Podcast #18: 7 Ways Doctors Ruin Your Sleep

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In this podcast, Kathy and I talk about 7 Ways Doctors Can Ruin Your Sleep:

1. How this one type of surgery can sometimes cause nasal congestion years later

2. Which dental treatments can create smaller airways

3. How modern orthodontics and jaw surgery can aggravate sleep problems

4. Why medical or surgical menopause can ruin your sleep

5. Find out which commonly prescribed medications can prevent you from sleeping

6. What types of surgery can aggravate apneas during your hospital stay overnight

7. The pros and cons of the Back to Sleep campaign to prevent SIDS

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Shownotes:

Breathe Right strips

DNA Appliance

Homeoblock

Biobloc

Jaw surgery in Korea

Blood pressure medications lowers melatonin

Medications that make you gain weight

Do birth control medications cause weight gain?

Timing of heart attacks in patients with obstructive sleep apnea 

Delayed development in infants who sleep on back

Improved sleep in tummy sleeping infants

 

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Please note: I reserve the right to delete comments that are offensive or off-topic.

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One thought on “Podcast #18: 7 Ways Doctors Ruin Your Sleep

  1. Dentofacial orthopedics (aka first-phase treatment) is basically still headgear. It’s only saving grace is that it’s largely ineffective. The main reason orthodontists don’t add growth to jaws is that there’s no evidence based treatments for doing so. There’s a few devices that claim to do it. You can protract the maxilla to a limited degree with reverse pull headgear. You can do more with bone anchorage but it’s still experimental. The whole midface moves with it too, btw, which avoids the “horse face” look mentioned.

    I think forward growth gets too much attention, vertical growth is significant too. The maxilla grows down posterior and that allows the mandible to grow forward. When it doesn’t grow down enough, the gonial angle increases and then the forward growth is less effective at opening up the airway. That is, you can have a normal sized mandible body but if it’s steep the airway is going to be small too. Orthodontists can address this problem but only a few degrees and restricting growth is a side effect.

    Extractions gets too much criticism I think. Once you have small jaws, extractions are the best solution at that point to obtaining a functional bite with long term stability and periodontal health. You can avoid them with palatal expansion in the maxilla but if the mandible is too small there’s no treatment today. The mandible suture fuses at 1 and surgical expansion has problems. Dr Posnick agrees with this position in his textbook.

    Oral surgeons seem to be more aware of airway problems than other professions but their practices are largely still driven by aesthetics, functional bites, and short sighted conservatism. Some don’t do CCW rotations, are unwilling to “ugly” a person by sufficiently advancing the jaws (but not rest of the face), do single jaw surgeries when double jaw is needed, etc. The two growth patterns I see mishandled most frequently are underbites and gummy smiles. Both cases often need double jaw surgery with maxillary advancement. None seem interested in lengthening the hard palate in conjunction with LeFort advancement, which would raise the soft palate and avoid the need to remove tissue later.