How My Dentist’s Office Cured My Insomnia – and May Have Saved My Life
By Stuart Diamond
Sleep. Experts recommend 7 to 8 hours each and every night.
Really? Who even has that much time to devote to sleeping? And even given that amount of time off the grid (of consciousness), how much sleep do we really get? The Center for Disease Control (CDC) reports that 33% of the United States population does not get enough sleep.
That’s an epidemic and it is serious. More and more research is concluding that lack of sleep (less than 7 hours a night) has important health consequences, apart from daytime sleepiness.
The daunting list includes:
- Brain damage
- Cardiovascular diseases such as hypertension (high blood pressure), heart failure, stroke, heart arrhythmias (irregular heartbeat), myocardial ischemia (decreased blood flow to the heart) and pulmonary arterial hypertension (high blood pressure in the lungs)
- Cognitive Impairments such as dementia, ADHD (Attention Deficit Hyperactivity Disorder) and other cognition / behavioral problems
- Certain types of cancer
- Depression and anxiety
- Higher risk of injury or death from car and other accidents
This brings us to my story. I have had insomnia to varying extent since my mid-thirties. As far as I can recollect, it began after some sort of existential crisis. Though the crisis quickly resolved, the sleeplessness remained. Decades later it still is an important health risk issue.
Since I am in healthcare journalism, I have immediate access to every bit of news on the latest in sleep solutions. Thus, I have followed many paths looking for any effective strategies in pursuit of solid night’s sleep.
Pharmaceuticals? Ambien and all the other modern-day insomnia remedies worked for a while. Inevitably, however, there were side effects. After a few days, I found myself in an overall state of grogginess or some other state of cognitive impairment. Hardly a solution, if the artificially induced sleep left me feeling worse than my natural insomnia did.
Holistic, alternative, or natural methods? I have tried every herbal supplement, melatonin compound, GABA remedy possible. I have worn orange tinted glasses at night to filter out blue light. I have slept in cool rooms, taken hot showers, starved before bedtime, ate just the right tryptophan-rich foods, exercised morning, noon, or night. Entrained my brain waves. The result? Not an extra wink of slumber gained.
Chinese Medicine told me that it was a disturbance of the function of my liver meridian. A nice diagnosis but none of the treatments – from special home-brewed herbal concoctions to acupuncture – made a difference.
That brings me to my sleep – or lack thereof – pattern. I fall asleep easily and then wake up 3 hours later – like clockwork. The challenge is to get back to sleep. Meditating, breathing, visualizations – all to a degree successful or not. My best strategy lately was a small dose of liquid diphenhydramine. That’s the soporific found in Nyquil and other over the counter sleep aids. With a liquid I could adjust the mid-nightly dose – not taking too much or too little – just enough to maybe doze off after awakening up in the middle of the night.
My own self-diagnosis was that my insomnia was a case of circadian rhythms – the internal cycle of my neurological biology, determining when I was awake and when I should sleep – an autonomic clock that could not be meddled with.
But my life was about to change – and maybe saved – by all people, my dentist, Dr. Liana Gedz.
I was in the Rockefeller Cosmetic Dentistry office. We were discussing my dental health and somehow I mentioned my insomnia. She asked, “Did you ever consider that you may have sleep apnea?”
Now, sleep apnea – the cessation of breathing while you sleep – was at the bottom of my list of possible causes. After all, I do not have any of the risk factors typically associated with sleep apnea. For the record they are:
- Excess weight, especially obesity – about half of all sleep apnea sufferers are overweight
- Male, although recent research has indicated that women’s risk increases to about the same level as men once they reach post-menopausal age
- Over the age of 60
- Enlarged tonsils and adenoids, one of the most common factors for children with sleep apnea, particularly overweight children
Yes, I am male and over 60, but my overall health is excellent. I am slender, and all my “vital numbers” are outstanding. But Dr. Gedz insisted that anyone could have sleep apnea and suggested that I should be tested.
An immediate question came to mind: Why is a dentist discussing sleep apnea with me in such depth? Turns out, a few dentists are now treating sleep apnea through a custom manufactured and fitted dental sleep appliance.
I was willing to try. And since insomnia and sleep apnea are considered risk factors for major other health issues, it was easy to get the testing, diagnosing, and any remediation covered by insurance.
Just a few years ago, an insomniac like myself would have to spend a night in a sleep clinic, fully tethered to an array of hardware to determine my sleep apnea status. Today, you take home a kit, a technological contraption you wear on your forehead – reminding one of some digital phylacteries.
I was suspicious. What result could the contraption record, since the device itself seemed to keep you awake? Especially when a woman’s voice would pop up from the device itself, waking me up to say I wasn’t using it right.
After a night of minimal sleep, I returned the device to the doctor’s office and went my way. A few days later, the doctor called. Indeed I had a slight case of sleep apnea – and referred me back to Dr. Gedz for treatment.
A quick, refresher course on what is sleep apnea: Sleep apnea occurs when there is an ongoing micro-cessations of breathing during sleep. This results in not enough oxygen getting to the brain. The consequence is poor quality of sleep and waking up throughout the night. With other risk factors, such as a heart condition, the health consequences can be minor or serious – including death. Most commonly the cause is obstructive – a physically blocking of the airways.
Was that possible? But as thought about it, and my background, I found a clue. I am a musician, as well as a medical journalist. I grew up playing wind instruments. This means I had been trained as a child in holding my breath to create proper breath support. And I am often told I am inadvertently holding my breath. Was it conceivable that I was holding my breath, while I slept – as a matter of muscle memory and habit? Was this a form of behavioral sleep apnea?
Next step was back to Dr. Gedz’s office. There, under a dentist’s guidance, I simply bit into upper and lower plates of blue “gunk” – the customized mold for the special dental appliance that was to be manufactured.
A few weeks later I returned to the office. The dentist made a few minor adjustments and sent me home with simple instructions. The goal was just to try it for a few weeks to adjust and see what happens.
The appliance itself is an upper and lower retainer that fits over one’s teeth. The upper and lower plates are connected together with slender pins. The effect is to slightly force your lower jaw forward, releasing the airway passage at the back of the throat. Just enough to keep it open during the night.
First night? I wake up exactly at the same time as every other night. And struggle to get back to sleep. The retainer seems uncomfortable. The immediate thought – how will I sleep with this on every night? But oddly in the morning, despite the sleepless night I feel better, a little more rested than I might have. In two or three days, I adjust. The retainer feels natural, no big deal. Though I am still waking up, I do get back to sleep. And yes, I am feeling more rested.
A few days later, the sleep coordinator from Dr. Gedz’s office calls to see how I am doing. She is excited for me. Yes, this is exactly how it progresses. I am getting acclimated to the device and my sleep appears to be improving. But then she asks me one more question – and an odd one at that: “Are you remembering more dreams?”
“Dreams? Well, as a matter of fact, yes, I am.”
“Excellent. That means you are getting deeper REM sleep. Dreams are associated with deep REM sleep. Remembering dreams is a sign that the device is working.”
Now, that was a surprise. So I go back to work or rather start looking forward to each night – to see if my sleep improves. I still wake up, but more often than not I do seem to get back to sleep. Sometimes I go 4 or 5 hours before waking up. And most importantly, I am feeling more rested.
Final evaluation? Sleep is complicated. There may be multiple factors that influence one’s ability to fall and stay asleep for the full, prescribed amount of time. Yet, for the first time in years, I see hope that I can unravel the dilemma of sleep. That once I settle into a new pattern and solve the issue of sleep apnea, it will be far easier to resolve any other issues that disturb my search for a perfect night’s rest.