Sleep apnea among military veterans

Claire Szewczyk discusses “the silent battleground”

When we think of our brave military veterans, we often visualize valiant soldiers fighting battles on distant shores. Yet, there’s another battle many veterans face at home, in the silence of the night — sleep apnea. Dental practices can provide a beacon of hope to our military heroes.

Sleep apnea is a medical condition where an individual stops breathing temporarily during sleep.¹ These interruptions can happen several times during the night and can lead to a range of health complications if left untreated.

While anyone can develop sleep apnea, our veterans have unique risk factors due to their service experiences. From exposure to certain environmental factors to the physical and emotional tolls of service, the brave men and women of our armed forces have distinct vulnerabilities to this sleeping disorder.

Understanding sleep apnea

Sleep apnea is characterized by repeated stops and starts in breathing during sleep.² These interruptions can range from a few seconds to more than a minute, usually followed by startling chokes or snorts upon resumption.

Types of sleep apnea

There are distinct variants of sleep apnea.

• Obstructive Sleep Apnea (OSA), the most prevalent form, occurs when the throat muscles intermittently relax and block the airway during sleep.
• Central Sleep Apnea (CSA) emerges when the brain doesn’t send the necessary signals to the muscles controlling breathing.
• Complex Sleep Apnea Syndrome (CSAS) or treatment-emergent central sleep apnea, is when OSA and central sleep apnea happen simultaneously.

Diagnosis

Sleep apnea’s detection usually involves a sleep study, or polysomnogram, that observes multiple body functions during sleep such as brain electrical activity, eye movement, and muscle activity. Some might undergo home sleep tests, where primary metrics like heart rate and oxygen levels are gauged.

Dental exams are an often-overlooked avenue for recognizing this condition.³ Dentists might spot symptoms, like teeth grinding or throat inflammation from pronounced snoring, hinting at sleep apnea. This underscores the importance of a dental sleep practice visit both for detection and potential treatment options.

Symptoms and health risks

Many symptoms and health risks are associated with sleep apnea. Some of the more common ones include:

Symptoms

• Loud snoring
• Gasping for air during sleep
• Waking up with a dry mouth or morning headache
• Sleep interruptions
• Daytime drowsiness
• Daytime focus difficulties

Health Risks

• • High blood pressure, and its complications⁴
  • Strokes
  • Heart issues
  • Diabetes
  • Metabolic syndrome to liver problems

Early detection can drastically influence a veteran’s quality of life.

The connection: military veterans and sleep apnea

Members of the military face a greater susceptibility to sleep apnea. They are frequently exposed to various environmental factors, unique stressors, and traumatic experiences. This cumulative effect, combined with physical injuries or the mental toll of combat, can indirectly or directly increase sleep apnea risk.

Post-traumatic stress disorder (PTSD) and sleep apnea

PTSD, prevalent among veterans, exhibits a substantial link with sleep apnea.⁵ PTSD doesn’t just harm one’s mental state; it also has physical implications. Stress-induced ailments or conditions like bruxism (teeth grinding) can escalate throat and airway inflammation. PTSD-induced nightmares and sleep disturbances can also exacerbate or even trigger sleep apnea episodes.

Common environmental factors

Military service often involves deployment in varied environments, each presenting its challenges. For instance, veterans stationed in desert climates might inhale fine sand particles, potentially causing respiratory issues or throat irritations. On the other hand, constant exposure to high altitudes or deep-sea environments might have long-term impacts on lung capacity and breathing patterns.

Dental sleep practice: a potential solution

As sleep apnea solutions, CPAP machines are a frequent choice. While effective for some, they aren’t for everyone. This is where dental sleep practices can offer specialized alternatives tailored to individual needs, especially for veterans.

The power of oral appliances

Oral appliances resemble mouthguards or orthodontic retainers and are custom-fitted to the user.⁶ By adjusting the jaw’s position slightly, these devices ensure that the airway remains unobstructed during sleep. They are particularly beneficial for those who:

• Find CPAP machines cumbersome or uncomfortable
• Travel frequently and require a more portable solution
• Have mild-to-moderate sleep apnea

For many veterans, the simplicity and non-intrusiveness of oral appliances make them a preferred option. The ease of maintenance and the ability to integrate them into existing dental routines make them even more appealing.

Personalized treatment

Every individual’s journey with sleep apnea is unique, especially among veterans with varied service experiences and resulting health conditions. Dental sleep practices focus on understanding these unique needs, providing treatment options that consider the whole person, not just the disorder.

Collaborative care

Often, tackling sleep apnea requires a combined approach. Dental sleep practices frequently collaborate with sleep physicians, ensuring a comprehensive treatment plan. From the initial sleep study to determine the sleep apnea’s severity to deciding the best intervention, this collaboration ensures that veterans receive the most effective care tailored to their circumstances.

Advocating for awareness

Veterans, given their service and sacrifices, deserve the best care. Dental sleep practices play a pivotal role not just in treatment but also in spreading awareness about the heightened risk of sleep apnea in the veteran community. By fostering understanding and offering tailored solutions, they ensure that our servicemen and servicewomen achieve the restful sleep they deserve.

Tips for veterans battling sleep apnea

Knowledge is power. The more veterans know about sleep apnea and its treatments, the better equipped they will be to address it.⁷ They should be encouraged to attend workshops, engage with support groups, or research reputable sources online to get a comprehensive understanding of the disorder.

Engage with VA resources

The Department of Veterans Affairs offers numerous resources tailored for veterans. From clinics that specialize in sleep disorders to educational programs, make sure that they are aware of these avenues to get the support they need.

Prioritize good sleep hygiene

Creating a routine that promotes good sleep can alleviate some symptoms of sleep apnea. This includes:

• Maintaining a regular sleep schedule.
• Keeping the bedroom dark, quiet, and at a comfortable temperature.
• Limiting screen time before bed.

Consider lifestyle changes

Certain habits can exacerbate sleep apnea symptoms. They should contact their health care provider to find out more about reducing their incidence of sleep apnea, including: reducing alcohol consumption, avoiding sedatives, quitting smoking, and maintaining a healthy weight to mitigate the disorder’s impact.

Stay consistent with treatment

Whether your patients are using an oral appliance, a CPAP machine, or another treatment option, consistency is key. Explain that compliance for their chosen treatment as recommended will help them to reap the full benefits.

While sleep apnea poses a significant challenge, especially among military veterans, there are numerous avenues available for mitigation. From the specialized care provided by dental sleep practices to lifestyle adjustments and leveraging VA resources, veterans have many options.

Tackling sleep apnea means not only improving the quality of their sleep but also enhancing their overall health and well-being. With the right resources and determination, it’s one that can certainly be won. It’s a battle worth fighting.