Exercise & Sleep Apnea

Exercise & Sleep Apnea

Sleep apnea is a serious medical condition that affects the heart and how a person breaths during sleep. Symptoms of sleep apnea can range from loud snoring to excessive daytime sleepiness. There are a couple of types of treatment available to our patients, but recent studies have found that daily exercise can lower the severity of sleep apnea symptoms by about 25%.

Reducing the Danger with Exercise

Sleep apnea has been associated with various medical conditions, including high blood pressure and diabetes. It’s also linked to some cardiovascular problems, including:

  • Arrhythmias (fluttering heartbeat)
  • Heart attack
  • Stroke
  • Heart failure

Selecting a Treatment

The standard treatment for sleep apnea involves a bulky, invasive breathing device called a continuous positive airway pressure (CPAP) machine. CPAP machines and other sleep apnea treatment alternatives can be intolerable for some patients. Because of this, exercise can be a therapeutic alternative that is easy and inexpensive compared to the other options.

Dr. Simmons recommends a combination of a standard treatment option (e.g., CPAP, oral appliances, or upper airway surgery) and exercises even though it has been proven to decrease the severity of sleep apnea symptoms by 25%. Sleep apnea can, in the worst cases, cause death, so a mixture can significantly reduce the number of sleep apnea episodes a person has each night.

Also, it should be said that exercise refers to a workout program of brisk walking, jogging, running, and weight training, or a combination of one or more of these options. Christopher Kline, a postdoctoral scholar in the Department of Psychiatry at the University of Pittsburgh School of Sleep Medicine, noted that patients who were only introduced to daily stretching saw their breathing problems worsen.

Sleep Apnea: Advantages of Exercise

It’s well-known that being overweight is a risk factor for sleep apnea. Regular exercise will help you lose weight, but the advantages don’t end there. Other benefits of exercise include:

  • Increased sleep efficiency
  • Decreased symptom severity
  • Increased maximum oxygen consumption
  • Decreased daytime sleepiness

Dr. Simmons is Qualified

If you’re curious about sleep apnea, treatment options, or exercise, then we can help. Dr. Simmons is a qualified sleep dentist and will ensure you get the right diagnosis and treatment for your unique needs. Call our office at 818-300-0070 to schedule a consultation today. Additionally, you can fill out the submission form, and we’ll get back to you promptly.

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Getting the Most out of Your Sleep Study

Getting the Most out of Your Sleep Study

According to the American Sleep Apnea Association, approximately one in five Americans report having sleep-related problems. One of the most common sleep disorders is sleep apnea, which is a serious medical issue that increases your chances of suffering from a dangerous stroke, heart attack, or other medical problems.

No one is immune from sleep apnea — this is an issue that affects men and women of all ages and backgrounds. Common symptoms of sleep apnea include heavy snoring, restless sleep, and feeling tired or irritable during the day.

If you think you might be suffering from sleep apnea, Dr. Simmons will make sure you get the correct diagnosis and the care that’s right for you. Dr. Simmons will begin by examining your airway and asking you some questions about the quality of sleep you’ve been getting.

What’s a Sleep Study?

The next step in diagnosing sleep apnea is getting a sleep study. Also known as a PSG (short for polysomnogram), a sleep study provides detailed information about what’s occurring in your body while you sleep. A sleep study is performed overnight at a sleep center or hospital. It’s also possible to take your sleep study at home using a portable device.

During your sleep study, the technicians will apply electrodes—small metal discs with wires attached—to parts of your body that need to be monitored. The electrodes check a number of factors, including brainwave activity, heartbeat, muscle tone, leg movements, breathing patterns, and the oxygen level in your blood.

Tips to Prepare for Your Overnight Sleep Study

In the time leading up to your sleep study, there are a few conditions that can affect the precision of your results. For example, if you show up to your sleep study with wet or styled hair, it can taint the collected data. We recommend showering beforehand, but make sure to dry your hair fully before you arrive.

Another task that could enhance your results is to record your sleep schedule in a “sleep diary.” You should aim for about two-weeks of recorded data. The information you’ll be collecting is the time you went to bed, when you woke up, when or if you woke momentarily, and what you ate/drank prior to sleeping. This information can be extremely important, as it sheds additional light on the findings in the sleep study.

Other things to keep in mind while preparing for your sleep study include not taking a nap and avoiding caffeine prior to your appointment. These can both make falling asleep more difficult, and this can skew your results. It might help to walk or work out before your test as well. The goal here is to wear yourself out, so you can sleep as comfortably as possible, creating the best conditions for accurate results.

What You Should and Shouldn’t Bring

During your sleep study, it’s important to be as comfortable as you can. Besides your state-issued identification card and insurance card, there are a few other items you’ll want to bring to make your stay much more enjoyable including:

  • Comfortable pajamas
  • A change of clothing
  • Usual toiletries (toothbrush, toothpaste, floss, face wash, etc.)
  • Favorite pillow/blanket
  • Books/magazines, glasses—any other passive activities like crossword puzzles
  • Eye mask, ear plugs, white noise machines are all allowed, as long as they are your routine sleep aids
  • Any medication you take is fine, but bring a list so your doctor can review it

One item you don’t want to bring is any backlit device. The blue spectrum light emitted interferes with the production of melatonin, a hormone that helps regulate sleep. Signals from electronic devices like these can also interfere with the data that’s collected. Another reason to avoid these electronics during your sleep study is that they make noises that can be disruptive to other patients.

Getting the Help You Deserve

If you or someone you care about is struggling to get the sleep they need, contact Dr. Michael Simmons at the Encino Center for Sleep & TMJ Disorders today. He and his delightful staff will make sure you get the right diagnosis and the care you deserve.

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Does Sleep Apnea Affect Pregnancy?

What Are the Signs of Sleep Apnea During Pregnancy?

Loud snoring is usually what people associate sleep apnea with, but not all snorers have it. Partners have noted that the other partner sounds like they are choking or gasping breathlessly in their sleep.

Another sign of sleep apnea is waking up feeling restless and fatigued. This can be difficult to spot during pregnancy due to the natural stress on your body while carrying a child. If you find that you can’t regularly stay awake in the afternoons or dozing off while driving, then please contact Dr. Simmons today.

Other symptoms you may experience if you suffer from this sleeping condition include waking up with a headache or dry mouth, nighttime heartburn, and frequent urination. Evidently, these signs can also be associated with pregnancy, but if you’ve noticed these are ongoing patterns, it doesn’t hurt to contact our Encino sleep dentist with any questions or concerns.

How Sleep Apnea Affects Your Expected Child

Untreated sleep apnea during pregnancy has been found to be associated with gestational hypertension, diabetes, and unplanned Caesarean sections. It may also lead to fetal growth restrictions and prolonged labor. Women severely affected by sleep apnea may develop obesity hypoventilation syndrome, which happens when severely overweight people fail to breathe rapidly enough. This will result in low blood sugar levels and high blood carbon dioxide levels, which can be harmful to you and your baby.

Fortunately, we offer proper treatment plans that help increase your chances of having a healthy baby.

How to Treat Pregnancy-Related Sleep Apnea?

Treating sleep apnea is especially important during pregnancy due to the effects it has on the mother and fetus. The industry standard of treatment is known as Continuous Positive Airway Pressure (CPAP), but there are alternative options for those who can’t adjust to their CPAP machine.

One useful tip to help mitigate the adverse effects of sleep apnea while pregnant is to have the mother sleep on her side. This method of positional therapy will prevent her from snoring and lower the chances of her sleep apnea condition from arising.

According to the National Institute of Health, about half of the people with sleep apnea are overweight. If the patient is substantially bigger or is having twins (triplets, quadruplets, etc.), then the use of a BiPAP (Bilevel Positive Airway Pressure) machine may be more suitable. The pressure applied from these machines will need to be altered as the pregnancy progresses and weight is gained.

In extreme cases, the use of surgical procedures, such as a tracheostomy will be required in order to make sure the mother and child are getting the amount of oxygen they need. However, no kind of surgery is preferred as a treatment option because of the risk of adverse outcomes.

Sleep Better for You and Your Child

If you want to learn more about snoring and sleep apnea treatments appropriate during pregnancy, please call (818) 300-0070 for an appointment with our sleep dentist, Dr. Michael Simmons, at the Encino Center for Sleep & TMJ Disorders.

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How Your Snoring Affects the Person You’re Sleeping With


A lot of people snore, and it’s common for snorers to report that it bothers the people close to them. This is particularly true for spouses and sleep partners who share a bed with someone who snores loudly on a regular basis.

Snoring can put a great deal of stress on a relationship. Sleep mates frequently complain that they’re losing sleep due to their partner’s snoring and this leads to resentment and arguments.

The tension caused by snoring can damage intimacy in a relationship, turning the bedroom into a battleground.

How Snoring Affects Your Sleep Partner’s Health

In addition to putting a strain on your relationship, snoring can also damage your partner’s health. That’s because getting a good night’s sleep is essential to your physical wellbeing. In fact, people who lose sleep on a regular basis due to their partner’s snoring can suffer from the same types of harmful consequences as people who have sleep apnea.

The daytime effects of sleep deprivation are significant. That’s why sleep partners of heavy snorers often feel tired, lethargic, or cranky during the day. Missing out on sleep makes them more susceptible to anxiety and depression as well as impaired memory and reduced intellectual function.

The medical risks of losing sleep are even more alarming. Sleeplessness leaves you more vulnerable to heart disease, strokes, weight gain, and diabetes. It can also diminish your libido.

Snoring Hurts Your Partner’s Quality of Life

Many times spouses or sleep mates don’t realize how much their partner’s snoring is affecting them until they spend some time apart. Some sleep doctors even recommend that partners take a “sleep vacation” by sleeping separately for a few weeks.

Sleep mates often discover that they feel a lot happier and healthier after spending some time sleeping apart. What’s more, studies indicate that after patients have received effective treatment for their snoring, “the spouses’ quality-of-life scores jumped significantly.”

Relief for People Who Snore

Dr. Simmons is a highly experienced sleep dentist. We feature a number of effective treatments for both snoring and sleep apnea, including our small and convenient oral appliances. Call 818-300-0070 today and find out how we can help you.


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How do I know if I have sleep apnea?

How do I know if I have sleep apnea?

Monday, October 23rd, 2017

Sleep apnea – defined as frequently interrupted breathing while you sleep – is just one of the major sleep problems you can have, along with others like insomnia, circadian rhythm problems, movement disorders during sleep and others. But apnea is one of the most common complaints, and one of the most serious.

So how do you know if you have apnea?

Here are a few clues:

  • Do you snore frequently, and loudly enough that it can be heard in another room?
  • Are you a child and you snore?
  • Are you pregnant and you snore?
  • Do you wake up gasping for air?
  • Are you sleepy during the day?

Gasping for air when you wake is a particularly serious clue. That means you’re actually waking up to breathe, and that interruption in your sleep cycle is probably happening over and over again during the night.

Sleepiness, on the other hand, can be deceptive. First, be honest about how much you’re sleeping each night. Everyone gets tired, and sometimes you simply didn’t get enough sleep on a particular night and you’re feeling the effects. In that case, getting sleepy in the afternoon is absolutely normal. But if you’re consistently getting eight or ten hours and you’re still exhausted throughout the day, something is going on. Unfortunately, even people with serious sleep apnea are often so busy, so engaged in their daytime activities, that they don’t report being sleepy at all. They don’t notice it, or they’re used to it. But that doesn’t mean the problem doesn’t exist.

Is any snoring benign?

It can be. The problem is, we don’t know exactly what “benign snoring” is. Certainly if you only snore when you sleep after drinking alcohol, or after taking muscle relaxers, or when you’re exhausted from stress or an especially long day, that’s not as problematic. But if you’re snoring every night, and loudly enough that someone in another room can hear you, that’s a problem.

It isn’t about a single symptom or one bad weekend. It’s about an ongoing pattern of sleep disturbance, and a cluster of indications. Certainly loud snoring or lapses in breathing are a strong clue, but you’re allowed to stop breathing every once in a while. You can have apnea events up to almost 5 times an hour and still be considered normal. But if it’s more frequent or more severe than that – if it’s consistently bothering you – it’s time to visit our offices for a full assessment.

There are many alternatives to CPAP available, and a lot of good reasons to deal with apnea as soon as you notice it’s there.

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The Comorbidities of Sleep Apnea

The Comorbidities of Sleep Apnea

Monday, October 2nd, 2017

Sleep apnea is fascinating because there are so many comorbidities associated with it. If that’s a new word to you, no worries: A “comorbidity” is a medical term; it means the presence of a second (or third or fourth) chronic disease or condition in a patient who already has one chronic condition. Sadly, a number of chronic conditions tend to cluster together. They seem to run in packs.

So if you have sleep apnea … what other conditions or disease are most likely to be present?

Number One: Hypertension

Chronically high blood pressure, or hypertension, is the most common comorbidity associated with sleep apnea. In fact, there is an actual cause-and-effect relationship, meaning that sleep apnea actually causes hypertension. There’s more than enough evidence to make that bold statement.

How does that happen? The mechanism is straightforward. When you go to sleep and you have a sleep apneic event – when your breathing is interrupted by an obstruction in your mouth or throat – your oxygen level drops. When your oxygen level drops, your body screams out and forces you to wake up enough to breathe. During that distress, there is damage being done, a little at a time, to all the blood vessels in your body. The endothelium—the layer of tissue inside your blood vessels, no thicker than one cell—responds to the lower oxygen levels and a cascade of events occur, including the development of plaque; plaque is what leads to high blood pressure.  Once that distress is relieved – when you start to breathe again – that plaque doesn’t go away. Even though the amount of damage that’s done with each apneic event, each interruption, is very small, it occurs every time you have an event. And the effect builds up.

Then there’s the rest of the hit parade:

There are many other comorbidities related to sleep apnea, though none with the same demonstrated level of cause and effect. Those include:

  • Insulin resistance
  • Glucose intolerance
  • Diabetes
  • Heart disease
  • Impotence in men
  • Some cancers
  • Stroke

… In fact, strokes are associated not only with sleep apnea, but simply with snoring alone. Any one (or more) of these comorbidities is serious, some even life-threatening, and the presence, or even the risk, of any one of them should be enough to get you to your medical caregivers, and into our office for an assessment and consultation concerning your sleep apnea.

There’s really no reason to wait –

Time really is an important factor. The longer your sleep apnea goes untreated, the more damage is being done, and the greater the risk to your health, or even your life. Please don’t wait for a medical emergency, like a stroke or a heart attack, before you deal with the management of your sleep apnea. It’s far better to treat it and even prevent it – and its comorbidities – in advance, rather than waiting until after the damage is done.

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Why Do I Specialize In Sleep Disorders?

Why do I specialize in sleep disorders?

Friday, August 4th 2017

Over the years, I have treated many patients and helped with the great many challenges people face. One issue I constantly confront in patients is sleep disorders. It has become a major focus of my practice.

So many people I helped didn’t know why they were feeling so poorly. Sometimes they knew they weren’t sleeping well, but they didn’t know why; others couldn’t figure out what their problem was at all. I began to look into it, and because I was in a teaching institution at the time, I was around a lot of pioneers in the field, people who made big differences in people’s lives in the areas of facial pain and dysfunction. And two things became very clear: Sleep disorders in general, and sleep apnea in particular, was a major problem for many of my patients. And even more important, I came to realize, oral appliances are very effective in treating sleep apnea.

This was an important discovery on my part. It was important because at the time – and for many, even now – the most common, most conservative therapy for sleep apnea is not an appliance, but a face mask tethered to a breathing machine, and it was very clear that most people didn’t tolerate it very well. In fact, long-term studies showed that only about a quarter of the people who were prescribed these breathing machines, regardless of their design, used them for a long period of time. Often it was as little as a day, a week or two, or a month. Some even persisted for a year, but truthfully, very few patients, regardless of the severity of their apnea, kept using the devices at all, and oftentimes those who did persist in trying CPAP would remove the machine during sleep, or pull off the nose piece or the full face mask, reducing or eliminating the therapeutic value of the process. So their problems remained untreated.

I decided years ago that oral appliances were another approach to the treatment of sleep apnea that had great potential, and since then I’ve dedicated my time and my practice to providing that alternative, as well as conducting research and teaching others about this approach. Over the years, I’m proud to say I’ve helped thousands of men and women deal with their sleep disorders and live healthier, happier lives. Choosing this specialty was one of the best decisions I ever made.

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How can I tell if I’m a good candidate for a mouthpiece?

How can I tell if I’m a good candidate for a mouthpiece?

Thursday, July 20th, 2017

I truly believe that the properly made and maintained mouthpiece (called an oral appliance) can help most patients, at almost any age, with apnea, snoring, obstructive sleep apnea, and more than occasionally for insomnia. But how can you tell if you are a candidate for this particular treatment?

As with many other things in life, timing is important. Have you just completed any major orthodontic procedure? This is a major factor. If it’s been over a year since you’ve completed orthodontics and the position and strength of your teeth have stabilized, then you may be ready.

Additionally, ask yourself if you’re ready for the long-term commitment to health. Though the process is usually only weeks long, your personal involvement is essential. For instance, when you begin using a mouthpiece that brings your jaw forward, there can be some shifting of your teeth and your jaw; in fact, your jaw joint can actually remodel slightly, and your teeth may not bite in exactly the right place. To address this issue, we provide you with a “morning positioner” that can help you make sure your teeth and jaw are going back into position, and we’ll teach you how to use that positioner properly. Still, it’s up to you to stay on top of this process between visits and follow-ups to our offices, and to let us know if there’s a change, so we can address it quickly.

You need to be willing to follow up with us as well. If you have a mouthpiece and you don’t stay in touch with your dentist, your bite could change and you wouldn’t know it until your next visit … and so that visit should be soon and regular.

Dental oral appliances to treat sleep disorders have great potential. But it’s important to know when to get them, how to use them, and how to maintain them and use them properly. And regular contact and follow-up with Dr. Simmons and the Encino Center for Sleep and TMJ Disorders is important to ensure the best outcome.

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