In recent years, in several developed countries, there has been an increase in the recognition and research of, as well as treatment for, GERD (gastroesophageal reflux disease) and sleep-related issues.
Gastroesophageal reflux disease - the condition of gastric acid flowing up into the esophagus through a faulty functioning lower esophageal ‘valve’ - is the more serious and chronic (meaning occurring more than twice a week) form of acid reflux.GERD can have a detrimental impact on one’s sleep. There is an increased risk of aspirating (breathing in) stomach acid while sleeping, developing or worsening of obstructive sleep apnea, and sleep fragmentation/deprivation due to the discomfort of gastric symptoms.These two conditions were thought to be unrelated until recent years. Research, however, is bringing to light some links that were never considered before. Plus, in the European Community Respiratory Health Survey III in Iceland, researchers concluded “nGER (nocturnal GER) is associated with symptoms of asthma and bronchitis, as well as exacerbations of respiratory symptoms.” ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5029098/ )
Sleep Disorders Can Be A Well-hidden Condition
Like many sleep disorders, acid reflux can be a hidden problem. Chronic laryngitis and chronic dry cough are just two of the possible symptoms of nocturnal GERD. For some helpful info on what to look for, this article on sleep apnea and GERD at sleepapnea.com can help you determine if your (or a family member’s) unexplained issues might be related to nocturnal acid reflux and sleep apnea. ( https://www.sleepapnea.org/acid-reflux-gerd-sleep/ )According to the aforementioned article and a study done by Doctors SK Wise, JC Wise, and JM DelGaudio from the Archives of Otolaryngology at the National Library of Medicine ( https://www.ncbi.nlm.nih.gov/pubmed/16890078 ) states that “gastric acid reflux is prevalent in SDB (sleep-disordered breathing) patients.”And, this study published in the Journal of Neurogastroenterology and Motility the researchers found “Nighttime reflux can lead to sleep disturbance and sleep disturbance may further aggravate GERD by prolonged acid contact time and heightened sensory perception. This may facilitate the occurrence of complicated GERD and decreased quality of life.” ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2879818/ )Every one of these studies mentions that a high BMI is usually a big contributor to GERD and OSA. Lowering a patient's BMI to a normal level is strongly advised. But it is only one part of the underlying issue.A search online for “ sleep-related illness “ reveals an incredible array of information for the effects of poor sleep on both children and adults.
Sleep Problems Can Come Before Full-Blown Apnea
Before sleep problems become serious enough to labeled as full-blown OSA (obstructive sleep apnea), they can present in disturbed sleep by what the patient believes to be pain, or the need to urinate or even nightmares. The patient is often unaware of the actual cause of their sleep disturbances: breathing issues. Partial obstruction of the airway, whether due to poor muscle tone of the genioglossus, improper oropharyngeal muscular habits (chiefly chewing, swallowing, etc) or even upper airway resistance from allergies or improper development of hard and soft tissues of the maxillofacial region can all cause chronic sleep issues that often get worse as the patient ages.Studies indicate that for a significant number of patients, simply correcting oropharyngeal muscle habits are very effective in correcting the sleep disturbances. And, if you think about it, it makes perfect sense. Muscles improve and grow stronger when we use them correctly, right?Since much of our nighttime breathing is impacted by our oropharyngeal muscles (namely the genioglossus - if you care to impress your friends with a new medical term), weak muscles = poor breathing when lying down, strong muscles = proper breathing when lying down. If we strengthen the weak muscles in our faces and throats, our nighttime breathing, and therefore our sleep (and often our overall health), will improve.
Correcting The Underlying Causes Of Sleep Disorders and Apnea
Just how do we “work out” these muscles? Through myofunctional therapy - which utilizes temporary oral appliances and exercises. No surgery required! It is extremely cost-effective and non-invasive, and, most importantly perhaps, it is also very effective!An oft-cited study published by Oxford Academic Sleep Research Society states:“... that myofunctional therapy decreases apnea-hypopnea index [an index used to indicate the severity of sleep apnea] by approximately 50% in adults and 62% in children.” ( https://academic.oup.com/sleep/article/38/5/669/2416863# )“Myofunctional therapy is a series of exercises that not only strengthen, but repattern oropharyngeal muscles and their use. The exercise sequence is sometimes called rehabituation. It teaches people how to break old habits and create new ones.” ( https://www.rdhmag.com/articles/print/volume-36/issue-6/contents/troubled-sleep.html ) Because we want these new habits to last a lifetime, the therapy may require extended use for some patients, but positive results can begin to be seen very quickly. Sometimes within a few weeks.
Sleep Disorder Testing Is Easy At Home
So, how do you know if you or a loved one may have a sleep disorder when the symptoms can mimic other things? Testing by diagnostic centers can be difficult and expensive (unless you qualify for a study), as well as frustratingly inconclusive, and if you find one that provides definitive answers, it can take months to finally arrive at a place where you can actually begin treatment.One of the easiest, most effective, and fastest routes to optimal customized treatment is with the MATRx system by Zephyr Sleep Technologies.You get to test your sleep in your own home, and with Zephyr’s ‘theragnostic study’ mechanism you will know almost immediately what therapy you will need for best results - which gets treatment to you much faster than going the study-referral route.For a brief overview of the Zephyr system, feel free to download the MATRx Plus PDF ( https://www.zephyrsleep.com/pdf/MATRx-plus_Overview.pdf ), or you can contact us here at Sunrise Orthodontics and schedule a consult.We might be not able to directly help you with lowering your BMI, but we can help you get a better night's sleep which will definitely help you along on the road to optimal health.
References
Zephyr Sleep Technologies
http://www.zephyrsleep.com/resources/downloads/
Oxford Academic, Sleep Research Society
https://academic.oup.com/sleep/article/38/5/669/2416863#
RDH Magazine - Troubled Sleep
https://www.rdhmag.com/articles/print/volume-36/issue-6/contents/troubled-sleep.html
Respiratory symptoms, sleep-disordered breathing and biomarkers in nocturnal gastroesophageal reflux -- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5029098/
Gastroesophageal Reflux Disease and Sleep Disorders: Evidence for a Causal Link and Therapeutic Implications -- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2879818/
Gastroesophageal reflux and laryngopharyngeal reflux in patients with sleep-disordered breathing. -- https://www.ncbi.nlm.nih.gov/pubmed/16890078
Acid reflux and sleep disorders: Both can be hidden -- https://www.sleepapnea.org/acid-reflux-gerd-sleep/
Is there a relationship between obstructive sleep apnea and gastroesophageal reflux disease? -- https://www.cghjournal.org/article/S1542-3565(04)00347-7/fulltext
