The Nightly Grind – Coping with Sleep Bruxism

Nightly tooth grinding is a taxing problem that can result in chronic headaches, earaches, jaw pain, worn tooth enamel and sometimes flattened, shortened or even broken teeth and fillings. Also known as sleep bruxism, nightly grinding plagues as much as 10 percent of the adult population and as many as one-third of children. And yet, it is still unclear what causes it.

Some studies have connected sleep bruxism to sleep apnea. In fact, research shows that treating sleep apnea may help alleviate sleep bruxism. Alcohol consumption, cigarette smoking, caffeine intake, snoring, excessive daytime sleepiness and certain medications also have been linked to sleep bruxism, according to the National Sleep Foundation.

Meanwhile, one recent Sleep study indicates that the “daily grind” also may contribute to nightly tooth grinding. In other words, people who are under high levels of stress or experience troubles at work may be more likely to grind their teeth at night. According to a report in Head & Face Medicine, gnashing teeth was especially common in those dealing with stressful work situations and it was particularly evident in people who cope with difficult situations by escaping. It is suggested then that tooth grinding is a way for the body to release pent up stress and anxiety.

If your sleep bruxism is related to stress, experts suggest trying to relax in the hours before bedtime to reduce stress levels and to maintain a regular soothing bedtime routine. Creating a sleep environment that is cool, dark, and quiet may also be helpful.

Other suggestions for coping with sleep bruxism include:

• Change sleeping positions. Tooth grinding has been linked to back sleeping. So, try to sleep on your side or your stomach to ease symptoms.

• Manage stress. Learn and implement relaxation techniques such as deep breathing or yoga. If your stress is severe, counseling may be a useful tool in alleviating tension.

• Get adequate sleep and exercise. Sleep deprivation and lack of physical exercise may increase stress and exacerbate tooth grinding.

• Focus on relaxing. During the day, relax your jaw and facial muscles and at bed engage in a soothing bedtime routine like a taking a warm bath, reading a good book or listening to soothing music.

• Soothe sore muscles. Apply ice for pain or use a warm, wet washcloth to relax tight muscles.

• Change your habits. Limit your caffeine and alcohol intake, especially before bed. And if you are a smoker, consider quitting.

• Visit your dentist. Your dentist can help realign your bite, build up worn-down teeth and fit you for a mouth guard.

• Change your medication. Talk to your doctor about the medications you are taking to determine if they may be causing sleep bruxism. Additionally, doctors can prescribe muscle relaxants if needed.

• Have a sleep study. Talk to your family doctor about a sleep study to determine if you have sleep apnea. Correcting sleep disorders can help control sleep bruxism.

If you or someone you know have sleep bruxism, it is important to seek treatment before permanent dental damage occurs. A sleep specialist, a dental sleep specialist or your family dentist may be a good place to start. Your dentist may suggest that you be fitted with a night guard, a plastic appliance that you wear at night to protect your teeth. This is custom fitted to your teeth during a dental visit and is sometimes prescribed in conjunction with a muscle relaxant. For children with sleep bruxism, symptoms can be discussed with your pediatrician.

This article has been taken from http://www.zimbio.com/Insomnia/articles/teYZryl4Tcb/Nightly+Grind+Coping+Sleep+Bruxism?add=True

Sleep apnea: more on sleeping

Just like drinking and driving, sleepiness and driving do not mix. In fact every day, sleepiness is a major cause of motor vehicle crashes. What’s more, a higher percentage of those crashes involving a person asleep at the wheel result in fatalities than those attributed to other causes, according to the American sleep apnea Association (ASAA).

Typically, sleepiness is caused by sleep deprivation, untreated sleep disorders, shift work and jet lag. The most common cause of sleepiness, or falling asleep at the wheel, is sleep deprivation. In fact, recent studies done by the National Highway Traffic Safety Administration (NHTSA) found that drowsy driving contributed to 100,000 crashes each year, ultimately killing more than 1,500 people and injuring another 71,000. And as many as 20 percent of serious car crashes involve some type of Sleep disorders according to New England Journal of Medicine.

In a study conducted by the Federal Motor Carrier Safety Administration (FMCSA), about half of truck crashes result in fatal or incapacitating injuries and in 87 percent of these crashes the truck driver was judged to be at fault. Furthermore, many accidents that involve buses and big rigs have been linked to drowsy operators who suffer from a sleep disorder. In fact, one study indicates that nearly 28 percent of commercial drivers have sleep apnea. Meanwhile, a separate study found that commercial drivers with obstructive sleep apnea (OSA) were six times more likely to be involved in a traffic accident than the average driver and seven times more likely to have multiple accidents. Finally, experts maintain that commercial drivers have a higher percentage of sleep apnea than the general population because as a group they tend to be more obese than normal – particularly at a young age.

Not surprisingly then, sleep apnea is a major health and safety concern among commercial drivers who spend hours behind the wheel at a time. When left untreated, sleep apnea can make it difficult for them to stay awake, to focus, to remain alert and to react to driving situations. Many people with sleep apnea say they never fall asleep at the wheel, but they do not have to fall asleep to cause an accident. Lack of focus or being inattentive, which is common with sleep apnea, can also contribute to auto accidents. As a result, lives may be lost needlessly because sleep apnea is a treatable condition.

For this reason, the FMCSA is studying the effect of sleep apnea and its potential impact on truck drivers. In August, it will consider recommendations from its Medical Review Board and its Motor Carrier Safety Advisory Committee. Discussions will include testing all drivers for sleep apnea, how to treat the sleep apnea cases discovered and how this will impact driver certification.

The meeting is tentatively scheduled for August 29 in the Washington, D.C. area. It is hoped that they will be able to develop recommendations for agency action at this meeting. Although this meeting may not lead to actual rulemaking on sleep apnea, it does advance the issue. Currently, the rules do not explicitly require testing and treatment.

Initial reports indicate that the board believes that the diagnosis of sleep apnea should not necessarily bar a driver from certification. Instead, they would like for certification to be conditional based on the severity of the sleep apnea, its impact on a driver’s sleepiness and whether or not the driver is getting the treatment he or she needs.

Overall, both the sleep community and the commercial driving industry want to improve the health, safety and well-being of commercial drivers while minimizing fatigue-related accidents on the road. But what concerns the transportation industry is that in an effort to improve safety, they will be faced with a number of restrictions which can mean smaller paychecks and lower standard of living for drivers and less profitability for the industry as a whole.

The key then, is to find a solution that both sides can feel comfortable with. According to experts, the solution should ensure that public safety is improved, operational efficiency is maintained, and the individual driver's job security is not threatened by a diagnosis of sleep apnea. Additionally, there should be some type of process to ensure the driver is getting treatment, following the directions of his or her doctor and improving due to treatment.

For more information on this issue, visit the ASAA website (http://sleepapnea.org/) and the FMCSA website (http://www.fmcsa.dot.gov/).

This article has been taken from http://www.zimbio.com/Insomnia/articles/0OYfbGQx9u0/Sleepiness+driving+not+mix?add=True

Sleep Apnea: Sleep well

Maybe you realize that it is time to seek some help relating to your sleep complications. Where do you start and whom will you encounter along the way? Or maybe you’re interested in a career in sleep medicine. Let’s take a deeper look into the various professions of the sleep industry, as a patient would encounter them along their path to wellness.

Nearly every patient that is suffering from chronic sleeping issues will start at the same place, a consultation with a sleep specialist. A sleep specialist is a medical doctor who specializes in sleep medicine. This physician has completed a full medical education to earn either an M.D. or D.O. degree, as well as instruction and training in sleep medicine. He or she has been schooled exclusively in areas related to numerous aspects of sleep and sleep disorders and is likely a member of the American Academy of Sleep Medicine. Commonly sleep physicians will have a primary specialty that relates closely with sleep medicine, such as pulmonology (associated with respiratory issues, such as sleep apnea) or Neurology (dealing with the nervous system which relates to narcolepsy, restless leg syndrome, etc.). However, it is not uncommon to find sleep specialists with psychiatry or internal medicine specialties. Sleep specialists are typically found in sleep labs or clinics. Once you meet with a specialist, they will review your symptoms and order additional testing such as a sleep study, after which they will be able diagnose and treat your sleep disorder. They have the education and ability to treat many aspects of sleep conditions ranging from obstructive sleep apnea (OSA) to bedwetting with numerous sleep ailments in between.

After an initial consultation with a sleep specialist, they will likely order a sleep study that will provide a better look at your sleeping patterns. Sleep studies are usually performed at night while you sleep and are administered by a Registered Polysomnographic Technologist (RPSGT). An RPSGT is a professional that has obtained credentials through the Board of Registered Polysomnographic Technologists. In order to earn this title, a RPSGT must have attained the essential clinical hours (usually 18 months of paid clinical experience), have BCLS (Basic Cardiac Life Support) certification and passed an extensive examination and has proven proficiency in polysomnography. If a patient has been ordered to undergo a sleep study, they will visit a sleep lab or clinic and spend an evening or two being observed by the RPSGT. RPSGT’s are able to identify numerous irregularities in sleeping patterns and will then pass along this data to the sleep specialist, from which the sleep specialist will be able to prescribe a treatment.

Sleep Apnea is one of the more common sleeping disorders and generally involves the treatment of a Continuous Positive Airway Pressure (CPAP) machine. These machines are provided by a Durable Medical Equipment (DME) company and will likely be set-up by a Respiratory Therapist (RT). A Respiratory Therapist is a trained and certified professional that specializes in cardiopulmonary and/or breathing disorders. In order to become accredited, the therapist must have at least attained an associate degree. In addition, the National Board for Respiratory Care (NBRC) has certain requirements that must be met in order to become a licensed Respiratory Therapist. The RT will set-up your PAP based on the prescription given by your doctor.

Not everyone is able to tolerate CPAP. If after a few months you haven’t adjusted to the treatment your sleep specialist may recommend you visit a Sleep Dentist. A Sleep Dentist is a trained, professional dentist or orthodontist that has received additional training in sleeping disorders that related to jaw, teeth and tongue position. Sleep Dentists are usually members of the American Academy of Dental Sleep Medicine. For those patients that are not able to tolerate a CPAP machine the Sleep Dentist can offer a dental device or oral appliance that may help to improve their sleep apnea. There are two main types of devices. The first is the Mandibular advancement device, which pushes the lower jaw forward and down, allowing the soft tissue of the throat to open and the airway to remain clear during sleep. The second type of dental device is the Tongue retraining device. This apparatus fits around the tongue and holds it forward. There is also an orthodontic treatment option available that slowly widens the upper jaw by using a screw that is placed in the upper teeth. This screw is tightened regularly until the jaw is narrowed to its desired position. This procedure is known as maxillary expansion and it is another non-surgical method used for improving breathing during sleep.

If your sleeping disorder is not breathing related other forms of treatment would need to be explored. Cognitive Behavioral Therapy is a growing form of treatment that is provided by a Cognitive Behavioral Therapist (CBT). This therapy involves correcting faulty thoughts and behaviors that commonly result in insomnia. However, CBT has also proven effective for narcolepsy, RLS, and many other medical disorders. A great example of how CBT works is through the replacement of negative thoughts with positive thoughts; which will ultimately attract positivity and happiness in the patient’s life. A CBT must have attained a Bachelor’s, Master’s or Doctorate degree in psychology, psychiatry or counseling. They are then certified through the Academy of Cognitive Therapy. Treatment by a CBT usually involves a series of one-on-one sessions during which they will work to slowly correct your thoughts and behaviors.