Patient # 101 (face masked out for privacy) was referred to us by her physician.  She had been diagnosed with obstructive sleep apnea and was not able to tolerate CPAP therapy.  Her fatigue level was 45 out of 63 on the Fatigue Severity Scale. In addition, she was diabetic and was not able to keep her blood sugar under control.  She had high blood pressure which was well treated with medication.  She reported that she would normally awaken 4-5 times a night to go to the bathroom and also stated that she would vomit in the middle of the night most nights.  

To understand vomiting in the night better watch the following video. Notice how much effort the woman in this video is making to breath in air. This effort generates negative pressures within the abdominal cavity and the contents of the stomach can literally be sucked out of the stomach. This is why heart burn occurs commonly with sleep-related breathing disorders.  In our patient’s case, this phenomenon caused night time vomiting.

The first night using her oral appliance, she slept through the night without awakening to go to the bathroom and she did not vomit in her sleep.  Now, one month after using her oral appliance, her blood sugar is under control and her physician is reducing her diabetes medication.  To understand why there is a significant connection between her blood sugar and sleep go here.  In addition to having her diabetes medicine reduced, her physician is now reducing her medication for high blood pressure.  The change in her fatigue level is shown in the following chart:

Furthermore, with no change in her exercise schedule or food consumption, she is now, for the first time in years, loosing about a pound a week.