One Downside Of Snoring Mouthpieces

There are perhaps thousands of anti-snoring products that are currently on the market, some of which are downright bizarre. Throughout the years, the snoring mouthpiece and chinstrap have remained two of the most popular over the counter snoring solutions, each being sold by a number of different manufacturers.

The snoring mouthpiece stops snoring by holding the jaw forward which clears the airway while a snoring chinstrap holds the jaw closed but does not necessarily exert much pressure to prevent the jaw falling back into the airway which can cause a blockage. While chinstraps are useful in some circumstances, they are not nearly as effective as some of the other stops snoring products that are being sold.

Snoring mouthpieces have been around since the mid-1990’s and have grown in popularity ever since. New mouthpieces enter the market every year, some innovative while others are simply another spin-off of products from the past. In recent years we have seen advancements in mandibular advancement splints. We have even seen a completely new design emerge, classified as a tongue stabilizing device which works by holding the tongue forward instead of the jaw.

While technology has advanced, one common complaint often expressed is the issue of keeping a mouthpiece in throughout the night. In fact, having a mouthpiece fall out during the night is one of the most common complaints that is often expressed. Some mouthguards, such as the SleepTight have made an extra effort to design their product so that it would remain in the mouth throughout the night, however, the majority of devices all seem to share the same flaw.

The solution to address this issue may be easier than you think.

The Solution: A Chinstrap to Hold The Snoring Mouthpiece In

While not exactly it’s intended use, some mouthpiece users have found that a chinstrap can serve as a useful tool when it comes to holding a mouthpiece in.

The reason why snoring mouthpieces tend to fall out is that they often do not fit tightly and as we sleep, the jaw drops. When the jaw drops, this provides the perfect opportunity for a mouthpiece to fall out. The solution is to prevent fallout by holding the jaw closed with the mouthpiece inserted. Exactly how is this accomplished? If you guessed with a chinstrap, you would be correct.

Due to the elastic nature of neoprene material that is used in most chinstraps, these headbands have taken on an entirely new purpose which is to help hold a mouthpiece in. The key is to choose two products that work well together.

When choosing a mouthpiece, it is very important to select one that has holes at the front which will allow for proper breathing. Most of the mouthpieces today offer a breathing hole feature, although not all products are created equally. Some have larger holes while others are smaller which can cause a restricted airflow.  The best rule of thumb is to select a  mouthpiece that has a large breathing hole that will allow for adequate airflow.  You will also want to consider the overall design of the mouthpiece which should fit snugly against the teeth when molded. Other considerations should be whether a product is FDA approved, the material that is made from, and the warranty that comes with it.

Selecting a chin strap is much easier simply because there are not so many considerations. The chin strap should be soft and flexible as well as large enough to comfortably fit around your head. The better-designed chin straps will wrap around your chin and then connect to the back of your head with holes cut out for the ears.

After choosing a chinstrap and mouthpiece combo that’s a good fit for you, give the mouthpiece a try by itself to see how often it falls out while asleep. Afterwards, you can try using the two together. You will likely notice that using the two together works well.

Which Mouthpieces Require a Chinstrap?

Generally speaking, most OTC mouthguards can benefit from the use of a chinstrap. This is especially true for products such as the zQuiet and the VitalSleep. The reason being is that they do not fit very tightly which makes them more likely to fall out while asleep. This is also true for a number of other mouthpieces.  The easiest way to decide is to use the mouthpiece for a few nights. If you are waking up with it next to your pillow, using a chinstrap to keep it in may be a good idea.

If falling out is not an issue, there is, of course, no need to wear a chinstrap.

Will A Chinstrap By Itself Stop Snoring?

You might be wondering if it’s possible to completely forgo the mouthpiece all together and just use a chinstrap. Is this even a possibility?

While there’s certainly no shortage of chinstraps on the market that claims to put an end to your snoring, in my experience, they do not seem to deliver as promised when used as a standalone unit. The reason behind this has to do with the mechanics behind the chinstrap. Simply stated, the positioning along with the elastic nature of the chinstrap actually supports the jaw by holding it up, but it does not help by preventing the jaw from falling back and closing off the airway. This function is best served by a boil and bite style mouthguard which actually keep the jaw forward and in place. Once in place, a chinstrap will help by preventing the mouth from opening while sound asleep.

Chinstrap Use With CPAP

In addition to holding the mouth closed and preventing oral appliances from falling out, a chinstrap can also be used to hold the mouth closed in order to make CPAP nasal pillows more effective. A common complaint among CPAP users is that their mouth opens while using a nasal pillow which can dramatically decrease efficiency and cause dry mouth. The solution is to hold the jaw closed in order to prevent air from escaping. The elastic nature of the chinstrap acts as a giant rubber band that is used secure the jaw closed. The chinstrap can be used with a variety of different equipment, so take a close look at the design to determine if it’s going to work well with the equipment that you currently use. Some chinstraps are specially designed to accommodate CPAP users.

Concluding Thoughts

The combination of a mouthpiece along with a chinstrap is a little-known secret that can be used by anyone who is experiencing difficulty keeping their mouthpiece in at night. If you are considering a mouthpiece and have concerns about it falling out or already own one and could use a little help keeping it in, a chinstrap is an excellent solution.

There’s a large variety of different chinstraps to choose from and they come in many different colors. As for cost, they are fairly inexpensive. One can be purchased on average at a cost of around $20. Philips Respironics makes one that is quite popular. If you haven’t already purchased a mouthpiece, they can be found in combo packs which include both items in one package.

Alternatively, you can search for a mouthguard that fits tightly, which will help to prevent fall out from occurring.

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☆☆☆☆☆ 4.5 Star Rating

Nitetronic – The Manufacturer of The GoodNite Anti-Snoring Pillow

Nitetronic, the company behind the Goodnite anti snore pillow, claims to be the first and the only clinically proven anti-snoring smart pillow currently on the market. The German-based company was established in 2012 and their product was an instant success in Europe.

Nitetronic is based out of Hamburg, Germany where all of the research and development was performed. Their manufacturing facility is located in Shanghai China. What started out as a small company in 2012 has now spread globally with distribution centers in Canada, Thailand, Japan, Hong Kong, China, Netherlands, and Europe. On August 1st, 2016, the GoodNite pillow was introduced to the United States and Canada when the company opened Nitetronic America LLC in Upland, California.

The first generation GoodNite Pillow was released in 2012 and in January 2016, an improved second generation Goodnite pillow was released which offers improvements in comfort as well as advancements in the algorithm which controls the pillow and an updated version of the app – NiteLink2.

About the GoodNite Smart Pillow

At first glance, the GoodNite Pillow may seem a bit daunting. The unit contains a pillow with a hose exiting from it which connects to a control box. In addition, there is a smartphone app that is also used.

My first reaction was “Wow, how the heck does this thing stop snoring?” After reading and digesting all the information that I could find online, I was no longer intimidated by this pillow but rather intrigued, as I was then able to see exactly how such a device could actually work. As it turns out, the unit is able to operate independently from the phone app, although the app does offer valuable information as well as provides evidence that the pillow is actually working by recording how much you snore throughout the night along with a plethora of other information. It establishes a baseline by recording snoring habits for three nights prior to activation. This allows you to perform a before and after analysis to determine whether or not the Goodnite pillow is effective.

The Anatomy of The GoodNite – How The GoodNite Works

The GoodNite is a queen size pillow, measuring 24″ X 14.5″ X 3″. The pillow can be fitted with a standard pillowcase which can be exchanged to keep it clean and fresh.

Inside the pillow, there’s a polyester filled pocket on both the top and bottom face of the pillow. In the middle, is the working parts of the pillow which are responsible for monitoring snoring and head position as well as inflating the air chambers.

What makes this pillow unique is the fact that there are six individually controlled air chambers that run horizontally along the full length of the pillow. Each chamber has three bags that are stacked on top of each other. Also within the pillow is a series of MEMS sensors which are able to detect the noise and vibration associated with snoring. With the machine turned on, these sensors are constantly listening for the sound of snoring. When snoring is detected, the sensors deliver the message to the control unit informing it of the snoring and the exact head position. The control unit then responds by activating the built-in air pump which delivers air through the tubing into one or more of the six air chambers. The end result is that the chambers slowly inflate where needed and the head is slowly shifted to the side which opens the airway and stops the snoring. The sensors continue monitoring and making adjustments throughout the night. This design is unique in comparison to other inflatable smart pillows that I have seen which are only capable of raising or lowering the head and contain only a single air chamber which does not necessarily shift the head left or right.

An initial concern that I had with this product was that the constant slow movement of my head would keep me up all night.

Within the Goodnite study (mentioned below), it was stated in the conclusion that there was  “no deterioration of the sleep and breathing sleep disturbances” related to the active head position changes. In other words, the head movements are gentle enough not to wake you up. My fears were put to rest knowing that this information was coming from an actual published study which was conducted in a sleep lab using sophisticated equipment that monitors breathing, heart rate, brain wave activity, etc.

Why Does It Work?

The technology behind the Goodnite pillow is indeed fascinating but this leaves one very important question – How does slowly moving the head to the side while asleep prevent snoring?

While asleep, the tongue, as well as other muscles within the airway, tend to relax and fall back which often obstructs the airway. This problem is more prevalent in those who are overweight and are older. While breathing through an obstructed airway, oxygen is forced through this narrow obstructed opening and tissue within the airway begins to collide which in turn causes the sound of snoring.

A surprising number of snorers can treat their snoring by simply moving their body or head to one side which permits free breathing. This is possible because moving the head to one side reduces the effects of gravity on the airway. This is referred to as positional therapy and is the reason why a smart pillow may be effective.

Not convinced? Try this: relax, lay back and mimic the sound of snoring. Next, continue to create the snoring sound and slowly shift your head to the left or right. Be sure not to alter the intensity of your “snoring”. When you turned your head, did you notice that the sound of snoring was greatly reduced or even eliminated? If this is the case, this pillow may be a good choice for you.

How Much Does the GoodNite Cost?

How much do you expect to pay for such a product? It seems as if a lot of effort and capital have been invested in bringing this device to market, so I wouldn’t expect it to be inexpensive. The retail price for the GoodNite pillow is currently set at $299. Nitetronic does offer free shipping which is, of course, nice considering that it’s a fairly large investment.

In comparison to other product that is similar in nature, the GoodNite is competitively priced.

Risk-Free Trail and Warranty 

Nitetronic backs their product with an impressive 30-night risk-free trial in which they allow you to test their pillow for 30 nights prior to deciding whether to keep it or not. The trial period begins the day that you receive it and ends 30 days later. This will give you enough time to acclimate to a new pillow as well as monitor your progress with their smartphone app. According to Nitetronic, after establishing a baseline with the app, you should notice results the first night that it’s activated and every night thereafter. This guarantee seems fairly generous, considering that this is an expensive piece of equipment that can be returned.

There is one caveat which is that returns are subject to a $50 restocking fee.

The GoodNite pillow is backed by a 1-year limited warranty which begins on the date of purchase and covers defects in material and workmanship while under normal use. The warranty can not be transferred and does not cover abuse, misuse or normal wear and tear. Nitetronic covers return shipping for warranty claims.

Can the Nitetronic Pillow Be Used Instead of A CPAP?

If you are currently using a CPAP to treat Obstructive Sleep Apnea, you may be wondering if the Nitetronic pillow can serve as a replacement for your CPAP. This product has been studied for the treatment of snoring only and not OSA. Because of this, you should not replace your CPAP with the GoodNite pillow. According to the manufacturer, you could potentially use this pillow as a supplement for your CPAP, but not as a replacement. As always, you should first speak with your physician prior to making this decision.

Nitetronic Goodnite Pillow vs Smart Nora

Smart Nora, one of Nitetronic’s only competitors, offers a similar product that’s used to stop snoring. There are however a few key differences between the two.

The first difference has to do with the location of the sensor(s) which monitor the sound of snoring.  The Goodnite pillow has sensors integrated into the pillow which are able to identify snoring as well as locate the position of the head. When the sound of snoring is detected, this information, as well as the position of the head, is transmitted through a wire that is housed within the cord connecting the pillow to the control unit.

In contrast, the Smart Nora uses a “pebble”, which is a small wireless device that is about the size of a computer mouse, to listen for the sound of snoring. It’s placed on the nightstand or mounted directly above the head. When snoring is detected, it sends a wireless signal to the controller which responds as needed. The Nora, however, does not feature head position sensors.

Another key difference between the two has to do with the air bladder which inflates and deflates. With the Nora, a single air chamber inflates and deflates in order to move the head up or down which stimulates the airway just enough to cause it to tighten and prevent snoring.

In contrast, the Goodnite pillow contains six individual air chambers that work together to actually rotate your head from one side to another in order to provide a clear path for air to flow. The pillow sensors detect the sound of snoring as well as head position and use this information to inflate one or six chambers to rotate the head to the left or right.

Finally, the Nora allows you to place their insert inside of your regular pillow while the Goodnite components are integrated into a provided pillow.

These two products do share several similarities. Both smart pillows allow you to easily store the control unit under your bed, both can be used with a smartphone app to track your snoring, and both cost right at $300.

The Nitetronic Clinical Study

In the “anti-snoring” industry, very few products have been clinically proven to be effective. There are a number of reasons for this, one being the costs associated with conducting a study. Another reason may be because a product simply does not work. Clinical evidence is a strong selling point for any anti-snoring product.

Prior to conducting a study, an empirical test which included 157 people indicated a 67% reduction in snoring.

In December 2014, Nitetronic Europe GmbH conducted a study to determine the effectiveness of their product, Goodnite. The study was conducted by Dr. Uwe Mehrmann from Nitetronics and supervised by Dr. Joachim T. Maurer at the University ENT Clinic at Mannheim sleep lab.

It was a controlled crossover study that examined how changing the position of the head may affect snoring. Participants stayed overnight in a sleep lab for two consecutive nights during this study. The first night they slept with a pillow that was inactive (did not move) while the second night they slept with an active Goodnite pillow. Participants were both men and women over the age of 18 with a BMI of less than 30.

A polysomnography (PSG) study was conducted and the patients were asked about their experiences.

The results were very convincing. There was a significant decrease in the snoring index when the pillow was being used. The conclusion – the snoring of every patient was greatly reduced and the sleep and breathing-related parameters were unaffected. In other words, it reduced snoring without compromising sleep.

 

My Experience Testing Out the Nitetronic GoodNite Smart Pillow

The Nitetronic clinical study was convincing enough that it persuaded me to try out the Goodnite pillow myself and see how it compared to other snoring treatments that I am familiar with such as the snoring mouthpiece.

The Arrival

The GoodNite Pillow arrived in a large shipping box and was carefully packed inside of a retail box. Once the box was opened, it revealed a soft pillow with a braided line exiting from the center, which contained what I assumed to be the tubing that inflates the air chambers as well as the sensors which pick up the sound of snoring. This line was connected to the control unit which was packed to the right of the pillow in a separate compartment. The package also contained an instructional manual which was written in several different languages.

Before reading over the instructions, I had to know what was inside of the pillow. When I grabbed a hold of it, I noticed that it was very soft and cozy. A zipper on both the left and right sides of the pillow allowed me to take a closer look inside. Inside of the pillow were three additional zippers – one at the top, one at the bottom and one in the center. The upper and lower zipper compartments were filled with an extremely soft polyester material. I noticed that the top portion contained more filler than the bottom which makes sense because if they were filled equally, the profile would be very high.

At the center was the inflatable unit which is responsible for moving the head to prevent snoring. I wanted to take a closer look inside but there was a lock holding the two zippers together. Additionally, there was a tag that read “Do not open”. I was able to hold the unit up to the light and see that there were six distinctive chambers which ran across the entire span of the insert. Additionally, there was a thin piece of perforated foam running across the six air chambers. After examining the pillow, I zipped everything back up and moved on to looking at the rest of the unit.

The braided line leading the pillow measured just over 5′ in length which should be plenty to reach under my bed.

Attached to the braided line was the control unit which contained the brains as well as the working parts such as the pump that sent air through the tubing which inflates and deflates the bags. The control unit is rather large in size, measuring approximately 11″ X 6″ X 3.5″. At one end was the On/Off switch. The braided line exited from the other end and a DC power port was located nearby which allows you to plug into the 5v power adapter that is provided.

The top of the unit had a Bluetooth button which I’m assuming is used to connect the nitetronic pillow to a smartphone. The bottom of the control unit had large rubber feet which help to prevent the unit from easily sliding.

After examining all components, my overall impression was that the Goodnite pillow was well engineered and made from quality materials.

I was anxious to get started but first needed to read over the instructional manual.

The user manual was thicker than expected, but after opening it I quickly realized why. Since the Nitetronic is sold worldwide, the instructions are printed in several different languages. In fact, of the 54 total pages, only 5 pages were printed in English. Surprisingly, the quick start instructions only required 3 steps:

1. Connect the power supply to the main unit.
2. Place the pillow on your bed.
3. Turn on.

I was expecting the setup to take several minutes and require many adjustments, but no – it was ready to use in literally two minutes.

The manual suggested allowing 5-10 nights to become accustomed to sleeping with their pillow. Since I planned on using the Goodnite pillow for several nights, this should allow plenty of time to become adjusted.

Getting Started

As mentioned, the initial setup was quite simple. In order to test it, I recreated the sound of snoring. After three or so loud snores, I suddenly felt my head slowly lifting up on one side. As I continued to make the snoring sound, the air bladder continued to inflate very slowly and my head starts to shift to the side. A few minutes later I tested it again and the opposite side of the pillow inflated, shifting my head the opposite direction. It was interesting to see how the unit responded to the replicated sound of snoring. I also found it interesting how quiet the control unit pump was. The sound was virtually undetectable. Pump noise was a concern of mine at first but this was no longer the case.

Method

When testing the effectiveness of all anti-snoring device, I always spend at least 14 nights putting it to the test to ensure that I’m able to:

1. Determine if it works and
2. Discover any issues that may exist.

To start off I decided to test the Nitetronic pillow by itself for the first 3 night, without pairing it with my smartphone. The idea is that this information would be helpful to those who do not own a smartphone or are not interested in using the app.

As for measuring the effectiveness of the Nitetronic without the app,  I’ll have to rely on my wife who sleeps next to me each night. She typically stays up much later than I do, so she will be able to tell me whether or not it’s working within the first ten minutes of me falling asleep.

For the remaining 11 nights, I will measure the effectiveness using the Nitelink2 which is a free app that is available for both Android and Mac users.

The Results

Nights 1-3

Before going to bed, I had turned the control unit on and laid my head at the center of the pillow. The pillow was rather soft and comfortable. I would even go as far as saying that the pillow was more comfortable than the one that I was currently using.

While laying waiting to fall asleep, I didn’t notice the pillow inadvertently activating which was, of course, a good sign.

It wasn’t long before I was sound asleep with my wife monitoring my snoring closely. Within seconds of the start of my snoring, the pillow activated and slowly raised and rotated my head until the sound of snoring slowly diminished. Thereafter, if I started snoring again, the pillow would begin making adjustments in order to silence the sound of snoring.

The first three nights went well. My snoring was kept at bay and my wife had approved.

Nights 4-6

Over the next 3 nights, I decided to test the capabilities of the Nitelink2 app that had I downloaded to my smartphone.

The instructions indicate that you should spend the first three or so nights recording your snoring with the pillow deactivated, meaning that it will inflate or deflate. The enables you to establish a baseline in which you can compare the nights in which the pillow is activated. That being said, I went into the settings and deactivated the pillow. In addition to deactivating the pillow, I had also set a schedule which allowed it to record from my bedtime of around 11 pm until 7 am the following morning.

After the first night, I went back and reviewed all of the data that was collected throughout the night. It was very interesting to see the percentage of the night in which I snored as well as my sleep efficiency and snoring index. The app even kept track of my snoring intensity, snoring count, and the longest snoring. I was somewhat surprised to hear that I was spent so much of my night snoring.

The following two nights in “inactive” mode showed similar data. The data confirmed what I already knew which is that I snore, and I snore a lot.

Nights 7-14

Now that I had established a 3-day baseline, I was curious to see the quantitative results with the pillow activated and compare this information to what to the prior three days. Before going to bed, I went into the settings and reactivated the pillow.

Over the next eight nights, there was a stark difference percentage-wise between the first three nights when it was deactivated and the following eight nights activated. This information was enough to confirm the effectiveness of the Nitetronic Pillow.

Concluding Thoughts and Recommendations

After two weeks of testing GoodNite anti-snoring smart pillow, the results have proven that it’s, in fact, an effective product. During my trial, the Goodnite pillow had proven itself night after night using both observations as well as recorded data.  Overall, I had a great experience which exceeded my expectations. Nitetronics lived up to all of their claims, which is a breath of fresh air in an industry where so many anti-snoring products fail to meet expectations.

As for the $300 price tag, the look, and feel of what you receive justify the cost. It’s a quality product that’s German engineered and well crafted.  If the cost of the Goodnite pillow vs performance is a concern, you can rest assured with a risk-free 30-night trial. This will give you more than enough time to decide if this product is a good fit for you.

One of the most attractive features of the Goodnite pillow is the fact that it’s the only clinically proven anti-snore pillow with smart technology. Being clinically proven is a strong selling point that gives this product credibility.

Due to the fact that it’s clinically proven, high quality comes with a risk-free trial and is easy to use, I have decided to give it my highest recommendation when it comes to smart pillow technology.

 

Pros:

• Easy setup / easy use
• Clinically proven to work
• Personally tested and proven effective
• Non-invasive snoring solution
• German engineered and well crafted
• Air pump is virtually silent
• Offered with a 30-night risk-free trial
• Allows you to establish a baseline to compare snoring before & after
• Can be used independently or with smartphone app
• Inflation systems and sensors are integrated into a comfortable pillow

Cons:

• $50 restocking fee if returned
• Not a suitable replacement for CPAP

 

 

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Adaptive Servo Ventilation (ASV) and CPAP Therapy

Snoring is the most common and recognizable symptom of sleep apnea, a serious and sometimes life-threatening sleep disorder.  There are two main types of sleep apnea: obstructive sleep apnea and central sleep apnea.  Both types have several forms of treatment options but the most commonly prescribed and used treatment for both is the use of Positive Airway Pressure therapy or PAP.  There are specific types of PAP units for each type of apnea.  Those with obstructive sleep apnea get treatment from a

CPAP machine and those with central sleep apnea use an Adaptive Servo Ventilation machine. To better understand how the units treat the apneas, it is important to know the difference between OSA and CSA first.

Obstructive Sleep Apnea (OSA)

Obstructive sleep apnea is the most common form of sleep apnea at the moment.  OSA occurs when you stop breathing throughout your sleep in the middle of the night.  The pause in breathing can last for several seconds and can occur up to 100 times in just one night.  This pause in breathing is caused by an obstruction of the airway.  The obstruction could be caused by your tongue relaxing and blocking the flow of air, or it could be related to sinus congestion or excessive phlegm buildup in the throat.  Other causes could be problems with a deviated septum, adenoid issues, or inflamed tonsils.  The most common sign of OSA is loud snoring followed by an abrupt pause in snoring, which is when the body stops breathing, and then followed by a deep breath and loud snore.  This occurs because your body is trying to catch your breath after it has just momentarily paused.

Central Sleep Apnea (CSA)

Central sleep apnea is different from obstructive sleep apnea in that the body stops breathing because there was no signal from the brain telling the respiratory system to breathe.  Central sleep apnea is not as common as OSA but is still just as dangerous.  In both cases, there is a lack of oxygen going into the body and most importantly into the brain.  When the body is lacking oxygen, it, in turn, has an overabundance of carbon dioxide, which leads to several chronic and life-threatening medical conditions.

There are several causes of central sleep apnea:

Being Overweight or Obese

Central sleep apnea can also occur due to you being overweight or obese.  Inflammation and high blood pressure typically fall hand in hand with being overweight.  Both of these conditions can impact the health of your brain and if the nerves happen to misfire at all, it could trigger central sleep apnea to take place.

The Use or Overuse of Narcotics

The use or misuse rather of opioids and narcotics in the United States and Canada has tremendously increased in recent years.  These painkillers will actually numb the nerves not only in specific parts of the body where the pain is being felt but also in areas of the brain.  If brain nerves become paralyzed or numb, then there is no way for the body to signal to the respiratory and nervous systems that it needs to breathe in order to survive.  If you currently are using a prescribed opioid or narcotic medicine and think that you suffer from sleep apnea, you should consult your doctor immediately to reevaluate your condition, as this could be life-threatening.

 

Brain Stem Malfunctions

Since the underlying reason for central sleep apnea involves brain misfires, it’s common for people who suffer from brain diseases, brain infections, spinal issues or stroke to have central sleep apnea.  Any of these conditions can be the reason why the brain does not signal to the body to breathe continuously during the night.

Adaptive Servo Ventilation or ASV

Adaptive Servo Ventilation is specifically designed for people who suffer from central sleep apnea.  This type of therapy is relatively new to the industry and has only been around for a few years.  ASV is noninvasive and is said to be more comfortable and user-friendly than CPAP machines used to treat obstructive sleep apnea.  The difference is that ASV machines continuously change the pressure flow of air based on the actual person’s breathing patterns.

The most common complaint of users with sleep apnea and undergoing PAP therapy is that the patient has to get used to the continuous flow of oxygen – it’s set at one preset flow and may feel unnatural to the user at first.

ASV differs because it actually has ‘smart’ technology and senses one’s breathing patterns and continuously fluctuates the air pressure so that it still promotes the flow of oxygen but is making it more natural for the patient using it.  Since this technology is so new, there are constant studies being performed

on this therapy to ensure its safety and effectiveness.  In May of 2015, researchers found a disturbing correlation between ASV and chronic heart failure.

It is still unknown as to why ASV promotes heart failure, however, it has been recommended to doctors in the industry to avoid suggesting this therapy to people who have chronic hypoventilation, severe lung disease, or neuromuscular disease.

Continuous Positive Airway Pressure or CPAP

CPAP machines have been the gold standard treatment for obstructive sleep apnea as they maintain the constant flow of oxygen in through the nose, down the throat, and then into the lungs.  CPAP machines are not recommended for the treatment of central sleep apnea because people with central sleep apnea usually still tend to breathe throughout the night but their breathes are more shallow and do not fully capture the oxygen needed.  The forced airflow from the CPAP does not really do anything for that kind of patient because the steady stream of airflow still does not signal to the brain that it should be breathing.  The more natural irregular flow of oxygen from the ASV machine is more effective for those who suffer from central sleep apnea.

It’s important to understand the two different types of PAP machines and treatment options available for central sleep apnea and obstructive sleep apnea.  Both therapies are effective as long as you are using the correct PAP device for your apnea.

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The Relationship Between OSA, Arthritis, and Osteoporosis

Only in recent years have we discovered the relationship between snoring, sleep apnea and several medical conditions including heart disease, high blood pressure, anxiety, depression, and ADHD.

We are now learning of two more conditions that are related to snoring and sleep apnea – Osteoporosis, and Osteoarthritis. While snoring itself does not cause either condition, it is one of the most common symptoms of OSA and because it’s so common, it’s often overlooked and does not receive much attention by both patients and physicians.

Let’s examine these three conditions and then discuss how recent medical research has found a link between the three.

What is OSA?

Obstructive Sleep Apnea (OSA) is classified as a sleep-related breathing disorder and it affects nearly 25% of adults 30 years and older. The condition occurs when the airway becomes obstructed during sleep which causes breathing pauses and arouses the body to awaken throughout the night in order to stimulate the airway to clear the obstruction and resume normal breathing. This perpetual cycle occurs throughout the night, causing the affected person to wake up feeling tired and lack energy throughout the day.

The issue with OSA is that stopped breathing, even momentarily, causes carbon dioxide levels to rise and oxygen levels to fall which can lead to a number of other conditions.

In addition, the lack of quality sleep leads to daytime sleepiness which has a multi-million dollar economic impact due to lost productivity as well as workplace and auto accidents.

What is Osteoporosis and How Does It Relate To OSA?

Osteoporosis is a common bone disease that occurs when bone density is reduced, causing bones to become weak and brittle. It’s most common in people who are older than 50 and the diagnosis often comes as a surprise after one breaks a bone. It’s estimated that over fifty million Americans are affected by this condition. The disease is more common in women – affecting nearly 50% while only 25% of men are affected.

Injuries that are common in those with Osteoporosis include broken hips, wrist, or spine although breakage can occur in a number of other areas. Serious complications can occur after an older person breaks a hip, which is one of the reasons why this condition should be treated soon after discovery.

Osteoporosis can be detected by conducting a bone density test. When examined closely under a microscope, a normal bone structure appears as a honeycomb with tissues formed tightly together. With Osteoporosis, the “holes” become larger due to tissue loss, resulting in bones that are more prone to breaking.

Recent research has found a strong link between sleep apnea and osteoporosis. The results of the research showed that having sleep apnea may increase your risk of developing Osteoporosis by 2.7 times. ‘

While researchers are not completely sure how the two conditions are related, there are a few theories.

One theory has to do with the acidic environment that is caused by oxygen deprivation. As mentioned earlier, with OSA, breathing stops which causes not only a rise in CO2 but also a drop in blood oxygen levels. When oxygen levels are lowered, it causes inflammation which increases acidity in the body which can promote bone loss.

The other theory has to do with the consequences of lack of quality sleep. During sleep, our bodies go into “repair mode”. With OSA, we never fully achieve deep sleep and heart rhythm can be affected which can cause bone metabolism imbalances and ultimately bone loss.

What is Osteoarthritis & Rheumatoid Arthritis and How Does It Relate To OSA?

Yet another common medical condition is being linked with sleep apnea – Arthritis.

Rheumatoid Arthritis (RA) is the most common form of arthritis and is actually classified as an autoimmune disease that affects an estimated 1.3 million American adults, mostly elderly women.

RA occurs when the body mistakes healthy body tissue as a foreign object and attacks it, resulting in pain, swelling, and eventual bone loss and deformity. While this often occurs in joints such as the hands, it can affect other parts of the body including the heart, lungs, and skin.

Osteoarthritis is another form of arthritis that also results in inflamed joint and discomfort. The primary difference between osteoarthritis and Rheumatoid Arthritis has to do with the cause of the disease.

As mentioned, RA is an autoimmune disease that attacks healthy tissue, resulting in inflammation and pain. In comparison, osteoarthritis is caused by physical wear and tear which also causes inflammation. The key difference here is that osteoarthritis is not an autoimmune disease.

Exactly how are sleep apnea and arthritis related?

Once again, we can not say with complete certainty why the two are related, although there’s at least one theory as to why those with sleep apnea are at higher risk of developing arthritis.

With sleep apnea, pauses in breathing cause inflammation of the blood vessels throughout the body. Over time, this constant inflammation may cause arthritis which can appear in the joints as well as other parts of the body.

What Can I Do to Prevent Osteoporosis and Arthritis Caused By OSA?

While it may be some time before we know exactly why OSA contributes to so many conditions such as arthritis and osteoporosis, we do know that there is a correlation between each. The question is, what can we do to reduce the risk of developing these and other conditions caused by OSA?

The answer is to get screened for OSA if you suspect that you may have this condition. Common symptoms of OSA include the following:

• Loud snoring
• Pauses in breathing while sleeping often followed by snoring or gasping for air
• High blood pressure
• Daytime Tiredness
• Nighttime sweats
• Difficulty concentrating
• Dry mouth or a sore throat in the morning
• Morning headaches
• Mood changes
• Depression or Anxiety

If you are experiencing any of these symptoms, consult with your doctor who will evaluate the possibility of OSA. Your physician will ask a series of questions to determine if you should visit a sleep specialist for further evaluation. If sleep apnea is likely, you may be asked to perform an overnight sleep study where several sensors will monitor functions such as heart rate, breathing, brain activity, blood oxygen levels, etc.

If it’s determined that sleep apnea is present, you may be prescribed a CPAP machine or Oral appliance to assist with nighttime breathing which helps to prevent apnea events from occurring throughout the night. If you are overweight, your doctor may also help you develop a weight loss plan which is often helpful in treating OSA.

Aside from Osteoporosis and arthritis, OSA can cause several other health conditions. Doctors are only recently paying close attention to this condition as research is showing that OSA is related to so many conditions.

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Sleep Apnea and Anxiety

Snoring and sleep apnea limit the amount of oxygen to the brain leaving an overage of carbon dioxide which may be linked to anxiety.  When the brain is lacking oxygen, certain areas of the brain become impacted by the oxygen shortage and can trigger anxiety, fear, panic attacks, and depression.  This is a serious issue and a lack of oxygen to the brain occurs when a person has sleep apnea.  Is there a link between snoring, sleep apnea, and anxiety?  Let’s take a closer look at the evidence behind this.

High carbon dioxide levels in the body can increase acidity in the body – specifically in the amygdala.

The amygdala is a piece of gray matter located in the cerebral hemisphere of the brain.  Its main function is to control emotions that include motivation, fear, and stress.  So what does sleep apnea have to do with the amygdala?  First, you must understand what happens during sleep apnea and how oxygen becomes limited to the brain.

Sleep Apnea – Step by Step

You Fall Asleep

Some people use sleep aids in order to fall asleep at night.  These can include alcohol, prescription drugs, or narcotics.  All of these sleep aids may cause you to over-relax, especially if you sleep on your back, and may promote the relaxation of your tongue.

A Blockage in the Airway Occurs

When the tongue relaxes, it rests towards the back of your mouth and actually blocks your airway, prohibiting the flow of oxygen to your body and the brain.  Other airway blockages can occur that do not relate to the tongue.  These include excessive phlegm located in the back of the throat or mouth, congestion in the nose, and excessive fat deposits in the neck due to being overweight or obese.  Whatever reason for the blockage, in one form or the other, it obstructs the flow of oxygen while you sleep.

Snoring Begins

Loud, obnoxious snoring is one of the main indicators that you suffer from sleep apnea.  Snoring is directly related to the obstruction of your airway.  When the blockage of air occurs, again for whatever reason above, it narrows the airway passage that carries oxygen into the lungs and the rest of the body.  Although the passageway is narrow, oxygen is still able to get in, and it finds a way to bypass the obstruction and continue to flow.  The back of the mouth and throat is lined with tiny flabby tissues and when the air flows passed these flabby tissues trying to make its way into the lungs, the tissues start to gently vibrate as you inhale.  The vibrating tissues create a noise as the oxygen flows by and this is the resulting sound of snoring.

Oxygen is Limited to the Brain

The blockage in your airway limits the amount of oxygen flowing into your lungs and causes you to stop breathing for several seconds.  This is commonly witnessed by your partner sleeping next to you.  Since the snoring is usually loud and burdensome, it’s easy for the bed partner to notice the loud snoring and then abruptly hear complete silence.  This moment is when your body has stopped breathing.  The flow of oxygen to the brain has completely stopped. It can be very scary for the bed partner to hear or witness this.  It’s very dangerous and sleep apnea is a serious sleep disorder that needs to be addressed with your doctor.

The Brain Realizes it’s not getting Oxygen

When the flow of oxygen stops, the brain quickly realizes that it has an abundance of carbon dioxide present.  This increases brain acidity and it activates proteins and the amygdala that cause fear and anxiety. The brain activates the nervous system at this point and signals to the respiratory system that it needs to breathe again immediately.

You Wake up Startled, Frightened, and Try to catch your Breath

Once the lungs start to function again, you inhale a deep breath of oxygen and usually awake and sit up frantically gasping for air because your brain signals to you that you were oxygen deprived.  The feeling of fear is also triggered in this moment due to the high acidity levels now present in the brain.  It may take a second or two for you to realize that you couldn’t breathe and then you lay back down.  In some cases though, the person with the sleep apnea takes a loud gasping breath but does not wake up and just continues to sleep and snore again.  When you have sleep apnea, you unknowingly awaken, breathe, forget you woke up to breathe, and then go right back at it again.  This is the most dangerous part of having sleep apnea because if you do not have a bed partner to witness this, you may never know that you snore or stop breathing.

The Process Repeats

Some people who suffer from sleep apnea can stop breathing anywhere from 4-55 times a night, based on the severity of the sleep disorder.

What are the causes of sleep apnea?

There are several reasons why a person develops sleep apnea.  These include:

• Having large adenoids
• Having large tonsils
• Deviated septum
• Jawbone issues
• An airway blockage due to:
  • Being obese or overweight
  • Nasal Congestion
  • Relaxed throat muscles
  • Relaxed tongue from sleeping on your back, drinking alcohol, or the use of certain medications

What you can do to stop or prevent snoring and sleep apnea

The first step in preventing snoring and sleep apnea is to consult with your doctor on the matter.  Your physician will refer you to a sleep clinic and you will most likely undergo an overnight or at-home sleep study in order to determine the presence of sleep apnea.  If you do have sleep apnea, there are a series of treatment options available that include CPAP therapy, the use of oral appliances, surgery, or other holistic treatments.

Snoring & Anxiety

As mentioned above, the lack of oxygen passing to the brain can trigger brain matter and proteins to produce unnecessary acids which then impact the amygdala, where fear emotions are managed.  This can lead to anxiety during your night’s sleep but also may progress to short term or long term anxiety issues.  If you are able to have the sleep apnea diagnosed and then treated, the anxiety should disappear, however, may still linger with some patients.  Here is a list of recognizable signs of anxiety below.

Signs of Anxiety

• excessive and exaggerated worry
• physical twitches or chest pain that mean no harm medically
• being overwhelmed by small things or non-issues
• stress
• nausea
• dizziness

When you do not get a deep night’s sleep due to being woken up in the middle of the night from sleep apnea, the nervous system is not fully rested and can create anxious thoughts and feelings that leave you stressed, irritable, or nervous.  Make sure you schedule an appointment with your doctor in order to address any concerns related to sleep apnea, snoring, and anxiety.

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Routinely waking up each morning with an unexpected headache is a concern that should be appropriately addressed as it may be an indicator of an underlying condition.

While there are a number of possible explanations for morning headaches such as severe high blood pressure, dehydration, hangovers,  bruxism, low blood sugar, and caffeine withdrawal, we are going to examine the possibility of morning headaches that are related to sleep apnea.

If you are experiencing morning headaches, it’s important to speak with your doctor who will be able to help you identify the issue and discuss proper treatment.

How Obstructive Sleep Apnea Can Cause Morning Headaches

Obstructive Sleep Apnea (OSA) is a sleep-related breathing disorder that is characterized by a breathing pause while asleep. This condition is fairly common in the United States, affecting an estimated 18 million American adults. Disturbingly, only a small fraction of those affected are aware of their condition.

Among the long list of symptoms related to OSA is morning headaches which is a fairly common symptom along with daytime tiredness, loud snoring,  and difficulty concentrating. There are several other symptoms that are related to this condition.

What exactly does sleep apnea have to do with morning headaches? As mentioned, with OSA pauses in breathing occur while asleep. This is a result of the flow of air being physically cut off due to an obstruction, hence the “obstructive” portion of OSA. This obstruction can be caused by the relaxing of the airway which occurs when we sleep. Relaxing of the airway is caused by age, weight gain, alcohol, and sedative use, or simply due to how we are genetically built.

When an obstruction occurs, air is unable to travel to and from the lungs. Due to the lack of oxygen, the body responds by awakening you (often without you ever remembering in the morning) in order to stimulate the airway which clears the obstruction. This cycle can occur several times per hour which is why those with OSA experience daytime tiredness.

Another consequence of obstructed breathing is the rise of carbon dioxide in the blood and deprived oxygen.

When air is unable to enter the lungs, blood oxygen levels tend to drop. Additionally, air that is unable to escape the lungs due to an obstruction will cause a rise in carbon dioxide levels which is primarily what we breathe out. Carbon dioxide becomes trapped in the lungs and tends to build. As a result, blood vessels within the head begin to dilate which results in morning headaches and migraines. Said backward, morning headaches are the result of dilated blood vessels that are caused by a build-up of CO2 which is caused by lack of oxygen which is caused by an airway obstruction which is caused by age and or extra fat. It’s a vicious compounding cycle that is caused by OSA and often goes undiagnosed.

What Can Be Done to Treat Morning Headaches Caused By OSA?

Treating morning headaches that are caused by OSA is accomplished by treating the root of the problem which is of course OSA. Today’s treatment options often include weight loss, CPAP, and Oral Appliance Therapy. Recently, the American College of Physicians (ACP)  has set new guidelines which place a heavy emphasis on weight loss as a first line treatment option for obstructive sleep apnea. A short summary of each treatment option follows.

Weight Loss

While not all who experience OSA are overweight, a disproportionate number of individuals are. This is clearly demonstrated by the correlation between weight gain in the United States and the rise of sleep apnea.

What exactly does carrying extra weight have to do with sleep apnea?  Carrying extra fat, particularly in the neck area, applies downward pressure on the airway. This is especially true when one sleeps on their back which allows gravity to weigh accumulated fat against the airway.

It’s well known that obesity and OSA are often closely related. Because of this, the ACP guidelines now recommend weight loss along with CPAP therapy as a method of controlling OSA. Loosing only a small portion of weight can have a dramatic effect on restoring normal breathing function during sleep which may result in not having to depend upon equipment to facilitate nighttime breathing.

Continues Positive Airway Pressure 

Long considered the “gold standard” of OSA treatment, the Continues Positive Airway Pressure (CPAP) therapy is one of the most prescribed treatment methods for OSA. With CPAP therapy, a continuous stream of air is delivered to the face from a CPAP machine. This stream of air effectively “blows open” the airway which treats the obstruction and allows normal breathing to occur.

It’s likely that you have hard of CPAP therapy because someone that you know may use one. The reason why the CPAP has become the most popular treatment option is that it’s simply very effective when used as directed, although long-term compliance is one of the biggest challenges faced by patients. Machines that are not properly adjusted, masks that are not a good fit or machines that dry out the airway due to lack of humidity cause patients to discontinue use within weeks of beginning.

Oral Appliance Therapy

As the name implies, Oral Appliance Therapy involves therapy that uses an oral appliance or mouthpiece. A physician will create a custom fitted mouthpiece that works by holding the mandible forward. In doing so it helps by relieving pressure from the airway caused by the jaw falling backward at night.

While oral appliances are not prescribed nearly as often as CPAP machines, they are becoming increasingly popular, especially for those who have mild to moderate sleep apnea. One of the greatest advantages of oral appliances is that they don’t come with the burden of carrying around a large machine, tubing, and a mask. An oral appliance is simply inserted into the mouth before going to bed and is removed in the morning. Also, oral appliances do not require electricity to operate so you can take them with you nearly anywhere that you travel.

Oral appliances that are used to treat non-OSA related snoring can be ordered online. Our website has extensive information on the use of an oral appliance for snoring. Remember that you should always consult a doctor if you suspect that your snoring is related to OSA.

Final Thoughts On Headaches and OSA?

If you are constantly experiencing morning headaches, it’s important to discuss these and other symptoms that you may be experiencing with your doctor who can provide their professional opinion. If your doctor determines that you have sleep apnea and it may be the root cause of the morning headaches, it’s important to seek treatment quickly as your body may be deprived of oxygen and or is holding carbon dioxide, both of which have harmful effects on the body.

Morning headaches that are caused by OSA are typically easy to treat, however, the link between the two is often not discovered by doctors and OSA is commonly left undiagnosed.

Treatment options include weight loss, oral appliance therapy, and CPAP. There are also alternative treatment options such as positional therapy, and surgeries such as Laser-assisted uvulopalatoplasty.

 

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According to a study conducted at Standford University, those that are clinically diagnosed with depression are more at risk of developing sleep apnea compared to those that are not depressed.  The study showed that those with depression were five times more likely to be diagnosed with sleep apnea.  Researchers are still studying whether or not the depression or sleep apnea starts first, but either way, there is a strong correlation between the two.

The UCLA Sleep Center has also done a tremendous amount of research on sleep disorders and has found that depression may not be the reason for not sleeping well at night, but that depression symptoms may occur due to an underlying sleep disorder.  The most common sleep disorder is sleep apnea.  Sleep apnea causes the body to miss breathes during your sleep which prevents the flow of oxygen to the brain.

Sleep Apnea

To better understand how depression and sleep apnea are linked, it’s important to understand what sleep apnea is, what the noticeable symptoms are, and how it’s treated.

What Happens When You Have Sleep Apnea?

Sleep Apnea Symptoms

 

Loud disruptive snoring

Disruptive snoring is typically noticed by your bed partner.  Extremely loud snoring is usually followed by a noticeable pause and then a huge gasp for air which may or may not wake you during the night.

Not breathing while asleep

This is typically noticed by your bed partner as well and is very scary for most people that witness it.  You can actually hear the pause in breathing and may wonder when the person is going to start breathing or snoring again.

Dry mouth

Many people with sleep apnea experience a dry mouth when they wake up in the morning or may even have one during the day.  Most people with sleep apnea are mouth breathers, so when the air is ingested through the mouth, it tends to dry out the mouth and throat and saliva is not produced as abundantly.

Sore throat

Waking up to a dry mouth or a sore throat are both normal symptoms of sleep apnea.  The flow of air continuously passing down the throat during your sleep tends to dry out the mouth and decrease saliva production.  This, in turn, dries out the throat and may become irritated or scratchy.

Waking up to choking or gasping for breathes

This is one of the most noticeable symptoms of sleep apnea and is usually witnessed by another bed partner.

Daytime drowsiness and lack of energy

Your body needs oxygen in order to survive and sleep apnea seriously decreases the flow of oxygen to the brain.  This is not only dangerous but impacts a good night’s sleep for your body.  When you are not well-rested, you tend to lack energy throughout the day.

Falling asleep while driving or working

This goes hand in hand with daytime drowsiness.  Many people endure long commutes to and from work and sleep apnea may put you at risk of falling asleep at the wheel during your commute.

Sleep Apnea Treatments

Oral Appliances

An oral appliance resembles a sports mouth guard or mouthpiece.  Its purpose is to hold the jaw in the optimal position in order to keep the airway open and clear, thus preventing snoring from occurring.  Oral appliances are effective at treating snoring, but only some are approved to treat sleep apnea.

Surgeries

There are several types of surgeries that can stop snoring and sleep apnea altogether.  These surgeries include the Pillar Procedure, a tracheostomy, maxillomandibular advancement, or a uvulopalatopharyngoplasty.  Depending on the surgery, some can be minimally invasive and can be done in a few simple outpatient visits.  Others require overnight stays and up to weeks or months of recovery time.

CPAP Therapy

CPAP Therapy is the most common treatment for sleep apnea.  CPAP stands for continuous positive airway pressure.  The CPAP machine has become widely used in the sleep disorder industry.  The machine itself constantly pumps oxygen through a hose and into a nose or face mask.  This positive flow of oxygen prohibits the body from pausing and missing a breath.  The machines have come a long way in recent years and are very quiet, small, and are easy to travel with.  Most insurance providers cover CPAP therapy.  You must consult with your doctor if you think you have sleep apnea so they can schedule a sleep study.  If you are officially diagnosed, the CPAP therapy will be the first recommended treatment for your sleep disorder.

Depression

Signs of Depression

• Loss of interest in activities
• Increased Sleep or Unable to sleep
• Lack of energy
• Guilty Feelings
• Trouble concentrating
• Suicidal thoughts
• Unable to make decisions easily – indecisiveness
• Feeling worthless
• Reoccurring sad moods
• Irritability

How to Treat Depression

Antidepressants

There are several different types of antidepressants on the market that are used to treat depression.  The most common types of these medicines are known as SSRI’s which are selective serotonin reuptake inhibitors.  These medicines re-balance any chemical imbalance in the brain which is most likely the culprit of the depression.

Psychotherapy

Psychotherapy is a treatment option for those who do not want to be put on antidepressants for various reasons.  It involves talking through a series of topics that relate to your lifestyle, work, and personal life with a psychologist.  Psychotherapy is not for everyone, but it is an effective treatment for depression.

Holistic Treatments

There are other natural holistic treatments out there that can positively benefit someone that is depressed.  The most common forms of holistic treatments include regular exercise, yoga and natural breathing exercises, the use of essential oils, and changing your diet to one that is all natural, healthy, and balanced.

How Sleep Apnea and Depression May be Linked

Sleep apnea can be very disruptive if it’s gone untreated.  It may cause daytime drowsiness and can impact your family life.  All of these complications may just be a recipe for depression.  Sleep apnea and snoring can impact your daily routine and quality of life.  A good night’s rest makes you alert during the day, gives you more energy, helps to think clearer, and promotes good decision making.  If you suffer from snoring or sleep apnea, all of these positive impacts from not getting sleep can be turned upside down and may lead to depression without you even seeing the connection.

Linked Sleep Apnea and Depression Symptoms

• Lack of Participation in Activities
• Inability to sleep
• Lack of energy and motivation
• Irritability and mood wings
• Daytime drowsiness

The above symptoms are found in both sleep apnea and depression.  It’s difficult to define which symptoms started with sleep apnea or with depression, but the point is that they do relate to each other and one disorder may link the other.

In conclusion, the similarities between sleep apnea, snoring, and depression is very similar.  It’s difficult for doctors to blame one causing the other, however, their symptoms correlate tremendously.  Consult your doctor if you think you suffer from sleep apnea or depression.  There are treatment options for both and you deserve a good night’s sleep and a healthy mind.

 

 

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Parkinson’s disease affects nearly 10 million people worldwide and 4 million of them suffer from snoring and sleep apnea.

What is Parkinson’s Disease

Parkinson’s is a chronic neurodegenerative disease that attacks neurons located in the brain.  The neurons release a chemical called dopamine which causes the brain to lose control of body movement and function.  The more dopamine is released, the more spastic the body movements become and cannot be controlled.

Parkinson’s Disease Symptoms

Noticeable signs of Parkinson’s include:

• Serious Hand, Arm, and Leg Tremors

  

  • One of the most recognizable symptoms of Parkinson’s is tremors.  They occur in the hands, arms, legs, and even in the face.  They are uncontrollable by the patient and can become very burdensome and frustrating for the individual as the disease becomes more chronic.  Some patients are not aware of the tremors in the early stages of Parkinson’s.  The same is true for the later stages when they lose all feeling and control during the tremor movements.

• Stiff Body Movement

  • Stiffness in the body can also occur.  Stiffness in the muscles is referred to as rigidity.   The muscles tighten and are not as flexible as they once were.  The stiffness may look like partial paralysis in certain limbs including the legs, arms, feet, and neck.

• Slowness or Impaired Movement

  • Another symptom of Parkinson’s is slowness or impaired movement in the body and actions – commonly referred to as Bradykinesia.  Spontaneous and quick movements or impulses are typically eliminated or are seen on rare occasions.

• Loss of Balance

  • Losing your balance is also a common symptom of Parkinson’s.  Typically many of these symptoms are occurring at the same time and it may be difficult to walk and keep your balance when you have leg and arm tremors happening alongside the tightening of your muscles.  Many patients use a wheelchair as their symptoms worsen over time.

• Restless Leg Syndrome

  • Restless leg syndrome is usually a side effect that occurs at night.  Nighttime can be extremely difficult for those with Parkinson’s since medicine keeps them and their partner awake.  Restless legs can interrupt sleep and also prevent one from falling asleep.

• Sleep Apnea and Snoring

  • Snoring is a side effect of sleep apnea, and apnea is present in at least forty percent of Parkinson’s patients.  Some antidepressants trigger sleep apnea which may be prescribed to patients.  Other airflow obstructions can also occur which limits the amount of oxygen to the brain, which is already stressed from the disease.

There currently is not a cure for this disease, however, it can be treated with a range of medicines and surgeries in order to manage the side effects as best as possible.

Parkinson’s & Sleep Apnea

One of the many side effects of Parkinson’s is interrupted sleep and nighttime disturbances.  Due to the tremors and limb stiffness, it is often difficult for those with Parkinson’s to fall asleep.  These interruptions can also wake you up if you are in the middle of a deep sleep.  Discomfort due to limb rigidity and tremor movements do not help the situation either.  Some medicines can also interrupt sleep and some patients end up getting their days and nights mixed up with certain prescription medicines.

According to the Parkinson’s Disease Foundation, over 40% of Parkinson’s Disease patients suffer from sleep apnea.  Many people with Parkinson’s are loud snorers as well, a symptom of sleep apnea.  Sleep apnea and snoring occur when there is an obstruction in the airway.  When air has to find another route around an obstruction, it passes down the throat near the sides of the pharynx next to the fatty mouth tissues.  These tissues start to vibrate as the air hits them and the vibration creates the loud sound of snoring.  Sleep apnea comes into play when your body actually pauses breathing or snoring, and the oxygen flowing into your body and brain become interrupted.  When this happens, you literally stop breathing.  When your body senses this stop, a signal from the brain is sent and you wake up (sometimes unknowingly) and start breathing again, usually with a deep gasp for air or extremely loud snore.  This type of sleep apnea is called obstructive sleep apnea or OSA.

Another type of sleep apnea is known as central sleep apnea.  Central sleep apnea (CSA) is also linked to Parkinson’s disease because unlike an obstruction in the airway in OSA, CSA results in a miscommunication from the brain.  The brain fails to signal the muscles in your respiratory system to breath, thus skipping a breath or multiple breaths.  This is more common in Parkinson’s patients since neurons in the brain are already malfunctioning and producing dopamine.  Scientists relate to sleep apnea with Parkinson’s due to these brain malfunctions, which is why the presence of sleep apnea is so common in the disease.

Snoring and Sleep Apnea Treatments for Parkinson’s

There are several types of treatments and therapies out there specifically to treat snoring and sleep apnea.  Let’s look at a few options below.

Sleep Apnea Treatment for Parkinson’s Patients

The main treatment for sleep apnea not only for Parkinson’s patients but for the vast majority of sleep apnea sufferers is the use of a CPAP machine.  CPAP stands for continuous positive airway pressure and it is a therapy for treating obstructive sleep apnea.  The CPAP machine is a small lunchbox-sized machine that sits on your nightstand or next to your bed with a series of tubes connected to a face mask.  The person wears the face mask which is attached to a tube where oxygen is being pumped by the machine and into your nose.  The oxygen is pumped by a steady flow consistently throughout the night so that there is no breathing pattern interruption.

Work with your doctor to determine which type of sleep apnea you are experiencing.  Your doctor will administer a sleep study to better understand your sleeping patterns and the extent of the apnea.

Snoring Treatment for Parkinson’s Disease

There are several snoring treatments available on the market.  Over the counter, products include nasal cones, nasal strips, nasal sprays, essential oils, and night guards.  Prescription based products including snoring mouthpieces and tongue stabilizing devices can also be quite effective.  Surgical procedures like the pillar procedure and a tonsillectomy are also other more invasive options.  It’s important to consult your doctor when deciding on the best snoring solution for you or a loved one with Parkinson’s disease.

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Nasal cones and Mouthguards, What’s the Difference?

Nasal cones, vents, dilator, clips, no matter what you call them they all serve the same purpose which is to hold your nostrils open to maximize breathing for better sleeping and less snoring. Nasal cones are sold under a variety of names including WoodyKnows, P&J Health, NoseDoze, Turbine, Stanaway, Enshey, Snore Stopper, Mute, Sleep Well, MaxAir, as well several dozen other names. As for price, they can be purchased for as little as $3 and as much as $20.

What’s A Nasal Cone and How Do They Stop Snoring?

Nasal cones are typically made from a soft plastic or silicone material and are made in a number of different shapes. Some, such as Mute or WoodyKnows is a clip style that fit inside of the nose and is designed with rings that expand the nostril out and open. The advantage of the clip style is that it takes up very little room in the nostril which allows for a greater volume of air to flow unobstructed.

Then there are the basket style vents which are typically cylinder shaped or cone-shaped. These are usually larger in size in comparison to the clip style which can be counterproductive as they consume a bit of space within the nostril and restrict airflow. One advantage of this style of Nasal cone is that they are easy to find and relatively inexpensive.

The last type is not actually a clip or cone but rather a flexible strip that fits on the outside of the nose and dilates the nostrils by attaching to the outside of the nostril and actually pulling it open using a spring-like action. The most well-known brand of nasal strips is Breathe Right. Of the three types, nasal strips are the least obstructive because they fit on the outside of the nose and do not cause any resistance. The downside to using nasal strips to dilate the nostrils is that they are disposable and must be replaced every night. Also, attaching them to the face that is not completely free of oil and dirt, as a clean surface is necessary to ensure proper adhesion and functioning.

While there are several reasons why people choose to use nose dilators, the primary use is typical to clear up sinus congestion and prevent snoring by opening the nasal passages.

Seasonal allergy sufferers or those who are experiencing a cold will find relief with nose dilators, but what about those who are interested in using one of these products to prevent snoring? How can they help to prevent snoring?

Snoring often originates in one of two parts of the body, the nasal passage or more commonly, the airway. In some cases, snoring may occur in both the airway and nasal passage.

Nasal passages can become restricted for a number of reasons and when this occurs, snoring sometimes occurs as air is unable to travel without being slowed down. As air attempts to move around swollen air passages, nasal tissue can vibrate which results in the sound of snoring.

What’s A Snoring Mouthguard And How Do They Prevent Snoring?

Another popular snoring solution is often referred to as a snoring mouth guard or mouthpiece. Like Nasal cones, mouth guards are also sold by a number of manufacturers such as SleepTight, zQuiet, Good Morning Snore Solution, Zyppah, SnoreRx, PureSleep, and many others.  Unlike Nasal cones, mouth guards focus more on opening the airway rather than the nasal passages.

As for mouth guards, there are only two different types – those that hold the jaw forward and those that hold the tongue forward. Both types are equally effective, however, each has its own advantages as well as disadvantages.

Jaw-retaining mouth guards are the most popular type of mouth guard. They were originally only available from a dentist but several at-home versions have become available in recent years. This type is custom fitted inside of the mouth and sits sandwiched between the upper and lower teeth with the lower tray positioned slightly in front of the upper. While worn in place during sleep, it positions the jaw forward which relieves pressure that’s typically present in the airway. In turn, this helps to open the airway and free it of obstruction. The biggest advantage of the jaw-retaining style of mouthguard is that there are plenty to choose from and they are very effective. As for disadvantages, several are large in size which can make getting used to wearing one challenging.

The other type of mouth guard attaches to the tip of the tongue and works by holding the tongue out and forward while sleeping. This style of mouthguard is not as popular as the jaw-retaining style, although they are becoming increasingly popular.

By holding the tongue forward, the same group of muscles is targeted which reduces any pressure that’s exerted in the airway region, allowing for proper airflow. The advantage of the tongue retaining mouth guards is that a fitting is typically not required and they take up very little room within the mouth. As for disadvantages, tongue soreness may occur within the first few nights of use which typically clears up after a few nights.

Nasal Cones Vs Mouth guards – Which One Works Better?

Now that we have an understanding of what Nasal cones and mouth guards are and how they work, let’s get down to the million-dollar question which is ‘which product works better to stop snoring?’, the Nasal cone or mouth guard?

To answer this question with any level of certainty, you will need to know where your snoring originates from. Have you noticed that your snoring occurs only when you are congested such as when you are under the weather but lessens when your congestion clears up?  Are your nasal passages often inflamed and you are unable to breathe freely through your nose? If this is the case, you may be a nasal snorer and nasal cones may effectively reduce your snoring.

On the other hand, if you have always been a snorer and typically don’t experience issues with your sinuses, it’s likely that your snoring originates from the airway and a mouth guard will be helpful.

If you are unable to pinpoint the location of your snoring, a mouth guard will be your best bet as the vast majority of those who snore experience snoring from their airway.

In some cases, snoring can come from both the nose and airway. In this instance, you may want to try using a combination of both Nasal cones and a mouthpiece which will allow for the best chances of success.

Snoring can be a challenging nuisance to treat but by choosing the correct product for the needed application, you can avoid some of the expense and disappointment that many people experience when attempting to solve their snoring problem.

In addition to being a nuisance, snoring can also be an indicator of other health issues such as sleep apnea which is a more serious condition. If you have any doubts when it comes to your snoring, it’s always best to first speak with your doctor who can properly diagnose your condition and suggest a solution which may include either Nasal cones, a mouth guard or a combination of the two.

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