Dental Management of Sleep Disorders

Dennis R. Bailey, Ronald Attanasio

• Éditeur: Wiley-Blackwell
• Année: 2022
• ISBN:
  9781119014621
• Édition: 2
• Sujet: Medicine
• Sous-sujet: Dentistry

DENTAL MANAGEMENT OF SLEEP DISORDERS

A clinically focused, updated, and expanded edition of the leading resource on the dental management of sleep disorders

The newly revised Second Edition of Dental Management of Sleep Disorders delivers a focused and authoritative exploration of the dentist's role in managing patients with sleep problems, especially sleep-related breathing disorders and bruxism.

Full discussions of the use of appliances, overviews of current treatment modalities, and investigations of the relationship between sleep disorders and dental and orofacial features accompany detailed chapters on oral appliance therapy, pharmacological, and behavioral management of symptoms. The book includes a variety of revealing case studies that examine the treatment of different sleep disorders, as well as:

• Thorough introductions to the societal impact of sleep disorders and human sleep architecture and functional anatomy of the airway
• Comprehensive explorations of the pathophysiology and classification of sleep disorders and sleep disorders in the pediatric population
• Practical discussions of medical disorders related to obstructive sleep apnea and the dental and orofacial consequences of sleep-related breathing disorders
• In-depth examinations of the role and interaction of the dentist with the sleep physician and sleep study center

Offering practical advice for diagnosis and treatment, Dental Management of Sleep Disorders, Second Edition is a valuable resource for dental practitioners as well as students.

Section 1
Overview of Sleep Medicine

This section provides an overview of sleep medicine specifically as it applies to the practice of dentistry and in particular to anyone interested in becoming involved in this discipline or those already involved with the desire to develop and include this in their practice. In this section, there is a discussion related not only to the science of sleep medicine but also to the recognition that many of the patients who are seen daily may be at risk for a sleep disorder, based on history as well as conditions that the dentist encounters daily, with an emphasis on sleep‐related breathing disorders (snoring and sleep apnea). Additionally, the need to understand the impact sleep disorders have on our everyday life is discussed along with the wide variety of sleep disorders that exist and may go undetected.

This discipline is very dynamic. There are areas that are of interest and will continue to develop over time. Areas to monitor in the future are:

• The developing statistics relative to prevalence.
• Understanding the role of neurotransmitters in sleep as research discovers their expanding role and interaction.
• Developing understanding of the gut microbiome related not only to sleep but also to many other health‐related consequences.

1
Impact of Sleep Disorders on Society

Conceptual Overview

Sleep disorders can no longer be thought of as simply having a poor night's sleep. At the current time, there are a large number of different sleep disorders that may affect one's quality of life (QOL). In addition, there is a difference between the sleep state and the wake state. Sleep is not simply an altered state of consciousness. In other words, it is not simply a matter of being asleep or being awake. Sleep is a totally separate behavioral and physiologic state that is unique and well documented. Carskadon and Dement define sleep in this way: “Sleep is a reversible behavioral state of perpetual disengagement from and unresponsiveness to the environment” [1]. As such sleep is a combination of rapid eye movement (REM) and non‐rapid eye movement (NREM) sleep associated with well defined and variable brain activity [2].

Sleep disruption and the specifically recognized sleep disorder may have a major impact on one's well‐being, health status, and even QOL. There may also be other associated public health concerns that are related to accidents, mortality, morbidity, utilization of healthcare, executive function, and routine daily tasks. Therefore, as good sleep may have a positive impact on one's life, the presence of a sleep disorder may have the opposite effect.

The Evolution of Sleep in Modern Times

Sleep was not always as we know it today or have known it for over 100 years. Prior to the industrial revolution, sleep and wakefulness were mostly predicated by the rising and setting of the sun. When the industrial revolution occurred, the 24‐hour day was broken down into three 8‐hour periods: one for work, one for sleep, and the other one for pleasure and other activities. Prior to this time, sleep was typically broken down into two stages or shifts and was referred to as “segmented sleep” [3]. These were referred to as first and second sleep or alternatively as “dead sleep” and “morning sleep.” Between these two was a period referred to as “the watching,” which was a period of wakefulness that would last for an hour or even longer in some situations. Furthermore, the eight‐hour uninterrupted period of sleep became more common because of the use of supplemental light that resulted in bedtimes that became later and as such the period between the two stages eventually disappeared.

As sleep became more like we know it today, as is explained in a book by Benjamin Reiss [4], the industrial age changed many things. Where people would sleep in a communal manner, they now would have separate bedrooms. More importantly, sleep disorders that we recognize today most likely were being recognized and became more prevalent.

Another example was Henry David Thoreau's Walden. This was produced when he decided to abandon the sleep pattern of the day and return to one from the past. This led to a time of creativity that had not previously been experienced.

As time progressed, other changes in society were taking place that ultimately would impact our circadian clock and our sleep. One such change was in 1910 when standardized time zones were established, mainly because of the need for railroads to synchronize schedules. Today many changes related to modernization and technology are all in some way impacting our sleep.

Epidemiology and Prevalence of Sleep Disorders

The origin and onset of a specific sleep disorder is often multifactorial. Epidemiology as it applies here is the study of a particular sleep disorder and how it impacts the overall health of the patient. By de...