Shoulder Pain? The Solution & Prevention: Fourth Edition by Kirsch M.D. John M

Author:Kirsch M.D., John M.
Language: eng
Format: epub
Publisher: Bookstand Publishing
Published: 2013-04-04T00:00:00+00:00

Sleep Apnea and Sleep Position

By Thomas J. Honl, DDS MAGD FAACP AADSM Diplomat Eligible

Obstructive Sleep Apnea (OSA) is a serious medical condition affecting nearly one in four Americans today. It is a disorder that affects both men and women, and surprisingly 90% of those affected remain undiagnosed and untreated. The two most common indicators of OSA are snoring and excessive daytime sleepiness.

Obstructive Sleep Apnea presents during sleep, in which a sufferer struggles to breathe as the result of a blocked airway. This blockage occurs in the throat at the base of the tongue when the muscles relax, causing the airway to collapse. As a result, snoring commonly occurs, but people who suffer from OSA can also stop breathing completely for measurable periods of time. Oxygen in the blood can then plummet to harmful levels, stimulating the brain and triggering a response to awaken many times throughout the night. This decrease in available oxygen produces tremendous stress on the body, contributing to serious health problems such as high blood pressure, heart disease, stroke and even death. Other related co-morbidities of OSA include acid reflux, depression, dementia, cancer, decreased sex drive, cloudy thinking, obesity, diabetes, daytime sleepiness.

Continuous Positive Airway Pressure (C-PAP) is a common first line treatment in cases of moderate to severe OSA. C-PAP uses pressurized air to prevent the airway from collapsing during sleep. C-PAP is effective in all sleep positions, however many patients cannot tolerate C-PAP.

Oral Appliance Therapy (OAT) is an effective treatment for mild to moderate OSA. It is also recognized as a first line of treatment for people who are intolerant to C-PAP, or for people who simply prefer OAT. Appliances must be properly fabricated and fitted by an experienced dentist who practices dental sleep medicine.

Controlling sleep position can sometimes aid in the effectiveness of Oral Appliance Therapy. In some OSA patients, sleeping on the back contributes to the natural pull of gravity on the relaxed tongue, causing it to fall into the airway and block airflow. Therefore, it is sometimes necessary to encourage a side sleeping position. A device that wraps around the waist and resembles a small backpack is comfortably worn by patients while they sleep to keep them off their backs.

However, side sleeping requires pain free shoulders. In my experience, the least invasive, least costly and most effective remedy for painful shoulders is the hanging technique introduced and taught by John M. Kirsch, MD in “Shoulder Pain? The Solution & Prevention”. In conclusion, pain free shoulders can make the difference in the success of Oral Appliance Therapy for patients with Obstructive Sleep Apnea, a debilitating and deadly sleep disorder.

Dr. Kirsch’s contribution to shoulder rehabilitation has allowed me to increase the effectiveness of Oral Appliance Therapy for my patients.

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