Monday, November 21, 2016

The Danger of Undiagnosed Sleep Apnea, and Dental Treatment for Sleep Apnea

Once again, undiagnosed sleep apnea is in the news, as the cause of the September 29, 2016 Hoboken Commuter train crash.  It was also the cause of a New York City commuter train crash in 2013 and of freight train crashes in 2011 in Iowa, and in 2013 in Missouri. According to a report on 11/21/16), “Metro-North started testing for sleep apnea after the 2013 crash. Metro-North’s screening program has found sleep apnea in 51 of its 438 engineers and trainees, spokesman Aaron Donovan said. They are undergoing treatment, he said. Now Federal regulators are urging railroads across the country to test train operators for obstructive sleep apnea.”
Sleep apnea is especially troubling for the transportation industry because sufferers are repeatedly awakened and robbed of rest as their airway closes and their breathing stops, leading to dangerous daytime drowsiness. Studies have long concluded that people with the disorder have diminished performance in multiple areas during the daytime.
“You end up with an engineer who is so fatigued they’re dosing off, they’re falling asleep in these micro bursts and they often have no memory of it, and they’re operating a locomotive at the time, so they’re putting hundreds of people in danger,” (Sarah)Feinberg (of the Federal Railroad Administration) said.
“Airplane pilots with sleep apnea aren’t allowed to fly unless they’ve been successfully treated. Regulators are also pushing for bus and truck drivers to get tested.”
Treatment for sleep apnea may include:
Sleep hygiene measures such as: going to sleep the same time every night and getting up at the same time every morning in order to train your body when it should be sleeping, sleeping in a dark room, using the bedroom only for sleeping, and avoiding blue light from televisions, tablets and smart phones before bedtime.
Sleeping with a Continuous Positive Airway Pressure (CPAP) mask over the mouth and nose.  The air which blows into the mouth and nose keeps the airway open so that it doesn’t collapse when the airway muscles collapse during sleep.
Sleeping with a dental appliance which positions the lower jaw forward, so that the jaw position holds the airway open despite the collapse of the airway muscles during sleep.
In extreme cases there are surgeries which either cut away soft tissue or reposition bones to change the anatomy of the face and jaws, so that the airway is not obstructed during sleep.

All of these treatment options have side effects, but the consequences of leaving sleep apnea untreated are far more severe.  If you, or someone you know, is interested in treating their sleep apnea with a dental appliance, schedule a consultation appointment with Dr. Judith Okun to discuss your options and questions.

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