At the TMJ and Sleep Therapy Centre of London, Ontario, Dr. David Rawson and his staff are trained and practice with the concept of trying to separate if a patient has one condition or two. The bulk of what he's known for is TMJ, or temporomandibular joint, disorders, where patients come in with jaw pain, clicking jaw and jaws that don't work well.
The connection in Dr. Rawson's mind is if they're in chronic pain because of a malfunctioning joint or two and they're unaware of it, they're going to wear out their energy throughout the day. They're going to go to bed in an unrested state and probably won't be able to relax enough to get a good night's sleep. He says that they may sleep but they'll toss and turn all night and wake up exhausted, not knowing one fed into the other.
Dr. Rawson says that the practice of sleep therapy by dentists is challenging in Ontario because of the medical system there. Sleep apnea is a medical condition that legally and technically has to be diagnosed by a medical professional, he says. A medical doctor would typically refer a patient for a sleep study, usually done in a hospital setting or private medical facility, where the patient is monitored while they sleep.
Patients that are identified with moderate to severe sleep apnea are prescribed a CPAP (continuous positive airway pressure) device, which is a large mask. Quite often, Dr. Rawson says, there is very little follow up after that.
Dr. Rawson says that unless the factors leading up to a sleep issue, such as increased weight, increased medications and increased neck size have been removed, it's not likely the could get a good night sleep without a CPAP or oral appliance.