Hitting the Snooze Button

Lethargy, day-time sleepiness and morning headaches—until now these were blamed on a restless night and treated with anything from prescription sleep medicines to light music and warm shower rituals. But as recent research shows, sleep medicine studies disruptions in sleep and can provide long-lasting solutions. Dr Nupur Jhunjhunwala, dentist, sleep medicine practitioner and founder of Toothwise and Somniawise, speaks to The Perfect Voice on this new area of dentistry that’s gaining popularity.

How can dentistry play a role in sleep medicine?

Dentistry has an interesting role to play in sleep medicine. Obstructive sleep apnea, which is one of the commonest and most under diagnosed problems in the world today, can be treated by a dentist who is trained to do so. The treatment results in a drastic improvement in the quality of life and prevents the long-term ill-effects of untreated sleep apnea.

What symptoms are seen in people with sleep disorders?

Patients come with signs and symptoms like excessive daytime sleepiness, lethargy, apathy towards professional and personal lives, morning headaches, mouth breathing, the feeling of not having slept well, snoring, night grinding of teeth, acidity, frequent night time urination, uncontrolled blood pressure, diabetes, hormonal imbalance and weight gain.

What causes sleep apnea?

Smaller, underdeveloped and mal-positioned jaws lead to constricted airways and nasal passages. This leads to breathing difficulties especially while lying down. When we lie down the shape, size and volume of our airway can change in such a way that it constricts the passage of air causing snoring and sleep apnea.

How can it be diagnosed?

A sleep study can be conducted at home or in a sleep centre depending on the individual requirements. It must always be done under the guidance of a medical professional.

Are there any emotional or psychological causes?

Stress has a massive role to play in sleep disorders like insomnia. Stressful life events are closely associated with the onset of chronic insomnia, in the presence of predisposing factors like family history, past medical history, personality type, poor sleep habits, social and other environmental factors.

What’s the difference between oral appliances and sleep medicine?

Oral appliances treat only sleep apnea. Sleep apnea is one of the sleep disorders which are most commonly seen, the other being insomnia. For sleep apnea the treatment option chosen depends on the severity of the disease, type of sleep apnea, other comorbidities, underlying facial and dental problems, lifestyle, age and individual requirements. In other words an oral appliance cannot treat all sleep apnea cases.

How do sleep disorders impact the overall well-being of a person?

A nine-year-old girl came to me. She had been diagnosed with ADHD like behaviour and migraines. After doing her sleep study, I realized she had severe obstructive sleep apnea and started treating her for that. With treatment, she experienced complete transformation in her personality. She started doing better at academics and sports and the headaches reduced to almost negligible. Her migraine medications were stopped completely. Sleep apnea creates a struggle in the body where the brain and other body parts do not get enough oxygen and have to compensate for that in different ways that are harmful for health. These compensations may not be easily visible because they are developing slowly but ultimately, they show up in a variety of symptoms like the ones in this little girl.

What is good sleep hygiene that people must follow?

Sleep hygiene or good sleep habits are seemingly simple habits to follow but go a long way in ensuring good quality sleep, leading to optimal mental, physical and emotional health.

Firstly, have consistency in sleep and wake timings, put away phones, tablets, laptops, kindles and other light-emitting screens, an hour before bedtime. 

Keep a gap of 2-3 hours between bedtime and dinner and between bedtime and exercise. 

Make sure your bedroom is comfortable and conducive to sleep. Make it dark, quiet, cool and use good quality mattresses and pillows.

Reduce caffeine intake but if you already suffer from insomnia then, completely avoid caffeine in any form; limit afternoon naps, again if you suffer from any degree of insomnia then try to avoid aps completely. 

Create a relaxing bedtime routine that can involve warm showers, music or chatting with friends and family.