My Blog

February 18, 2017
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     Drugs can cause obstructive sleep apnea (OSA) and can make patients who already have OSA get worse.  An obstructive sleep apnea event is caused when the tongue blocks the throat repeatedly during sleep completely for at least 10 seconds.  If the number of those events is 5 or more per hour during sleep, a medical diagnosis of OSA is made.  Some of the signs of OSA include daytime sleepiness, loud snoring, witnessed breathing interruptions, acid reflux, and awakening due to gasping or choking.

     Antidepressant and antipsychotic medications can cause patients to gain significant amounts of weight, snore loudly, and end up with heart attacks and strokes.  Any medication which can cause a patient to gain weight has the potential to either cause OSA or make a preexisting condition of OSA worse.  OSA is mainly a structural problem of a narrow jaw and of a narrow upper airway.  If fat is added in the throat due to an overweight condition, the risk becomes much worse.

     Many antidepressants such as Pamelor, Paxil, and Elavil, stimulate people’s appetites.  Another side effect of some of these medications is to suppress rapid eye movement (REM) sleep.  Some of the costs of not getting enough REM sleep (should have 2 hours each night) include a more excitable nervous system which results in a lowering of pain thresholds.  There are also more cognitive problems such as learning and memory.

     Depakote, which is valproic acid, is a mood stabilizer used in treatment of bipolar disorder, seizure, and migraine.  One study revealed over 20% of patients on mood stabilizers gained 10 or more pounds over a one year period.  This can cause a great increase in OSA.

     Risperdal, Seroquel, Zyprexa, Abilify, and other anti-psychotics have been known to cause more than 5% weight gain in a great number of patients.  They also may cause insulin resistance and that can lead to diabetes.  Taking Zyprexa for just two weeks caused an increase in food intake by almost 20%.

     And, as is well known, chronic use of corticosteroids to reduce inflammation leads to significant weight gain.  A common one is Prednisone.

     Antihistamines, including Allegra and Zyrtec, have been found to increase overweight status of patients.  Over half of patients on these medications are more apt to be overweight.

     Patients on insulin have better control of sugar in their diets and therefore  should have better control of weight also.  But a study shows insulin by itself will promote increase in weight.

     Atenolol, metoprolol, and propranolol (beta-blockers) are associated with a significant amount of increased weight. 

     There are many, many more medications that cause weight gain which is causing sleep disturbances.  All patients, especially those who already have OSA, should be aware of the medications they are taking and note any weight gain to their sleep physician and the prescribing doctor to see if there are alternative medications they can take which do not cause weight gain.

     There is a simple test for OSA that can be done right in your home known as a home sleep test.  Make a free consultation appointment in our office to discuss this—OSA is deadly.  If you snore, have daytime sleepiness, or don’t feel FABULOUS when you wake up, you may have OSA.  And treatment does NOT have to be that “mask”.  Our website www.NwSleepDoc.com has a lot on information you may be interested in regarding OSA and its treatment.

       Dr. Donald Johnson founded Northwest Treatment Center for Snoring & Sleep Apnea in Coeur d’Alene to help patients stop their snoring and LIVE FREE WITH NO LIMITS!  His office is at 114 W. Neider Ave. Suite 102, in Coeur d’Alene, near Costco.  The website for more information is www.NWSleepDoc.com and the office phone is 1-844-84SNORE.  SCHEDULE AN APPOINTMENT TODAY!

     Parents, you are usually the first-line persons to recognize that there a potential problem with your child in almost every area of your child’s life!  Sleep disordered breathing (SDB) includes snoring, upper airway resistance syndrome (UARS), obstructive sleep apnea (OSA), and obesity hypoventilation syndrome.  OSA is a condition in which the tongue, tonsils, or adenoids completely obstruct the airway for 10 seconds or longer more than once per hour during sleep for children.  And OSA may be overlooked by medical professionals—dentists and medical doctors—because the symptoms may not be recognized and the seriousness of the health consequences of undiagnosed OSA may not be well known to the examining doctor.

     Children experience UARS more often than OSA and this condition is usually caused by airway interferences.  It is experienced by children with an airway that is more prone to collapse due to abnormal airflow when they inhale or when they exhale.  With UARS, there is not a complete airway obstruction as in OSA but the condition causes fragmentation in the child’s sleep as well as activation of the “fight or flight” response.

     Some of the symptoms to look for in children are:

  • Forward head position which helps open the airway
  • Long, narrow face
  • Dark circles under the eyes
  • Wiggly, hyperactive, poorly behaved child
  • Difficulty following directions
  • Constant nighttime snoring and tooth grinding
  • Mouth breathing at night and/or during the day

These children are very high risks for:

  • Misdiagnosis of ADHD
  • Social problems
  • Poor performance academically
  • Low attention to any task
  • Behavioral problems at home and at school
  • Anxiety and/or depression
  • Altered brain function—delayed processing
  • Trouble completing schoolwork
  • Poor grades in school 

The big tip-off is mouth breathing.  Another is waking up gasping.  If your child is a mouth breather or snores, he or she should have a formal sleep study since the consequences of an untreated sleep disorder are so drastic.

     When the child breaths with the mouth closed, the tongue is on the roof of the mouth 10-15 times a minute all night long helping to cause the upper dental arch to be expanded properly from birth onward.  If the child breathes with the mouth open, the tongue is on the floor of the mouth and the pressure from the cheek muscles will cause the arch to be too small resulting in crowded teeth, need for orthodontics, and a lifetime of OSA and the health consequences.  The child may use “binkie”, thumb, or finger sucking to reposition the tongue out of the airway to get more air.

     Wear on the primary teeth is the easiet to detect.  The child may grind the teeth at night to help open the airway; this grinding helps to pull the tongue forward off the airway.  Grinding when the child breaths through the mouth is destructive to the teeth since the mouth is dry and there is more friction on the teeth.  These teeth need to be built up until the permanent molars are fully erupted or the child will have “short” teeth and a reduced vertical dimension resulting in reduced room for the tongue.  Also, chronic dry, chapped lips are another tip-off that the child is a mouth breather.  These conditions can lead to OSA.

     Tonsils and/or adenoids may be the cause of mouth breathing with adenoids causing more trouble.  This is because they cannot be seen as easily as the tonsils and may be overlooked by health prefessionals.  Therefore an endoscopic exam should be done on any child with these problems.  Frequent enlarged tonsils, frequent sore throats, and frequent ear infections are also indications that tonsils and adenoids should be ruled out as the cause of mouth breathing.

     If the tonsils and adenoids are the main problem, removal may be the best choice you should make with the medical doctor.  This will facilitate the proper use of the tongue muscle during breathing.  The goal here is to get the child to breath with the mouth closed which will position the tongue on the roof of the mouth to help with ideal growth of the child’s midface.  If the problem is the tonsils or adenoids and one waits until about the age of 7 to remove them, the effect of the removal may not be ideal.  At that time, after removal, a palatal expander placed by a dentist or orthodontist can help give the tongue it’s proper room and help in development of the dental arches.  This can help the child avoid UARS and OSA in the future.

     And after removal of the tonsils and adenoids, you may find yourself saying, “We have a brand new child!”

     Dr. Donald Johnson founded Northwest Treatment Center for Snoring & Sleep Apnea in Coeur d’Alene to help patients stop their snoring and LIVE FREE WITH NO LIMITS!  His office is at 114 W. Neider Ave. in Coeur d’Alene, near Costco.  The website for more information is www.NWSleepDoc.com and the office phone is 844-847-6673SCHEDULE AN APPOINTMENT TODAY!

August 27, 2016
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It’s a familiar image on the comics page -- a man sleeping the couch with a speech bubble over his head that says something like “ZZZZZZ.

Funny, right?

Not really.

Snoring is no laughing matter. It can keep the snorer – and anyone around him or her – from getting a good night’s sleep. This results in fatigue and irritability for both parties.  And loud snoring is usually a sign of a truly deadly condition called Obstructive Sleep Apnea (OSA).

When you are asleep, the muscles in your throat & tongue relax. In people with sleep apnea this causes the upper airway to collapse, shutting off the supply of air sometimes for as long as 100 seconds at a time dozens of times every night.

When the airway is completely blocked, the sleeper eventually wakes up partially and gasps for air. Then the cycle begins again and again and again – more than once a minute in many cases.1

Because people don’t wake up completely, they may have no idea what’s happening – but their bodies know there’s been a breathing emergency. Their hearts beat faster and their blood pressure rises sharply.

Millions of Americans suffer from sleep apnea2—and 90% have no idea they have a problem. But, without proper treatment, all of them are at increased risk of coronary disease. In fact, according to David P. White, MD, director of the sleep disorders program at Brigham and Women’s Hospital in Boston, people with sleep apnea have a 27% increased risk of heart attack and a 240% increased risk of congestive heart failure.3

Stroke risk increases, too. A study in the American Journal of Respiratory and Critical Care Medicine reports that men with moderate to severe sleep apnea were about three times more likely to have a stroke than men without the condition.4

Because many people with sleep apnea don’t know they have a problem it’s often someone who sleeps nearby who persuades them to see a doctor.

Once the condition is diagnosed, it is totally treatable.  Lifestyle changes and surgery usually do not help much.

One treatment is a Continuous Positive Airway Pressure (CPAP) machine – a device that forces air into the throat to keep the airway open. Unfortunately, though, many people simply can’t tolerate their CPAP machines. Being tethered to the machine by a hose makes it hard for them to get comfortable in bed and many simply can’t get used to the face mask and the straps they need to wear around their heads.

Fortunately, our office can offer you another, far more comfortable way to protect your health AND get a good night’s sleep. Called mandibular advancement devices, these retainer-like appliances move the lower jaw and tongue forward to keep the throat from closing.

With these devices there’s no noise, no tubes, no straps, and no irritating air blowing into your nose or mouth. So they’re far easier to tolerate than CPAP. And according to PubMed.gov, a service of the National Institutes of Health, “Snoring is improved and often eliminated in almost all patients who use oral appliances. Obstructive sleep apnea improves in the majority of patients.” 5

If you or someone you love snores or has sleep apnea don’t wait. See your doctor right away. Then see us for a simple and comfortable way to breathe easier, sleep better and stay healthier.  Remember that anyone who has untreated sleep apnea will lose an average of 8-10 years of life!

     Dr. Donald Johnson founded Northwest Treatment Center for Snoring & Sleep Apnea in Coeur d’Alene to help patients stop their snoring and LIVE FREE WITH NO LIMITS!  His office is at 114 W. Neider Ave., Coeur d’Alene, near Costco serving the Spokane, Coeur d'Alene, Post Falls areas.  The website for more information is www.NWSleepDoc.com and the office phone is 844-847-6673.

SCHEDULE AN APPOINTMENT TODAY!

1, www.medicinenet.com/script/main/art.asp?articlekey=32422

2. www.Boston.com/news/globe/health/articles/2005/11/1
3. Ibid.

4. www.webmd.com/sleep-disorders/news/20100408/sleep=apnea

5. http://www.ncbi.nlm.nih.gov/pubmet/7481/pubmet/7481421





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