Went to the Inaugural meeting of the American Academy of Craniofacial Pain (AACP) Australian Chapter over the weekend at the Sydney Harbour Marriot. It was a fantastic event with many great speakers. The food was great and the discussions superb. Being a 3 day event it was quite draining but well worth it. Some of the best speakers in the world in their respective fields we there and they presented not only the science of what they do, but the clinical relevance.
Interestingly, the major point that came through was there was a huge relationship between sleep apnea and pain. It has long been known that the way a persons teeth close together (occlusion) can cause pain in the head and neck but we are finding out that sleep, or most accurately poor quality, interrupted sleep can worsen the pain and prolong pain symptoms and vice versa.
One speaker mentioned that at his Pain Clinic, about 20% of his patients were sleep apnoic 5 years ago, but that number is around 90% now. Almost all chronic pain patients have a sleep study or polysomnograph done. While the most likely candidates were considered to be older obese males, many cases of young, slim females with severe sleep apnoea were also shown. In some cases, patients with a history of pain lasting many years could be pain free in a very short period with mandibular advancement splints (MAS) like the Somnodent from Somnomed. This device when worn at night prevents the lower jaw from falling back and so keeps the tongue and associated structures from falling and collapsing into the airway causing obstructive sleep apnea (OSA). While a device like this can treat all types of sleep apnoea ranging from mild, moderate to severe, it does NOT treat central sleep apnea (CSA) which is when the brain does not tell the body to breathe.
Most importantly, this means that patients that have pain the head and neck, trigeminal neuralgia, pain in the temporomandibular joint (TMJ) or tightness of the jaw and neck muscles should visit a dentist qualified in the treatment of craniofacial pain. To see if you are a possible candidate for a Somnodent appliance, take this quick G.A.S.P. quiz:
- 1. Have you been told (or noticed on your own) that you snore on most nights?
- 2. Have you been told (or noticed on your own) that you stop breathing or struggle to breathe in your sleep?
- 3. Are you tired, fatigued or sleepy on most days?
- 4. Do you have acid indigestion or high blood pressure (OR use medication to control either of these conditions)?
- 5. Are you overweight?
Give your self a score of 1 for each Yes or Not Sure. 0 for No.
- • Score of 4 or higher: ALMOST CERTAIN to have OSA
- • Score of 3 or higher: HIGH RISK
- • Score of 2 or less: LOW RISK
If you scored 3 or higher you should be assessed as soon as possible because OSA is a life threatening condition that can lead to heart failure, cardiac arrhythmias, hypertension, stroke, weight gain and teeth grinding amongst other things. If you would like more information on sleep apnoea please contact us or call us on 02 9904 2880.
