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Thomas P. Connelly, D.D.S.

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Sleep Apnea and Cancer: Treating Sleep Apnea Dentally

Posted: 05/31/2012 1:42 pm

Let's talk today about sleep apnea and the treatments for such. This is on my mind because of a recent report that came out the University of Wisconsin School of Medicine and Public Health (1). The findings basically say that researches have discovered a link between sleep apnea and cancer, stating that those with sleep apnea or sleep disordered breathing are 4.8 times likely to die of cancer than those with no sleep disorder at all.

I found that rather interesting (and disturbing), and as an NYC Cosmetic Dentist, I do get asked about sleep apnea quite often, so it seemed like a good time to discuss it.

The first thing I want to do is discuss the study for a second. Because I'm not one to just jump lockstep to these types of things. Read the wrong way, this could be interpreted as "sleep apnea causes cancer," which is not accurate by any means. To be perfectly honest, the way I read it is "not getting good sleep makes you more likely to die of cancer." Because it's common knowledge that good sleep is healthy, and that not getting good sleep isn't healthy. I would not be surprised to find that "not getting good sleep" contributes to a multitude of afflictions, as not getting good sleep weakens our immune system. To succinctly illustrate this, I'll point to an online question answered by Mayo Clinic Sleep specialist Timothy Morgenthaler, M.D. (2). It's a pointed answer that sums up what most of us already know -- that a lack of sleep is not good for you.

Okay, so we know that getting poor sleep is bad for your health. Now let's talk about sleep apnea and what you can do about it.

To begin, sleep apnea is a condition where you essentially stop breathing for a bit while you sleep. It causes you to wake up and gasp for breath. However, these episodes are usually not remembered -- this is why sleep apnea is such an issue. It keeps you from getting good, restful sleep, but you aren't really aware of it. All you know is that you are always somewhat tired during the day. By the way, for purposes of this post, we're talking about the most common type of sleep apnea, which is obstructive sleep apnea -- this is where your airways become blocked, narrowed, or too relaxed. There are another two types that are far less common: central sleep apnea, which is when your brain "forgets" to breathe, and complex sleep apnea, which is a combination of both. Here's a good page on the basic ins and outs of sleep apnea (3). It's estimated that 12 million Americans suffer from obstructive sleep apnea (4). These pages I've just pointed you to have a good discussion of symptoms and who is at risk, so I won't repeat them here, preferring to instead talk about treatment (as this is what I am asked about a lot).

The most common treatment for sleep apnea is a CPAP Machine (CPAP stands for Continuous Positive Airway Pressure), and is essentially a breathing mask and tube that one wears while they sleep. The mask is connected to a pump that pumps air into your mouth and nose as you sleep. Does that sound uncomfortable and/or unwieldy? Unfortunately, for many people, it is. I've found that some people stop using the CPAP machine after a while, as it's just too burdensome to continually use. There are other machines (BPAP, etc.) that also help regulate airflow, but the bottom line is, they are also an unwieldy mask and may not be the best solution if you find wearing such uncomfortable. (To be fair, however, CPAPs and the like do work well, and many people swear by them. If you have bad sleep apnea, they may be your only solution.)

Besides CPAPs and the like, there are other devices that many people with mild sleep apnea find much more comfortable than a mask (and less obtrusive). Your local dentist (hello!) can help you with an oral appliance that you wear while you sleep. These are like a mouth guard that you wear, which help keep your airways open. I wanted to mention this because a lot of people are unaware these exists (because CPAP is the first thing mentioned, usually).

Personally, I'm of the thought that you should probably try the most comfortable option first, and then move on from there. I'll admit that given a preference, I'd rather wear nothing than wear any oral device, but then again, I'd MUCH rather wear the oral device than be tired all day (and be more likely to get... well, almost anything. Like we established earlier, no sleep is not good).

There are generally two types of oral appliances (5): one that acts as a tongue retainer, and one that acts as a mandible reposition device. Within these two broad types are many different shapes and sizes. You should definitely discuss them with your dentist, because he or she can help you pick the best one for your mouth and situation.

In the end, if you think you have sleep apnea, reach out to your doctor and let he or she guide you through the process. To state the obvious pun, you'll sleep better.

Until next time, keep smiling.

1. http://www.med.wisc.edu/news-events/news/sleep-apnea-associated-with-higher-mortality-from-cancer/37687
2. http://www.mayoclinic.com/health/lack-of-sleep/AN02065
3. http://www.mayoclinic.com/health/sleep-apnea/DS00148/METHOD=print
4. http://www.sleepassociation.org/index.php?p=sleepapneapublic
5. http://www.aadsm.org/oralappliances.aspx

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