Sleep Disorders and Information

More than eighty sleep disorders have been identified. Non-restful sleep is among the most common difficulties reported and as many as seventy million people in the United States alone suffer. Losses related to poor health, productivity, and accidents while driving or at work, are estimated to exceed twenty billion dollars annually. Your sleep pattern and requirement change throughout life, all sleep is not the same, and the amount of restful sleep may decrease with age.

SLEEP RESEARCHERS HAVE IDENTIFIED SEVERAL STAGES AND TWO DISTINCT TYPES OF SLEEP:

N-REM SLEEP: Approximately eighty percent of a normal night's sleep, provides the physical renewal we require and is essential for life! Four stages are related to this type of sleep, ie; wakefulness, drowsiness, moderate sleep, and finally deep restorative sleep.

REM SLEEP: Approximately twenty percent of a normal night's sleep, neither light nor deep sleep, characterized by dreaming, faster breathing, higher heart rates and rapid eye movement. REM sleep provides the emotional renewal we require.

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Sleep and Breathing

Normal Breathing:
During sleep, air passes through the throat on its way to the lungs and travels past the soft, flexible structures such as the soft palate, uvula, tonsils, and tongue. These structures, and the tongue and jaw relax during sleep, however, with no obstructions, the airway allows air to flow freely into and out of the lungs.

Snoring:
If our throat structures are enlarged and/or jaw and tongue relax too much during sleep, the air way is partially or totally obstructed or blocked. As air from the nose or mouth flows by the blockage, these structures vibrate, this causes the familiar sound of snoring. Noise from snoring often increases with age, weight gain, and if more of the airway is obstructed, snoring can be loud enough to wake you or others several times during the night and can be a sign of obstructive sleep apnea. Apnea is a serious disorder in which the snorer stops breathing causing a lack of oxygen to the brain, heart, and blood during sleep. 

Obstructive Sleep Apnea - "OSA":
Obstructive sleep apnea (OSA) is a potentially life-threatening condition. Apnea can be caused by a narrow airway, but is more commonly associated with obstructions of the nasal passages, soft palate, and base of the tongue. Apnea is defined as the lack of airflow for 10 seconds or more, despite a persistent effort to breathe. Hypopneas are caused by a partial airway collapse resulting in a decreased volume of air and lack of oxygen. Clinical manifestations of OSA, termed "obstructive sleep apnea", result from the cumulative effects of apnea and/or hypopnic events.

Hypertension has been reported in 50% of those who suffer from sleep apnea. Sleep fragmentation and OSA are associated with chronic fatigue, morning headache, irritability, short term memory loss, and sexual dysfunction. Patients suffer from a higher rate of automobile and work-related accidents, quality of life issues, martial difficulties, separation, and divorce.

Upper Airway Resistance Syndrome - "UARS":
Upper airway resistance syndrome is characterized by the absence of obstructive sleep apnea and oxygen desaturation, excessive daytime sleepiness, chronic fatigue, increased respiratory effort during sleep, leading to recurrent arousals, despite the absence of hypopneas or apneas. 

Bruxism:
Nighttime "nocturnal" bruxism is a disruptive sleep disorder and may occur in 50% of those patients who suffer from obstructive sleep apnea, morning headaches, and inadequate oxygen saturation during sleep.
Bruxism is defined as non-functional clenching and/or grinding of the teeth involving primarily the massiter, temporalis, medial and lateral pterygoid muscles. The results of this disorder are morning and contractual headaches, muscle tension, spasm, and fatigue. Bruxism is often the cause of a disruptive and non-restful sleep pattern and may complicate the management of TMJ joint disorders (TMJ).


The Bravo System

Custom Appliance:

"Boil & Bite" device for diagnostic and short term treatment of headaches related to TMJ sleep disorders.

The adjustable hinge provides for mandibular advancement and lateral jaw motion. Bruxism pads support the jaw joints and protect the teeth during sleep.

Professional Appliance:

A laboratory constructed oral appliance for long term management of snoring, mild to moderate obstructive sleep apnea and "UARS".

A Titanium "Halstrom Hinge" provides for multiple adjustments necessary to stabilize, advance and/or vertical position the jaw, tongue, and supporting structures to open the airway during sleep.

The Bravo Professional allows the clinician an option to utilize a lower daytime splint and combination of the upper and lower splint during sleep. The combined splints are effective in favorably positioning the condyle in the fossa and stabilization of the mandible and tongue during sleep.


Tips For Better Sleep:

 Go to bed only when sleepy.
 Sleep at least seven hours and rise at the same time.
 Keep your bedroom dark, quiet and cool.
 Eat a light and early dinner.
 Make a to-do list 30 minutes prior to bedtime.
 Avoid caffeine after lunch.
 Avoid eating and exercise prior to bedtime.
 Avoid alcohol and nicotine prior to bedtime.
 Avoid stressful encounters prior to bedtime.
 Herbal teas, and a warm bath can be helpful.
 Exercise increases deep sleep, but not just prior to bedtime.




Dr. Bryan O. Blevins
10 Medical Center Blvd. Ste. H
Lufkin, Texas 75904

phone 936.634.1111
fax 936.634.1110

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