TMJ 'dysfunction' - Health implications

Obstructive sleep apnoea in MSers

Sleepiness, fatigue, and risk of obstructive sleep apnoea using the STOP-BANG questionnaire in multiple sclerosis: a pilot study.

PURPOSE: This study aims: (1) to identify MSers who are at high risk for obstructive sleep apnoea (OSA) by utilizing the STOP-BANG questionnaire and (2) to evaluate the relationship between OSA risk as determined by the STOP-BANG questionnaire and self-reported sleepiness and fatigue using the Epworth Sleepiness Scale (ESS) and the Fatigue Severity Scale (FSS), respectively.

METHODS: A total of 120 consecutive MSers presenting to the UC Davis Neurology MS Clinic were invited to participate in an anonymous survey. The exclusion criteria were: age <18 years, indefinite MS diagnosis, or incomplete survey.

RESULTS: There were 103 subjects included in our study: 42% of subjects (n = 43) met the criteria for high-risk OSA, 69% of subjects (n = 71) screened high for fatigue (FSS ≥ 4), but only 24 subjects (23%) screened high for excessive daytime sleepiness (ESS > 10). In males, 44% of the variation in ESS scores and 63% in FSS scores were explained by the STOP-BANG components. However, only 17% of the variation in ESS scores and 15% of the variation in FSS scores was explained by the STOP-BANG components in females.

CONCLUSIONS: Over 40% of MSers were identified as high risk for OSA based on the STOP-BANG questionnaire. The STOP-BANG questionnaire offers clinicians an efficient and objective tool for improving detection of OSA risk in MSers.

Comment:
One has to ponder what came first, the sleep apnoea or the MS.

Obstructive sleep apnoea (OSA) is the condition in which the patients' upper airway becomes temporarily blocked and causes the patient to wake-up frequently at night.

The subject of sleep apnoea is very extensive and needs a great deal of explanation. Adult sleep apnoea patients also risk serious heart problems if corrective measures are not taken. Heart medication to improve heart function is again treating the symptoms and not the cause. The child and the adult suffering under these circumstances wake up feeling unrefreshed and sometimes even more tired than when they went to bed.

The correct treatment is attention to the cranio dental and skeletal asymmetries, which normally also resolves the other symptoms of fatigue!

References: Sleep Breath. Dias RA, Hardin KA, Rose H, Agius MA, Apperson ML, Brass SD. 2012 Dec;16(4):1255-65. doi: 10.1007/s11325-011-0642-6. Epub 2012 Jan 21. Department of Pulmonary, Critical Care and Sleep Medicine, PSSB Bldg Rm 3400 4150 V Street, Sacramento, CA 95817, USA.

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