Sleeping Remedies

Remedies for Obstructive Sleep Apnea and Snoring

  • CPAP is the only remedy that is proven to work for OSA and snoring.
  • Mandibular Advancement Devices - MAD - are dental appliances that are likely to work in some cases.
  • Lose weight: One of the most effective remedies for Obstructive Sleep Apnea - OSA - is weight loss. Overweight individuals who lose even 10% of their weight can reduce OSA incidents during the night and dramatically improve the quality of their sleep.
  • Avoiding the use of alcohol, tobacco, and sleeping pills can reduce the likelihood of airway closure during the night. They will make it harder for your air waves to stay open while you sleep.
  • Sleep on your side instead of your back. Sleeping on your side may help keep your throat open.
  • People who experience OSA only when they sleep on their backs can benefit from special pillows or folk remedies that encourage side-sleeping, such as the tennis ball sewn into the back of your pyjamas.
  • Regularize your sleep hours: Irregular sleep hours can throw off your sleep cycles and lead to breathing problems during the most important sleep stages.
  • For more see http://www.helpguide.org/life/sleep_apnea.htm.

About MAS - Mandibular Advancement Splints

The concept of the MAS is that a dental appliance is fitted to the mouth, either moulded to the shape of your teeth like a mouthguard, or fitted by a dentist.

There are a large number of MADs on the market, ranging in price from AUS$40 to $2,500, some good, some not. You can buy a MAD on the internet that is heated in warm water, then inserted in the mouth and pressed into shape using the tongue and pressure on the cheeks. In Australia there is a nationwide commercial organisation that advertises widely and fits MASs, although you may be advised to discuss this with your dentist who does not have to recoup the advertising costs.

Your dentist will tell you not to use a MAS for any length of time without dental supervision, as incorrect fitting can cause damage.

Common problems associated with the use of dental devices include:

  • Discomfort and soreness from the device
  • Saliva build-up during the night
  • Damage to teeth, mouth tissues, and jaw joints
  • Toothache and jaw joint pain
  • Nausea
  • Permanent change in the position of the jaw or teeth
  • Lack of long-term effectiveness in treatment because of problems with using the device
  • In a limited number of cases, the use of an oral device has made sleep apnea worse.

To avoid problems with oral appliances:

  • Make sure you are a good candidate for a dental device.
  • Monitor the effects closely after starting to use the device, such as regular visits to your dentist.

There are dentists who specialise in fitting MADs, but almost any dentist should do a good job. Dentists who specialize in treating snoring, sleep apnea, or jaw misalignment can help you evaluate the devices available and determine whether you might benefit from one of them. The following characteristics make you a good candidate for an oral appliance:

  • Healthy teeth
  • Lack of periodontal disease
  • No significant temporomandibular joint (TMJ) disease
  • Reasonable range of motion in the mandible (lower jaw)
  • Normal weight or only moderately overweight
  • Older than 18, but younger than 65
  • "Buck teeth" and a small chin
  • A jaw line parallel to the floor
  • The airway obstruction is in the middle of the airway, rather than very high or very low
  • You sleep on your back or stomach, rather than on your side
  • Diagnosed with snoring or mild to moderate Obstructive Sleep Apnea (not severe OSA)
  • You have moderate to severe OSA, but cannot tolerate or refuse CPAP treatment
  • You don't respond well to weight loss or change in sleep position, or these therapies are not applicable to you
  • Failure to be effectively treated with throat surgery
  • You refuse tonsillectomy, adenoidectomy, craniofacial operations, or tracheostomy, or these procedures are inapplicable to you.

See your dentist to discuss whether you are a good candidate for oral appliance therapy.

Extracted from http://www.helpguide.org/life/sleep_apnea.htm

There are also new medical procedures where the jaw is repositioned by a specialist, which are showing promise.

Healthy Sleep Tips

The following information is from the National Sleep Foundation website:
http://www.sleepfoundation.org/hottopics/index.php?secid=9&id=31

The following ten tips can help you achieve sleep and the benefits it provides. These tips are intended for "typical" adults, but not necessarily for children or persons experiencing medical problems.

You can find information on this site about children and sleep and NSF recommends that persons treated for medical conditions consult their doctor - check our resource, "Sleep Talk with Your Doctor."

Finally, if you have trouble falling asleep, maintaining sleep, awaken earlier than you wish, feel unrefreshed after sleep or suffer from excessive sleepiness during the day or when you wish to be alert, you should also consult your physician. Be sure to tell him/her if you have already tried these tips and for how long.

  1. Maintain a regular bed and wake time schedule including weekends.
    Our sleep-wake cycle is regulated by a "circadian clock" in our brain and the body's need to balance both sleep time and wake time. A regular waking time in the morning strengthens the circadian function and can help with sleep onset at night. That is also why it is important to keep a regular bedtime and wake-time, even on the weekends when there is the temptation to sleep-in.

  2. Establish a regular, relaxing bedtime routine such as soaking in a hot bath or hot tub and then reading a book or listening to soothing music.
    A relaxing, routine activity right before bedtime conducted away from bright lights helps separate your sleep time from activities that can cause excitement, stress or anxiety which can make it more difficult to fall asleep, get sound and deep sleep or remain asleep. Avoid arousing activities before bedtime like working, paying bills, engaging in competitive games or family problem-solving. Some studies suggest that soaking in hot water (such as a hot tub or bath) before retiring to bed can ease the transition into deeper sleep, but it should be done early enough that you are no longer sweating or over-heated. If you are unable to avoid tension and stress, it may be helpful to learn relaxation therapy from a trained professional. Finally, avoid exposure to bright before bedtime because it signals the neurons that help control the sleep-wake cycle that it is time to awaken, not to sleep.

  3. Create a sleep-conducive environment that is dark, quiet, comfortable and cool.
    Design your sleep environment to establish the conditions you need for sleep - cool, quiet, dark, comfortable and free of interruptions. Also make your bedroom reflective of the value you place on sleep. Check your room for noise or other distractions, including a bed partner's sleep disruptions such as snoring, light, and a dry or hot environment. Consider using blackout curtains, eye shades, ear plugs, "white noise," humidifiers, fans and other devices.

  4. Sleep on a comfortable mattress and pillows.
    Make sure your mattress is comfortable and supportive. The one you have been using for years may have exceeded its life expectancy - about 9 or 10 years for most good quality mattresses. Have comfortable pillows and make the room attractive and inviting for sleep but also free of allergens that might affect you and objects that might cause you to slip or fall if you have to get up during the night.

  5. Sleep on a low pillow.
    If you sleep on your back, try sleeping with less, a flatter pillow or now pillow. Just a suggestion from a patient who found that sleeping flatter kept the airways open.

  6. Use your bedroom only for sleep and sex.
    It is best to take work materials, computers and televisions out of the sleeping environment. Use your bed only for sleep and sex to strengthen the association between bed and sleep. If you associate a particular activity or item with anxiety about sleeping, omit it from your bedtime routine. For example, if looking at a bedroom clock makes you anxious about how much time you have before you must get up, move the clock out of sight. Do not engage in activities that cause you anxiety and prevent you from sleeping.

  7. Finish eating at least 2-3 hours before your regular bedtime.
    Eating or drinking too much may make you less comfortable when settling down for bed. It is best to avoid a heavy meal too close to bedtime. Also, spicy foods may cause heartburn, which leads to difficulty falling asleep and discomfort during the night. Try to restrict fluids close to bedtime to prevent night time awakenings to go to the bathroom, though some people find milk or herbal, non-caffeinated teas to be soothing and a helpful part of a bedtime routine.

  8. Exercise regularly. It is best to complete your workout at least a few hours before bedtime.
    In general, exercising regularly makes it easier to fall asleep and contributes to sounder sleep. However, exercising sporadically or right before going to bed will make falling asleep more difficult. In addition to making us more alert, our body temperature rises during exercise, and takes as much as 6 hours to begin to drop. A cooler body temperature is associated with sleep onset... Finish your exercise at least 3 hours before bedtime. Late afternoon exercise is the perfect way to help you fall asleep at night.

  9. Avoid caffeine (e.g. coffee, tea, soft drinks, chocolate) close to bedtime. It can keep you awake.
    Caffeine is a stimulant, which means it can produce an alerting effect. Caffeine products, such as coffee, tea, colas and chocolate, remain in the body on average from 3 to 5 hours, but they can affect some people up to 12 hours later. Even if you do not think caffeine affects you, it may be disrupting and changing the quality of your sleep. Avoiding caffeine within 6-8 hours of going to bed can help improve sleep quality.

  10. Avoid nicotine (e.g. cigarettes, tobacco products). Used close to bedtime, it can lead to poor sleep.
    Nicotine is also a stimulant. Smoking before bed makes it more difficult to fall asleep. When smokers go to sleep, they experience withdrawal symptoms from nicotine, which also cause sleep problems. Nicotine can cause difficulty falling asleep, problems waking in the morning, and may also cause nightmares. Difficulty sleeping is just one more reason to quit smoking. And never smoke in bed or when sleepy!

  11. Avoid alcohol close to bedtime.
    Although many people think of alcohol as a sedative, it actually disrupts sleep, causing night time awakenings. Consuming alcohol leads to a night of less restful sleep.

If you have sleep problems...

Use a sleep diary and talk to your doctor. Note what type of sleep problem is affecting your sleep or if you are sleepy when you wish to be awake and alert. Try these tips and record your sleep and sleep-related activities in a sleep diary. If problems continue, discuss the sleep diary with your doctor. There may be an underlying cause and you will want to be properly diagnosed. Your doctor will help treat the problem or may refer you to a sleep specialist.