-19, and surveyed Chinese college students.
This study was conducted with an online questionnaire, which was completed by 301 college students. A student’s degree of mobile phone addiction was measured with the Chinese iteration of the Mobile Phone Addiction Tendency Scale (MPATS), where higher scores indicate more intense addiction. The Chinese iteration of the Social Phobia Inventory (SPIN) was used to measure social anxiety, and higher scores indicate higher levels of social anxiety. Physical activity levels were measured with the Physical Activity Rating Scale (PARS-3) and insomnia by the Insomnia Severity Index where, similarly in both, higher scores indicate higher levels of activity and more severe insomnia.
Their results showed that mobile phone addiction had a positive association with social anxiety (P < .001) and that social anxiety was positively associated with insomnia (P < .01). Overall, the correlation between mobile phone addiction and insomnia was found to be significant (P < .001). These findings suggested that social anxiety could be a mediator of this relationship because the indirect effect between them was also found to be significant (indirect effect = 0.03; SE = 0.01; 95% Boot CI, 0.01–0.06).
The self-reports indicated that more physical activity could reduce both feelings of social anxiety as well as feelings of addiction to one’s mobile phone. This moderating role of physical activity on the relationship between insomnia and mobile phone addiction was found to be significant (P < .05). The authors went on to comment that physical activity has previously demonstrated to be beneficial for the management of stress and loneliness, and can improve one’s mental health. The authors’ findings were consistent with prior reports in this area.
“But it is worth noting that social anxiety could only partially account for the relationship between mobile phone addiction and insomnia; thus other key latent indicators, such as interpersonal distress, should also considered when examining the mediation role between them afterwards,” they added.
The limitations of the study include the inability to establish causal relationships due to the cross-sectional design, the risk of recall bias that comes with self-reported data, and the use of convenient sampling which resulted in a moderate sample size. Additionally, the exclusive focus on college students during a specific pandemic period may limit the generalizability of the findings.
“In summary, our research results indicate that increasing physical activity and reducing social anxiety can improve insomnia symptoms among college students,” the authors concluded. “To prevent future problematic behaviors among college students, it is necessary to adopt proactive health behaviors, such as engaging in physical activity, to counteract or avoid subsequent passive impacts.”
Reference
Wang J, Xu X, Zuo L, Wang H, Yang G. Mobile phone addiction and insomnia among college students in China during the COVID-19 pandemic: a moderated mediation model. Front Public Health. 2024;12:1338526. doi:10.3389/fpubh.2024.1338526
Comments Off on Sleep deprivation: A cause of high blood pressure?
by SadofNE
Is it true that sleep deprivation can cause high blood pressure?
Answer From Francisco Lopez-Jimenez, M.D.
Possibly. Sleep experts recommend that adults get 7 to 8 hours of sleep each night. Getting less than six hours of sleep is known to be bad for overall health. Stress, jet lag, shift work and other sleep disturbances make it more likely to develop heart disease and risk factors for heart disease, including obesity and diabetes. A regular lack of sleep may lead to high blood pressure (hypertension) in children and adults.
The less you sleep, the higher your blood pressure may go. People who sleep six hours or less may have steeper increases in blood pressure. If you already have high blood pressure, not sleeping well may make your blood pressure worse.
It’s thought that sleep helps the body control hormones needed to control stress and metabolism. Over time, a lack of sleep could cause swings in hormones. Hormone changes can lead to high blood pressure and other risk factors for heart disease.
Don’t try to make up for a lack of sleep with a lot of sleep. Too much sleep — although not as bad as too little sleep — can lead to high blood sugar and weight gain, which can affect heart health. Talk to your health care provider for tips on getting better sleep, especially if you have high blood pressure.
One possible, treatable cause of lack of sleep contributing to high blood pressure is obstructive sleep apnea. This sleep disorder causes breathing to repeatedly stop and start during sleep. Talk with your care provider if you feel tired even after a full night’s sleep, especially if you snore. Obstructive sleep apnea may be the cause. Obstructive sleep apnea can increase the risk of high blood pressure and other heart problems.
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