The Surprising Truth about Mouth Taping

There have been several articles floating around recently regarding mouth taping before going to sleep. Several of them have expressed alarm about the practice, which is understandable. But what might surprise you is that, as a leading sleep clinic, we actually endorse mouth taping as a short-term remedy for those suffering from obstructive sleep apnea.

Mouth taping is exactly what it sounds like: you tape your mouth shut before going to sleep. (We recommend a small strip of tape vertically from upper lip to lower lip. The idea is that it forces you to breathe through your nose during the night, thereby bypassing the mouth completely. It’s obviously a first step, and a very short-term step, to addressing sleep issues. It’s not something you can realistically do long-term, it’s not really an option for those suffering from allergies or nasal congestion, and most of all, it does nothing to address the underlying issues if you’re suffering from obstructive sleep apnea. But it does offer some very real up-front benefits:

  • It’s a simple test to see if you have sleep apnea. If you live alone and are uncertain as to whether you’re suffering from chronic snoring, try mouth taping for a night or two and see how you feel in the morning. If you feel more rested, then you may have a strong case of sleep apnea.
  • It’s cheap, and readily available. A decent CPAP machine will probably cost $1,000. The NightLase is well within reach for most people, even without insurance. But pretty much every remedy from the medical community is going to be more expensive than a $5 roll of tape and a couple of minutes in front of a mirror.
  • It’s an exceptionally fast remedy. Every meaningful treatment for sleep apnea can’t be implemented overnight. If you want to get a CPAP machine, you still have to get a doctor’s prescription. Even the laser treatment for snoring that we offer – which really does produce immediate results for the overwhelming majority of patients – still takes time to implement. (After all, you do have to come to the clinic!) But if it’s 10pm, and you’re desperate to get to sleep right now, mouth taping may be the only real option at your disposal.

Obviously, it needs to be done carefully. Use the wrong tape, and you could cause some serious skin irritation. (It’s one reason that some people can’t use CPAP machines.) And as stated above, it isn’t any kind of long-term solution. But in a pinch, it will do the job if you need a good night’s sleep ASAP.

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It has long been known that getting good sleep is invaluable to your overall health. Poor sleep has been connected to a range of other health problems, such as glaucoma. However, disrupted sleep has now been directly connected to heart disease.

The American Heart Association has added sleep to a list of factors considered essential to heart health. Previously it was accepted that poor sleep influences behaviors that can impact cardiovascular fitness, particularly around diet and exercise. (If you aren’t sleeping well you’ll start craving junk food, and it’s harder to go do some cardio if you haven’t been sleeping through the night.)

But this latest change on the part of the AHA goes beyond, and says sleep is a factor that has a direct impact on cardiovascular health for a few reasons:

  • Interrupted sleep patterns leave you at greater risk of developing hypertension, Type 2 diabetes and obesity which can all contribute to heart disease.
  • Deep sleep allows the body to go into a sort of “rest and recharge” state where circadian rhythms can be reset, and helps maintain healthy hormone and metabolism levels. In addition, the nervous system can dial down and rest, which can help keep blood pressure lower during the day.
  • Deep sleep also appears to be highly correlated with lower arterial blockage, which is directly connected to heart disease. “In a study of nearly 4,000 middle-aged men and women, researchers found more atherosclerosis, a condition characterized by a buildup of fatty plaques in the arteries, in people who slept fewer than six hours a night than in those who got seven to eight hours. The scientists found increased amounts of plaque and in more locations in the participants whose sleep was most fragmented compared with other study participants.”

Bottom line: there are lots of very good reasons to get back to having a good night’s sleep. You can just add this to the list.

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It’s long been known that getting deep, restful sleep is critical to overall wellness; we’re previously mentioned it here and here. Now another study surfaces demonstrating how uninterrupted sleep is connected to a longer overall lifespan.

A joint study between Stanford University and the Danish Center for Sleep Medicine administered more than 13,000 polysomnography tests. PSGs gather a range of biometric data while an individual is asleep, including nasal pressure, breathing rate, oxygen levels and heart rate. They can also tell if an individual is in REM sleep. In particular, they looked at the number of times an individual’s sleep was disrupted during the night, which can be used to calculate the individual’s “sleep age,” or the amount of sleep they’re getting relative to their actual age.

Researchers found a clear correlation between the amount of sleep you get and your overall mortality rate. Individuals who have more hours of uninterrupted sleep tend to live longer. Specifically, people whose sleep age is ten years younger than their actual age – i.e. have fewer sleep disturbances – can live up to 8.7 years longer than their peers with similar health profiles.

However, this cuts both ways. People whose sleep age is ten years older than their actual age – i.e. people who have fewer hours of uninterrupted sleep – can reduce their life expectancy by the same number: 8.7 years.

Bottom line: getting sleep issues under control can help you stay alive.

Source: Reducing The Amount Of Disruptions To Your Sleep And Making Sure You Are Well-Rested Each Night Can Lower Your ‘Sleep Age’ – And Extend Your Life Up To 8.7 Years, Study Finds (Daily Mail)

Obstructive sleep apnea is associated with a number of other health problems, including heart disease, high blood pressure and diabetes.  Surprisingly, it’s also correlated with another health issue: glaucoma.  

Glaucoma is a general term referring to a collection of diseases that result in damage to the optic nerve.  It is marked by loss of peripheral vision and later central vision, and can result in blindness if left untreated.  One form of this is normal-tension glaucoma.  Like its more common sibling, open-angle glaucoma, NTG develops painlessly and slowly over time, but has a unique characteristic: it lacks elevated intraocular pressure, the classic sign of glaucoma.  

Sleep apnea leads to hypoxia, or decreased oxygen levels in the bloodstream.  If hypoxic episodes last long enough and occur with sufficient frequency, they can result in optic nerve damage.  In addition, apneic episodes are associated with a decrease in intraoptic pressure.  Add the two together, and you end up with a contributing factor to NTG.  

One of the problems of glaucoma is how long it can take to get diagnosed.  Because the onset of so many forms of glaucoma is so slow, it may go unnoticed until a great deal of irreversible vision loss has occurred.  Regular checkups with an ophthalmologist can determine if you’re experiencing glaucoma.  

In the meantime, if you’re suffering from sleep apnea, do something to address it.  As discussed here, it can lead to all kinds of serious health issues, and can even lead to an early grave.

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Tinnitus afflicts millions of Americans each year. It’s generally connected to some sort of underlying condition, such as age-related hearing loss or some sort of ear injury. However, many Americans may be unaware that it can be connected to TMJ disorder, and could potentially be at least partially reversed with the right treatment.

Tinnitus is phantom noise, generally described as some sort of ringing in the ears that the individual encounters even though no external noise is present. Tinnitus sufferers describe the noise in a variety of ways, including hissing, clicking, buzzing and more. It very much lives on a spectrum: it can occur in one or both ears, it can come and go, and it can vary from being a minor annoyance to being so intense that it interferes with the individual’s ability to hear external sound.

Many cases of tinnitus are symptomatic of hearing loss. The inner ear, or cochlea, has tiny hairs that move when sound waves enter the ear. That movement generates electrical signals that are passed through your nerve from your ear to your brain, and the brain interprets those electrical signals as sound. But if those hairs are bent or broken – which can happen with age or if you don’t wear proper hearing protection when being exposed to loud noise – they can pass along random electrical impulses to your brain, which will cause tinnitus.

However, temporomandibular joint disorder can also be the cause. The TMJ is the joint in your jaw on either side of your head directly in front of your ears, where the lower jawbone meets the skull. Because of its placement, it can cause a number of complications with the inner ear.

  • The chewing muscles are near some of the muscles that also insert into the inner ear, so any problems with those chewing muscles can be transmitted up by the inner ear and can manifest as tinnitus.
  • There can be a direct connection between the ligaments that attach the jaw to the skull and one of the hearing bones inside the middle ear. Since bone is an excellent conductor of sound, ligament issues related to the bones can also present as tinnitus.
  • TMD can create a number of nerve-related problems. And the nerves connecting to the TMJ have some level of connection with the nerves related to the auditory system. As a result, TMD-related nerve issues can pass electrical signals over to the inner ear as well, causing tinnitus.

To be clear, TMD may not be the sole cause of tinnitus. If a person is at risk of tinnitus due to age or pre-existing hearing damage, TMD may simply aggravate the condition. But even in these cases, treatment for TMD may reduce tinnitus, which itself could be a real improvement.

When diagnosed with sleep apnea, turning to a continuous positive airway machine is generally the first route some people take to getting back to a good night’s sleep. However, many people quickly discover that using a CPAP comes with a number of downsides that can range from being minor annoyances all the way to deal breakers as far as using a CPAP is concerned.

1. Wearing a mask overnight may not be feasible.

Using a CPAP means you have to wear a large respiratory mask overnight, and that comes with a number of complications. Many users report skin irritation, particularly around the nose. Getting the mask to fit properly – if there are any air leaks, the CPAP won’t work – can be challenging. Most of all, some people just can’t get used to wearing a mask overnight. Some users end up pulling it off in their sleep, and for a few unfortunate individuals suffering from claustrophobia or some level of PTSD, wearing a mask for eight hours straight is just not an option.

2. Forcing air into your lungs comes with a number of downsides.

By definition, a CPAP blows a continuous stream of air into the wearer’s airway. Many users end up feeling bloated when they wake up, and for some, that’s a bit much to tolerate. Experiencing severe dry mouth or dry, cracked nasal passages is also common, and these can also be issues that interrupt sleep.

3. A CPAP is a machine, which means that it carries a machine’s limitations and annoyances.

  • Noise. While most newer CPAP machines run in near silence, older machines can sometimes generate enough racket that they ironically keep the user from getting to sleep.
  • Dependence on electricity. Every CPAP has at least one non-negotiable requirement: access to a functional electrical outlet. If you ever lose power, you also lose the ability to sleep through the night.
  • Travel can become more complicated. Many CPAP machines are relatively bulky and can eat up a lot of luggage space (and can you imagine the nightmare of an airline damaging or losing your CPAP?). Compact, travel-friendly CPAP machines are available, but they’re not cheap. And as noted earlier, CPAP machines require electricity, which can impact where you choose to go on vacation (overnight campouts may be off the table).
  • Many users quickly learn to hate the reality of regular machine maintenance. The CPAP is by definition a respiratory device, which means that its cleanliness requirements are rather stringent: they have to be cleaned at least once a month to prevent germs and other contaminants from growing inside and infecting the user. In fact, many CPAP machines require such frequent maintenance that some users buy a second machine to make it easier to clean.

Many folks are fine with using a CPAP machine to treat their sleep apnea systems and it is still the best treatment option for the most severe cases of sleep apnea. Given how widespread the CPAP has become, the machine is not going away anytime soon. But as with any treatment, it’s important to be aware of the limitations and side effects and that there are other less intrusive options available.

Sudden infant death syndrome is a nightmare for parents who have experienced it. Also known as crib death, roughly 3,400 babies die from SIDS annually in the U.S. alone – making up 37% of sudden unexpected infant deaths – and researchers have long struggled to understand what drives it and how it might be more effectively prevented.

Since it usually occurs when a baby is sleeping, SIDS is closely connected to pediatric obstructive sleep apnea. In most cases of an apneic episode in both children and adults, when the body becomes sufficiently starved of oxygen, the person will at least partially awake, gasping for breath. But a few babies simply don’t wake up to breathe, and end up suffocating in their sleep.

Now scientists think they have identified a contributing factor. In a recent study, researchers compared blood samples from babies that dies from SIDS and other unknown causes to the blood of 655 babies in a control group. They found that the children who died from SIDS were deficient in an enzyme called butyrylcholinesterase (BChE). This particular enzyme is part of the autonomic system, which controls functions like blood pressure and breathing. Simple version: a shortage of this particular enzyme could make some babies predisposed to SIDS.

While experts welcomed the discovery, they’re also moving with an abundance of caution, saying that this is only one piece of the puzzle. There’s plenty more that can contribute to a baby’s susceptibility to SIDS, such as premature birth and exposure to tobacco smoke. In addition, it’s going to take time to develop a screening test for BChE in infants. But this breakthrough can, at a minimum, reassure parents who have lost children to SIDS that their baby’s death wasn’t their fault.

Researchers Pinpoint Important Biomarker for SIDS (Biospace.com)
Study Identifies Potential Biomarker for SIDS, But a Test For It Is a Long Way Off (CNN)

Many people are concerned with the health impacts of obstructive sleep apnea. And with good reason! Let’s look at some of the ways it can go beyond merely being a nuisance to actively send you to an early grave.

How Many People Each Year Die from Sleep Apnea?

First off, it’s highly unlikely that sleep apnea is the sole cause of death for an adult.  To put it another way: Can an adult suffer from a case of sleep apnea so extreme that he or she will actually asphyxiate in his or her sleep?  Answer: no.  However, can untreated sleep apnea be a contributing factor in death?  You bet. 

  • The American Sleep Apnea Association estimates that 38,000 die each year from heart disease complicated by sleep apnea.  
  • In 1988, a random sample of 1,522 men and women were given an overnight stay in a sleep lab to identify those with sleep apnea.  Eighteen years later, researchers checked back in with the participants.  The results were startling:
    • 19 percent of the participants with sleep apnea had already died, versus just four percent of the participants without sleep apnea.  
    • Of those with sleep apnea who had passed away, 42 percent were attributed to cardiovascular disease or stroke, versus 26 percent of deaths of participants without sleep apnea.  
    • According to the researchers, “(s)evere sleep apnea was associated with increased mortality whether or not participants experienced daytime sleepiness.”
  • A series of studies have demonstrated a clear correlation between sleep apnea and highly dangerous and deadly conditions:
    • 2007: Sleep apnea can increase the odds of heart attack or death by 30 percent over a period of four to five years.
    • 2010: Sleep apnea can increase the odds of a stroke by two or three times.  
    • 2013: OSA is linked to cardiovascular disease and arrhythmias, and is shown to increase the risk of nocturnal sudden cardiovascular death.  

Why is sleep apnea so closely related to so many deadly conditions?  When you stop breathing often enough during the night due to sleep apnea, you deprive yourself of enough oxygen that you develop ischemia, or tissue death due to lack of oxygen, in your heart and brain.  If it gets bad enough – and doesn’t take much – the result can be a stroke or a heart attack.  And if it happens at night, when nobody around you is likely to be awake to call for emergency assistance, death is substantially more likely.  

Bottom line?  If you’re suffering from sleep apnea, do something to address it.

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Personally, I still think that they should make multivitamins with cocoa!  Either way, don’t forget to take your vitamins!

https://www.medscape.com/viewarticle/962772

Pauline Anderson

November 11, 2021

Taking a daily multivitamin for 3 years is associated with a 60% slowing of cognitive aging, with the effects especially pronounced in patients with cardiovascular (CVD) disease, new research suggests.

In addition to testing the effect of a daily multivitamin on cognition the COSMOS-Mind study also examined the effect of cocoa flavanols, but showed no beneficial effect.

The findings “may have important public health implications, particularly for brain health, given the accessibility of multivitamins and minerals, and their low cost and safety,” said study investigator Laura D. Baker, PhD, professor, Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.

The findings were presented at the 14th Clinical Trials on Alzheimer’s Disease (CTAD) conference.

Placebo-Controlled Study

The study is a substudy of a large parent trial that compared the effects of cocoa extract (500 mg/day cocoa flavanols) and a standard multivitamin-mineral (MVM) to placebo on cardiovascular and cancer outcomes in more than 21,000 older participants.

COSMOS-Mind included 2262 adults aged 65 and over without dementia who underwent cognitive testing at baseline and annually for 3 years. The mean age at baseline was 73 years, and 40.4% were men. Most participants (88.7%) were non-Hispanic white and almost half (49.2%) had some post-college education.

All study groups were balanced with respect to demographics, CVD history, diabetes, depression, smoking status, alcohol intake, chocolate intake and prior multivitamin use. Baseline cognitive scores were also similar between study groups. Researchers had complete data on 77% of study participants.

The primary endpoint was the effect of cocoa extract (CE) vs placebo on Global Cognitive Function composite score. The secondary outcome was the effect of MVM vs placebo on global cognitive function.

Additional outcomes included the impact of supplements on executive function and memory and the treatment effects for prespecified subgroups, including subjects with a history of CVD.

Using a graph of change over time, Baker showed there was no effect of cocoa on global cognitive function (effect: 0.03; 95% CI, -0.02 to 0.08; P = .28). “We see the to-be-expected practice effects, but there’s no separation between the active and placebo groups,” she said.

It was a different story for MVM. Here, there was the same practice effect, but the graph showed the lines separated for global cognitive function composite score (effect: 0.07; 95% CI, 0.02 – 0.12; P = .007).

“We see a positive effect of multivitamins for the active group relative to placebo, peaking at 2 years and then remaining stable over time,” said Baker.

There were similar findings with MVM for the memory composite score, and the executive function composite score. “We have significance in all three, where the two lines do separate over and above the practice effects,” said Baker.

New Evidence

Investigators found a baseline history of CVD, including transient ischemic attack, congestive heart failure, coronary artery bypass graft, percutaneous transluminal coronary angioplasty, and stent, but not myocardial infarction or stroke as these were excluded in the parent trial because they affected the response to multivitamins.

As expected, those with CVD had lower cognitive scores at baseline. “But after an initial bump due to practice effect, at year 1, the cardiovascular disease history folks continue to benefit from multivitamins, whereas those who got placebo multivitamins continue to decline over time,” said Baker.

Based on information from a baseline scatter plot of cognitive function scores by age, the study’s modeling estimated the multivitamin treatment effect had a positive benefit of .028 standard deviations (SD) per year.

“Daily multivitamin-mineral supplementation appears to slow cognitive aging by 60% or by 1.8 years,” Baker added.

To date, the effect of MVM supplementation on cognition has been tested in only one large randomized clinical trial — the Physicians Health Study II. That study did not show an effect, but included only older male physicians — and cognitive testing began 2.5 years after randomization, said Baker.

“Our study provides new evidence that daily multivitamin supplementation may benefit cognitive function in older women and men, and the multivitamin effects may be more pronounced in participants with cardiovascular disease.”

For effects of multivitamins on Alzheimer’s disease prevalence and progression, “stay tuned,” Baker concluded.

Following the presentation, session co-chair Suzanne Schindler, MD, PhD, instructor, Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, said she and her colleagues “always check vitamin B12 levels” in patients with memory and cognitive difficulties and wondered if study subjects with a low level or deficiency of vitamin B12 benefited from the intervention.

“We are asking ourselves that as well,” said Baker.

“Some of this is a work in progress,” Baker added. “We still need to look at that more in-depth to understand whether it might be a mechanism for improvement. I think the results are still out on that topic.”

 

More information about the study itself can be found here:

https://clinicaltrials.gov/ct2/show/NCT03035201