Reviewing the high comorbidity of craniofacial pain (chronic face pain, temporomandibular disorders, and primary headaches) with obstructive sleep breathing disorders and obstructive sleep apnea (OSA);
Dr. Steven Olmos, Specialist in Dental Sleep Medicine at The London Sleep Centre Dubai, through his study recommends that, physicians treating OSA and dentists treating chronic pain be aware of the concurrent chronic pain that affects quality of sleep, so that proper reciprocal referrals can be made to optimize patient’s treatment.
Establishing the relationship, The London Sleep Centre highlighted that, patients with primary headaches and facial pain are at high risk for sleep breathing disorders and vice-versa. However the centre raises an important fact that, the high comorbidity of sleep breathing disorders and chronic face pain and primary headaches is not limited to adults. Children have the same or greater risk of these relationships. That’s why screening for chronic face and primary headaches and sleep breathing disorders should be performed for all patients seeking care for either set of disorders.
Studying the correlation between Obstructive Sleep Apnoea and several chronic pains; the centre mentions that bidirectional prevalence has become pretty evident over a number of case studies and period of time. Headaches for example, are the most prevalent neurological disorders and one of the most frequent symptoms reported in general practice. Its rates of up to 51% have been reported in children and adults alike. Migraine is another highly prevalent disorder, currently estimated to occur in 10–18% of the population worldwide. Dr. Steven Olmos advocates, “Sleep disorders occur disproportionately among idiopathic primary headaches (migraine, tension type and cluster) and other headache patterns (chronic daily headache, ‘awakening’ or morning headache) irrespective of diagnosis. It is best that all headache patients, particularly those with episodic migraine and tension-type headaches, undergo evaluation of sleep disorders.”
Similarly, musculoskeletal, joint, neck and back pain have been known to have a correlation with sleep disorders. Sleep related bruxism, teeth grinding and forward head posture; are some of the many symptoms and conditions that The London Sleep Centre suggests for expert medical attention.
Concluding the report, both Dr. Steven Olmos and Dr. Irshaad Ebrahim from the London Sleep Centre Dubai agree, “The comorbid relationships of pain, obstructed sleep breathing (OSA and UARS), nasal obstruction, frequent awakenings, and daytime fatigue are well documented. When patients come for respite from sleep disorder, their intake questionnaire should be inclusive for chronic pain (specifically craniofacial pain) and disturbed sleep related symptoms. Patients with primary headaches and facial pain are at high risk of sleep breathing disorders. Therefore, to decide line of treatment and optimise its outcome, sleep specialists need to perform a thorough know-how of unclear symptoms of several types of pain.”