Craniofacial Pain, TMJ and Sleep of Oklahoma

448 36th Ave. N.W., Suite 103
Norman, Oklahoma 73072

Phone: 405.321.8030
Fax: 405.321.2108


Mon. - Thurs.
8:30 a.m. - 5 p.m.
8 a.m. - noon
(Business Office open only)

There are many sleep-disordered breathing problems that can affect you.  If you suffer from any of these types of sleep apnea, please do not hesitate to contact us.

Although it is often depicted comically, snoring can be a serious problem.  Men and those who are overweight are at the greatest risk, and the problem usually becomes more serious as you age. In addition to negatively impacting your health, snoring can cause disruptions to your bed partner's sleep, too. Snoring may be associated with problems such as:

  • Morning headache
  • Hypertension
  • High blood pressure
  • Diabetes
  • Fatigue
  • Difficulty concentrating
  • Reduced work performance

The loudness and tone of the snoring noise is affected by how much air is going through the passage. The greater the obstruction, the greater is the effort to draw air and the louder the noise. As it becomes harder to breath and snoring becomes worse, you may actually stop breathing. This can be a sign of a serious condition called apnea (meaning "want of breath"). However, not everyone who snores suffers from sleep apnea.
Source: National Sleep Foundation

The term "Upper Airway Resistance Syndrome" (UARS) is used to describe chronic daytime sleepiness that is often accompanied by snoring, brief yet frequent arousals, and only slightly abnormal breathing.  Unlike snoring and obstructive sleep apnea, UARS is often more prevalent among women than men.
Symptoms may include:

  • Sleep-onset insomnia
  • Headaches
  • Gastroesophageal reflux
  • Depression
  • Bruxism (grinding of teeth)
  • Rhinitis
  • Hypothyroidism
  • Asthma

People who suffer from UARS lack the typical findings of apnea, hypopnea and nighttime oxygen desaturation on polysomnography (diagnostic sleep studies). As a result, UARS is often not diagnosed by physicians. However, the arousals and sleep fragmentation related to an increased effort to breathe can be diagnosed by measurement of pressure changes in the esophagus.
Source: Quiet Sleep

The word "insomnia" comes from the Latin in ("no") and somnus ("sleep"), so it literally means "no sleep" or the inability to sleep. Insomnia can be transient (lasting for several days),intermittent (when transient insomnia recurs), or chronic (lasting for more than a month).
Insomnia is often characterized by one or more of the following sleep complaints:

  • Difficulty initiating sleep
  • Difficulty maintaining sleep
  • Waking too early in the morning.

The National Sleep Foundation (NSF) 2002 Sleep in America poll shows that 58% of adults in the U.S. experience symptoms of insomnia a few nights a week or more. People experiencing insomnia might begin by examining their sleep habits to see if their sleeplessness is connected with diet, exercise patterns, or sleeping environment. If changing these factors does not alleviate the insomnia symptoms, consult a dentist certified in dental sleep medicine or your family physician.
Source: National Sleep Foundation

Obstructive sleep apnea (OSA) is far more common than central sleep apnea . OSA occurs when air cannot flow into or out of the person's nose or mouth, although efforts to breathe continue. In a given night, the number of involuntary breathing pauses - or "apneic events" - may be as high as 20 to 60 or more per hour. Snoring and choking between apneic events is common, although not everyone who snores has OSA. The frequent interruptions of deep, restorative sleep often lead to excessive daytime sleepiness and may be associated with early morning headache.
OSA occurs in all age groups and both sexes but is more common in men (it may be underdiagnosed in women) and possibly young African Americans. Early recognition and treatment is important because OSA may be associated with irregular heartbeat, high blood pressure, heart attack, and stroke.
Once diagnosed, OSA is often managed through the use of a Continuous Positive Airway Pressure (CPAP) machine. Dental appliances that reposition the lower jaw and the tongue have been helpful, too.
Source: National Sleep Foundation

There are two main types of sleep apnea. "Central Sleep Apnea" appears to be related to a malfunction of the brain's normal signal to breathe. It is less common than "Obstructive sleep apnea" which may represent cessation of breathing due to mechanical blockage of the airway.
Prompt and proper diagnosis is an important first step to treating any and all forms of sleep apnea. Problems associated with untreated sleep apnea include hypertension, coronary artery disease, myocardial infarction, stroke, psychiatric problems, impotence, cognitive dysfunction, memory loss, and death.
Source: National Institutes of Health

Sleep Bruxism (SB) is the gnashing, clenching or grinding of the teeth during sleep. It is the third most prevalent sleep disorder, after sleep talking and primary snoring.
Tooth grinding or tooth-clenching during sleep may cause:

  • Abnormal wear of the teeth.
  • Sounds associated with bruxism (It's about as pleasant as fingernails on a chalkboard!).
  • Jaw muscle discomfort.

Some people have episodes of SB that occur less than nightly with no evidence of dental injury or impairment of psychosocial functioning. Others experience nightly episodes with evidence of mild impairment of psychosocial functioning. Yet others have nightly episodes with evidence of dental injury, temporomandibular joint (jaw) disorders , or moderate or severe impairment of psychosocial functioning.
When someone with suspected sleep bruxism has a polysomnographic test (that is, a diagnostic sleep study conducted at a sleep lab), there is evidence of jaw muscle activity during the sleep period and the absence of abnormal movement during sleep.  Other sleep disorders may be present at the same time.
Source: The Sleep Well, Stanford University

Americans experience sleep disorders that involve dreaming. These include nightmares, sleep terrors, and REM sleep behavior. Nightmares are dreams with vivid and disturbing content. They are common in children during REM sleep. They usually involve an immediate awakening and good recall of the dream content.
Sleep terrors are often described as extreme nightmares. Like nightmares, they most often occur during childhood, however they typically take place during non-REM sleep. Characteristics of a sleep terror include arousal, agitation, large pupils, sweating, and increased blood pressure. The child appears terrified, screams and is usually inconsolable for several minutes, after which he or she relaxes and returns to sleep. Sleep terrors usually take place early in the night and may be combined with sleepwalking. The child typically does not remember or has only a vague memory of the terrifying events.
REM sleep behaviors are similar to sleep terrors, but more common in adults. Patients with REM sleep behaviors may complain of sleep disruption, violent behavior with injuries to themselves or to their bed partner, or unpleasant and vivid dreams. Patients are usually middle-aged or elderly, and about one third have an associated neurological disease.
If you or someone you know is experiencing distributed sleep or incurring injuries due to any of these problems, they should consult their doctor. Sleep disorders can often be treated.
Source: National Sleep Foundation

Limb Movements (PLMS) in sleep are repetitive movements, most typically in the lower limbs, which occur about every 20-40 seconds. If you have PLMS, or sleep with someone who has PLMS (also referred to as PLMD (periodic limb movement disorder), you may recognize these movements as:

  • Brief muscle twitches
  • Jerking movements
  • An upward flexing of the feet that cluster into episodes lasting anywhere from a few minutes to several hours.

People with PLMS are often not aware of these movements, and often complain of several symptoms, including insomnia, excessive daytime sleepiness, frequent awakenings from sleep, or unrefreshing sleep
While often not indicative of a serious medical condition, PLMS may be a contributing factor in chronic insomnia and/or daytime fatigue because they may cause awakenings during the night. Occasionally, PLMS may be an indicator of a serious medical condition such as kidney disease, diabetes or anemia, which is why you should seek the advice of your family physician or a sleep medicine specialist.
Source: National Sleep Foundation

Restless Legs Syndrome (RLS) is a neurological disorder characterized by unpleasant sensations in the legs and an uncontrollable urge to move when at rest in an effort to relieve these feelings.
The most distinctive or unusual aspect of RLS is that lying down and trying to relax activates the symptoms. As a result, most people with RLS have difficulty falling asleep and staying asleep. Left untreated, the condition causes exhaustion and daytime fatigue.
The cause of RLS is still unknown, but the symptoms tend to worsen over the years and become more severe in middle-to-old age. The fact that it occurs 3x - 5x more frequently in first-degree relatives of people with RLS than in people without RLS suggests that heredity may be involved. Pregnancy or hormonal changes may temporarily worsen RLS symptoms. Stress, diet or other environmental factors may also play a role.
Source: National Sleep Foundation