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Obstructive sleep apnea (OSA) which is characterized by pauses in breathing while sleeping and snoring, may cause heart function problems sooner in females that in males. women than in men, according to a study (which included almost 5,000 participants) at a Radiological Society of North America (RSNA) meeting.  And what is more important, the study suggested that OSA is not diagnosed correctly when snoring is present—it goes undiagnosed to a great extent.  Snoring and excessive daytime tiredness and the two most common symptoms of OSA which can be deadly.

Subjects in the study had a heart MRI were grouped into three types—patients diagnosed with OSA, Patients who reported that they snored, and those without OSA or snoring.  While comparing the unaffected patients with the snoring patients, the study found a bigger difference in the left ventricular mass of the heart in the females than in males. The heart alterations in snorers indicated that there is a relatively large number of OSA patients who are undiagnosed.

"We found that the cardiac parameters in women appear to be more easily affected by the disease and that women who snore or have OSA might be at greater risk for cardiac involvement," Dr. Curta, one of the researchers, said. "We also found that the prevalence of diagnosed OSA in the study group was extremely low. Together with the alterations in cardiac function in the snoring group, it leads us to believe that OSA may be grossly underdiagnosed."

The results of the study indicate that it is very important for those who snore to get tested for OSA, and properly treated if the test results are positive for OSA.

Lately more experiments have looked at how breathing influences our cognition, especially memory.  The Journal of Neuroscience published a study in October, 2018 that looked at the relationship between our memory and our method of breathing—through the nose or through the mouth.

Many studies show that as rodents sniff anything including odorless air it starts activity in the brain by stimulating neurons in the olfactory bulb.  This in turn signals the hippocampus.  This is a region in the brain which is involved in creating and storing memories.   The researchers experimented to see if a similar thing happens to humans that breathe through their mouths instead of their noses.

The study looked at 24 healthy men and women.  They breathed 12 distinct scents and memorized them.  They then sat for an hour with their nose clipped shut to force mouth breathing during that hour.  They were then exposed to the 12 scents and other scents also.  They were asked if each scent had been one that they had sniffed before.  This was repeated with their mouths taped shut for that hour to prevent mouth breathing. 

The volunteers had better recognition of the scents when they breathed through the nose during the hour after they initially smelled the scents.  When they breathed through their mouths for the hour, they had worse recall and more incorrect answers.  The result was that nose breathing made memory consolidation better.  It was assumed that breathing through the mouth bypassed the olfactory bulb and did not start the same neuronal response.

Of course, memory problems are a symptom found in obstructive sleep apnea and so is breathing through the mouth.  Since we were designed to breath through the nose, there may be other similar neuronal pathways that are initiated by nose breathing.  Maybe taping the mouth shut the night before a big exam or presentation would help!  Nasal breathing has many good effects—too many to go into in this article.  But people who have been treated for sleep apnea do have improvement in their memory.

Sleep apnea may have a link to atrial fibrillation (AFib), which increases stroke risk, dementia risk, heart attack rick, and even death. A University of California - San Francisco study showed decreased REM (Rapid Eye Movement) sleep-stage 5 of sleep-is linked to higher chances of development of AFib.  A person needs about 120 minutes (2 hours) of REM every night.  AFib leads to things such as heart palpitations, chronic fatigue, shortness of breath, and kidney disease.

The study was in the June 26, 2018, publication HeartRhythm, which is the regular journal put out by the Heart Rhythm Society.

One study author, Gregory Marcus, MD, MAS, who is a cardiologist and researcher, said that clinical trials need to be done to see if interventions like CPAP or oral appliances in patients who already have AFib can help these patients.  5,703 participants were in the study and they were followed for over an average of 11.6 years.

This study, HeartRhythm, study measured various things like length of sleep and quality of sleep as well as time spent in REM sleep vs. time spent in non-REM sleep.  They found that frequent disruptions in sleep were related to over 30% greater risk of AFib.

There are several things that can cause these disruptions in sleep.  A snoring bed partner, sleep apnea, intolerance to using CPAP, pets, etc.  There are 5 stages in the sleep cycle and to get restful, restorative sleep, a person needs to go through these stages 4 to 5 times every night and that usually takes about 7 hours.  The total time spent in stage 4 should be 90 minutes to keep one from being depressed since serotonin is made in state 4.  Less that 90 minutes can lead to some level of depression.  The total time spent in stage 5 should be 120 minutes (2 hours) in order to repair your immune system and to rid your brain of the substances which are implicated in development of dementia and Alzheimer’s.

We can help if snoring, sleep apnea, or CPAP intolerance are the problems.  Make an appointment for a free consultation at our office to discuss the problem.  Your AFib could be caused by one of these things and treatment may reduce or eliminate the AFib.

Want to attract a Valentine’s Day sweetheart?  Don’t snore!  Over 25% in the USA said that they are annoyed or angry at a bed partner that snores.  This is from a survey done by the American Academy of Dental Sleep Medicine.  The study showed that 20% said that a partner who snores could/would drive them to sleep elsewhere.  So, Americans, both men and women, who snore could have their special night interrupted by the “chainsaw” buzzing.  This may put their relationship at risk.  40% of women in the US say that a snoring bed partner is a big turn-off.  Almost 10% of Americans say snoring hurt at least one romantic relationship. 

Moreover, snoring isn’t limited to older folks only.  Generation X’ers (35-44) reported the most snoring problems.  43%--“the snoring partner steals my sleep.”  35%--“it ticks me off.”  24%--“I want to or do go to a separate room to sleep because of the snoring.”  Snoring, the “elephant (buzzsaw) in the room,” needs to be addressed for both relationship and health concerns.  It’s important that people are made aware of the snoring and its effects on relationships and personal health.  Then they can take the necessary steps to get it treated.

45% of USA women worry about their bed partner’s health if they snore.  Snoring is a major symptom of obstructive sleep apnea (OSA) which is potentially a life-threatening situation.  OSA patients stop breathing during sleep sometimes for more that a minute.  And this can happen 10, 20, or over 3 times every hour of sleep.  Untreated OSA increases the risk of health problems—congestive heart failure, high blood pressure, heart disease, diabetes, depression impotence, etc.

Continuous positive airway pressure (CPAP) is a treatment but it is not the only option.  Many are amazed to find out that a “qualified” dentist—not just any dentist—can treat OSA with a custom oral device.  It is effective, less cumbersome, and more discreet for both the one who snores and the partner.  An oral device is a “sexier” option that a Darth Vader-like CPAP mask.

Our office has treated so many who say that an oral device saved their marriage/relationship.  It gives the snorer increased energy, better health, and the ability to stay in bed with their sweetheart at night.

The Continuous Positive Airway Pressure (CPAP) has been considered the "gold standard" to treat people that have been diagnosed with obstructive sleep apnea (OSA) and is usually the first choice prescribed by medical doctors.

But is it the “best” treatment for you??

The patient has to wear a specially designed mask that covers the face or nose or an insert into the nose.  The CPAP uses air under pressure through the nose or mouth to keep the throat open during sleep. But the patient has to force air out of his lungs against the pressure and then let air back in under pressure; this has to happen 12-15 times every minute!   CPAP is the most common sleep apnea treatment option, but it also is tolerated the least of the treatment methods.  And even though it is the most common, it may not be the best—especially for you.  It may be the most common because it is the only option the doctor gives to the patient.  Most users do not know that there is a comfortable alternative.  There are so many CPAP users who are intolerant to its use that there is a website called "I HATE CPAP!" ( 

And here is why.  Only a third of CPAP users have success with it.  What do the other two thirds do if they do not know that there is a comfortable alternative?  A patient came to my office and said that 6 years ago she was diagnosed with OSA and was prescribed CPAP.  She tried to use it for 1 month and then put it in her closet where it is today.  So for the past 6 years she has been an untreated OSA patient. night.  Some people can tolerate it only 4 hours or less per night; others cannot tolerate the face breakouts, the marks from the straps, eye and nose irritation, dry mouth, runny nose and sore throat.  And they cannot sleep on their stomach.

Many patients who are intolerant to CPAP have found oral appliance therapy to be the comfortable alternative they have been looking for.

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