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Is Snoring Making You or a Loved One Crazy?

It Can Be a Sign of a More Serious Condition

Many adults and children are affected by sleep and breathing issues that include Obstructive Sleep Apnea (OSA) and Upper Airway Resistance Syndrome (UARS). OSA is a potentially serious disorder in which breathing starts and stops repeatedly while sleeping. Loud snoring, waking up with a sore throat, or waking during the night with a choking sensation are common signs of sleep apnea. UARS is a similar disorder, but it causes only a brief awakening that is often undetected by the sleeper. The conditions interfere with getting an appropriate number of hours of sleep to maintain health and affect the amount of oxygen getting to the body and brain.

Research consistently indicates that OSA in children is related to cognitive deficits, ADHD, academic achievement, emotional instability and the autism spectrum. In adults, OSA has been linked to cardiovascular disease including high blood pressure, stroke, diabetes and dementia in the elderly, to name just a few.

Interestingly, a significant percentage of those diagnosed with OSA never realized they were affected. The American Sleep Apnea Association estimates that there are approximately 22 million Americans with OSA, and 80% of those with moderate to severe OSA are un-diagnosed. According to the February 12, 2019 Journal of the American Osteopathic Association, up to 15% of children have sleep apnea, yet 90% go undiagnosed.

Healthcare advocates recommend increased screening for OSA by both dental and medical providers. Signs seen in patients’ mouths and facial development can be early indicators for OSA and other airway disorders. A dentist may detect signs and symptoms of OSA such as clenching and grinding of teeth, narrow dental arches, a tethered tongue and a high palate to name a few. These dental signs may occur years before OSA appears in a routine medical examination. If there is evidence of possible OSA, the dentist should refer the patient to their primary care physician or a sleep physician for testing and diagnosis.

There are many connections between medicine and dentistry, yet somehow the close relationship between the two have been obscured in our modern healthcare model. Medical research for many years has concluded that the cause of obstructive sleep apnea is directly related to how the upper and lower jaws have developed. This is where dentistry comes into play. This development is well within the scope of modern dentistry and there are many ways that a dentist trained in dental sleep medicine can help.

Doctors Michael B. Russo, MD and Terence Q.L. Young, DDS, have developed a unique practice to help those with sleep disorders.Dr. Young’s practice focusses on the oral airway and jaw development. He examines for signs of OSA then screens his dental airway patients using a High-Resolution Pulse Oximeter to determine if breathing irregularities are present. If he finds them, he refers the patient to Dr. Russo, a sleep disorder specialist who then orders a sleep study to diagnose obstructive apnea. If the patient has it, Dr. Russo can order a CPAP or an oral mandibular advancement device, or a myofunctional device, or a combination. Dr. Young can make and deliver myofunctional and oral mandibular advancement devices.

Because so few dentists have this training, Dr. Young flies to Hilo and Kona, where Dr. Russo has offices, and sees the patients that need the devices and cannot easily fly to his and Dr. Russo’s offices in Honolulu. So, together they have developed a way of helping patients in rural or underserved areas who would not otherwise have access to these services.

Another very important part of their treatment involves the assistance of Myofunctional Therapist Carolinda T. Murphy, MS Certificate in Clinical Competency in Speech Language Pathology, Certified Orofacial Myologist. Myofunctional therapists help to properly train the muscles of the mouth, and improve tongue position, swallowing and nasal breathing. Research out of Stanford University and others have concluded that the severity of a patient’s sleep apnea can be decreased by up to 50% with myofunctional therapy.

Dr. Russo’s extensive clinical and research background in neurology and sleep medicine along with Dr. Young’s degree in Respiratory Therapy, (respiratory therapists help to deliver and adjust CPAP machines) as well as his studies in dental sleep medicine, allow them to effectively help patients with their CPAP devices along with fabricating dental devices for those who cannot tolerate CPAP machines. At times, the combination of both devices is used for more severe cases.

Ultimately early detection, regardless of age, is of utmost importance.

For more information or to schedule appointments, contact Dr. Terence Young, DDS, 1441 Kapiolani Blvd., Suite 1207, Honolulu at 808-945-9977, or visit AirwayFocusedDentalcare.com; and Dr. Michael Russo, MD, 250 Ward Avenue, Suite 170, Honolulu, 1335 Kalanianaole Ave, Hilo and 81-6623 Mamalahoa Hwy, Kealakekua, HI, at 808-294-3332, or visit HawaiiSleepNeurologist.com; Carolinda T. Murphy, MS Speech-Language Pathology, 725 Kapiolani Blvd #206, Honolulu, 1001 Kamokila Blvd., Suite 270, Kapolei at 808-596-0099, or visit SpeechSolutionsHawaii.com.

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