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Health Sleep, Healthy Ageing

Health Sleep, Healthy Ageing

World Sleep Day March 15 2019
This year world sleep day focuses on the importance of sleep and ageing. With ageing, changes in our body clock and hormonal changes can cause increased sleepiness earlier in the day. In addition the production of melatonin (a natural hormone that promotes sleep) is reduced and we can find it harder to fall off to sleep at a normal sleep time.

Medical conditions like Parkinson disease, waking at night to urinate, indigestion and lung diseases such as asthma or COPD can affect sleep. The drugs used to treat these conditions may also interfere with sleep. Mood disorders like anxiety and depression can both interfere with getting to sleep as well as cause wakefulness during the night.
At least 1 in 4 older people have sleep apnoea or periodic limb movement disorder. These problems can also disturb the sleep of your bed partner.

What can I do to improve my sleep?

  • It is very important to keep regular sleep hours. So try to go to bed at about the same time every night and get out of bed about the same time every morning. Avoid sleeping in, even if you have had a poor night’s sleep and are tired.
  • Don’t go to bed too early and try to only spend the time in bed that you actually need for sleeping. If you happen to wake early, think about getting out of bed and starting your day.
  • Exposure to sunlight during the morning and late afternoon also help your body clock.
  • Day time exercise (preferably outdoors) will help you to get sleepier at night.
  • Avoid eating and drinking alcohol 3hrs (preferably 4hrs) prior to bedtime.
  • Naps late in the afternoon or lasting longer than 15-20 minutes can affect your sleep. An afternoon nap may help your energy levels but may also interfere with sleeping at night and are best avoided.

Talk to a medical professional if you have persistent sleep problems, that affect your daytime wellbeing and energy or you are always feeling sleepy during the day. Neither of these is a normal result of ageing and help is available.

It is important to remember that your sleep needs and patterns change as you age. Focusing on your sleep is as important as looking after your diet and exercising.

Why mouth breathing is bad for your health?

Why mouth breathing is bad for your health?

Why mouth breathing is bad for your health?

At the dental gallery we routinely screen for correct breathing and tongue position during our regular 6-monthly preventative examinations

The nose is best suited for breathing because it warms, humidifies and filters the air to prevent bacteria and particles entering the lungs. Mouth breathing leads to chronic irritation of the airway and can result in enlarged adenoids and tonsils in children.

There are many research studies describing the bad health consequences of mouth breathing.

Here are a few reasons why it is bad to mouth breathe.

Less production of nitric oxide

Nitric oxide is a gas that dilates (makes larger) blood vessels in the body and as a result increases oxygen uptake by the lungs. This gas is made in the sinuses. By breathing through your mouth, you’re missing out on production of this gas and also about 10 to 20% of additional oxygen uptake. As a result, you can compensate by breathing a bit faster and breathing off carbon dioxide. This can cause your carbon dioxide levels to drop, raising blood pH levels, and preventing oxygen from being released as easily to your body’s tissues.

It can cause crooked teeth

Breathing through your mouth prevents your face and jaw from developing properly. Inadequate jaw development can lead to crowding of your teeth and even narrowing of the upper airway. For children, one of the biggest causes of teeth crowding is habitually breathing through the mouth rather than the nose.

One extreme example is often referred to as “Adenoid Facies”, which results in an open mouth and forward head posture, long, narrow face, high arched hard palate, recessed lower jaw, and chronic nasal congestion. Having a smaller jaw can make you much more susceptible to future sleep-related breathing disorders.

It can lead to dental cavities

Mouth breathing leads to you having less saliva and a dry mouth. Saliva reduces acid levels, and can help to prevent plaque build-up. Mouth breathing can also cause you to have bad breath.

Mouth breathing can cause your tongue to fall backwards in your mouth

Ever wondered why it’s harder for you to breathe when lying down in a dentist’s chair with your mouth wide open? Opening your mouth causes your tongue to fall back, preventing proper breathing and in severe cases can obstruct the airway. For adults, the changes to the airway introduced by mouth-breathing while sleeping can give rise to snoring and sleep apnoea.

Concerned? Here are some signs of mouth breathing:

  • Dry lips
  • Having an open mouth posture
  • Dry mouth with inflamed gums
  • A long and narrow face
  • Narrow high arched palate
  • Crowded teeth or lack of spacing between baby teeth
  • Enlarged tonsils
  • Having a forward head posture

Some Common causes of mouth-breathing are:

  • Allergies
  • Chronic colds and sinus infections
  • Enlarged adenoids and/or tonsils
  • Nasal polyps
  • Deviated nasal septum

So what can be done to address mouth-breathing?

At the dental gallery we take an integrative approach to mouth breathing and work with Ear Nose and Throat (ENT) specialists and medical professionals to address the causes. This includes:

  • Airway assessment with an ENT specialist
  • Assessment and management of chronic allergies and infections
  • Breathing retraining

Targeted dental treatment:
In children we can expand the upper jaw and this can allow the tongue to sit properly on the palate and correct teeth crowding.
In some cases the lower jaw can also be brought forward to improve the airway.
In mouth breathing adults, we can bring the lower jaw forward with a mandibular advancement splint.

Poor Memory has been shown to be related to poor sleep or upper airway resistance syndrome

Poor Memory has been shown to be related to poor sleep or upper airway resistance syndrome

Poor Memory has been shown to be related to poor sleep or upper airway resistance syndrome

Recent clinical evidence suggests that women with sleep disordered breathing may experience different symptoms to men. A recent study from UCLA which reviewed the brain scans and medical notes of women with sleep apnoea found thinning of the brain structure (frontal cerebral cortex), the part of the brain responsible for higher cognitive functioning like mental processing and memory.  The study was by Professor Paul Macy from UCLA and he states “Because women report different symptoms, they tend to be misdiagnosed…. Early detection and treatment is the best way to protect against damage to the brain and other organs”.

Women are more likely to experience upper airway resistance syndrome UARS and this can cause them to experience daytime fatigue, feeling groggy, lack of motivation to do anything, poor focus, concentration problems, bruxism or grinding of teeth, cold feet and hands, low mood and depression.

This study builds on other research that sleep disordered breathing is a spectrum – ranging from sleep apnoea to upper airway resistance syndrome (UARS).  Obstructive sleep apnoea is a well-known sleep related breathing condition where there is repetitive stopping in breathing during sleep, due to collapse of the tissues of the throat. Unlike sleep apnoea where you have an obstruction causing an apnoea or cessation of breathing for 10 seconds and then an arousal or waking up, UARS patients typically have mostly partial obstructions and increased effort of breathing and then arousals or waking up. Patients with UARS do not actually have the 10 seconds of cessation of breathing but are still doing the same harm to their bodies as those with sleep apnoea.

Patients will UARS have some form of fatigue, most will say they are “light sleepers,” and almost invariably, they don’t like to sleep on their backs.  Some people attribute their poor quality sleep to insomnia, stress or working too much. Due to repetitive arousals at night, especially during the deeper levels of sleep, one is unable to get the required deep, restorative sleep that one needs to wake feeling refreshed in the morning.

In most cases, the cause is due to collapse of the tongue and the muscles of the airway. There are many reasons for the tongue and soft tissues to cause obstruction including being too large/floppy or if you are overweight. But once the obstruction occurs, the only thing you can do is to wake up and stop yourself from suffocating.

Due to repetitive arousals, your body is under a chronic state of low-grade stress – or what is referred to as the “flight response”. This is akin to when you’re frightened or running away from something. Your heart rate and blood pressure go up, your vision and hearing become very sensitive, and all your blood flow and energy is ready for a fight. As a result, blood gets shunted away from your gastrointestinal system to the heart muscles, this can lead to chronic diarrhoea, constipation, indigestion, acid reflux or bloating. In addition we know that stress can worsen acid production in the stomach.  Many people with UARS also have laryngopharyngeal reflux which is different to gastro-esophageal reflux disease.

People with laryngopharyngeal reflux do not feel heartburn but can complain of  chronic throat clearing, hoarseness, cough, postnasal drip, ear or throat pain, a lump in the throat, difficulty swallowing, tightness or pain with swallowing. Once the stomach acid gets into the throat it can enter the lungs causing or aggravating asthma or bronchitis. Acid can even get into the nose and ears causing or aggravating nasal congestion, sinus or ear infection.

Another study showed that about 23% of people with UARS have low-blood pressure. In addition, these people feel dizzy or lightheaded which is worse when they stand up too soon.  Even if their blood pressure is normal, some may still be prone to bouts of dizziness or light-headedness.

Tension headaches and classic migraine can occur frequently in people in UARS along with TMJ (temporo-mandibular joint) problems, which is due to grinding and/or clenching of their teeth. TMJ pain can be felt in the ear and many people think they have ear pain, as well as headaches along the side of your head, and teeth grinding can wear down your teeth or lead to having cracked teeth.

Some people can also have chronic or recurrent sinus pain, pressure or infections. Frequently, patients present to their doctor with frequent and recurrent sinus infections and are given antibiotics (which only help temporarily). In many cases, migraines can also masquerade as a sinus headache without the classic symptoms.

Depression, anxiety or attention deficit problems can be also seen in people with UARS. Multiple arousals and the fact you don’t sleep deeply, has been shown to cause your body to produce increased levels of cortisol. Cortisol (is a hormone that) makes you eat more and put on weight. It also lowers your body’s immune system to fight infections and can lead to insulin resistance, and eventually diabetes.

It seems that UARS symptoms can be aggravated by small changes in the person’s life. Gaining a small amount of weight, even 2-5kg, can aggravate the symptoms which go away once the body adjusts and accommodates to the increased weight it has to carry. A bad cold or respiratory tract infection that causes swelling and narrowing of the upper airway can also aggravate these symptoms. Pregnancy is another situation where this can occur.

In most cases the treatment of UARS is like sleep apnoea. The options are trying to improve you nasal breathing, dental appliances, myofunctional therapy, CPAP, or surgery, as a last resort. A mandibular advance splint (dental device) that pulls the lower jaw forward, similar to one used for snorers and in sleep apnoea patients can help. By pulling the jaw forward, it also pulls the tongue forward, creates tone in the muscles of the airway which can lead to an improvement in the size of the airway.

Your Gut Health or Microbiome – Could be Affecting Your Moods & Sleep

Your Gut Health or Microbiome – Could be Affecting Your Moods & Sleep

dentist MelbourneImproving your gut health with prebiotics, eating a broad and inclusive diet of real foods (not processed), increasing fibre intake and eating fermented foods could improve your sleep and mood. Sleep deprivation increases your risk of obesity.

Lack of sleep results in a decrease in leptin, the hormone that makes us feel full and a rise in ghrelin, which stops us feeling satisfied with the food that we do eat. This can result in eating more that you need.

“We know that people who live with depression and people who sleep poorly both have abnormal microbes in the gut, which would suggest there is a very real connection here between all three” says Dr Tim Spector, Professor of Epidemiology at King’s College London.

This article from “The Guardian explains…