Sleep Apnea Dentist, Arthur M. Strauss, DDS of Falls Church, VA
Special Interest in
the Dental Management of Snoring,
Obstructive Sleep Apnea and
Awake Related Oral Function Issues


Arthur M. Strauss, D.D.S.
Diplomate, American Board of Dental Sleep Medicine *

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Articles - Your Health Magazine, February 2009

Sleep Apnea and Impaired Breathing

Narrow throats prevalent in snoring, sleep apnea and impaired oral function require greater body effort and blood sugar to maintain adequate air flow. This puts a strain on the cardiovascular system as well as on blood sugar levels.

While awake, many people are not able to breathe, swallow and speak without having a forward head posture (FHP). FHP is a very basic body compensation that provides a more open throat, the tongue can shift back into the throat if it is not appropriately held in the mouth.

FHP is not just a head and neck concern. The body will tip forward from the lower back to create the FHP. Moving the upper body weight forward would leave us unstable unless the knees lock backward as the head and upper body come forward. All these posture compensations change the loading on knees, hips, feet, spine and other structures, often resulting in joint changes and pain.

While, healthy, neutral body position is balanced and requires minimal effort, postural breakdown requires more muscle activity and excessive muscle contraction that results in pain. “Impaired oral function” with apnea and body posture breakdown progress as we age. The body produces adrenalin to allow better and more rapid muscle contraction and creates “on edge feelings” that can increase and decrease with the muscular pain. These feelings are a fight or flight, survival response and not of psychological origin.

Increasing amounts of blood sugar are also needed to feed the muscle. It is not uncommon for blood sugar levels to be elevated to pre-diabetic levels or more. Combating elevated blood sugar levels through diet can reduce the ability of muscle to function well, including management of our breathing. As this occurs, people often will progressively feel worse and more on edge.

During sleep, postural compensations are less active. Decreasing levels of adrenaline allow for restful sleep. However, they lower muscle tone that is needed to prevent the tongue from dropping back and blocking the throat. Decreased caliper of the air-tube requires the muscles in the chest wall to work harder to force air through the small throat opening. This is often experienced as a feeling of chest pressure and will result in greater negative inner chest (intra-thoracic) pressure. Blood returning to the chest and heart must overcome this pressure and will return in large segments. The blood volume, with each pulse, will increase and the heart rate will then decrease.

Back pressure on the vascular system from the elevated chest muscle activity may also cause peripheral edema (fluid retention). The same mechanism can also be responsible for negative changes in blood pressure and heart disease.

The repetitive increases of adrenaline production in response to the tongue dropping back prevents us from obtaining or maintaining deeper, more restorative levels of sleep. This manifests in sleepy, tired periods and short term memory loss prevalent with sleep apnea. “Stress like feelings” coincide with the tongue relaxing into the throat, both day and night. I believe the adrenaline issue is most likely related to this and it not only manifests in hormonal and endocrine upsets, it also impacts every other body system.

Night time treatment alone does help; however, the benefit of managing these concerns, both day and night, is required for overall health. Oral Systemic Balance (OSB) Therapeutic Systems was developed by Doctor Farrand C. Robson and addresses both day and night time symptoms.

* Denotes a board certified Diplomate of the American Board of Dental Sleep Medicine (ABDSM). The board is self designated and does not confer recognized specialty status by any certifying organization. The American Academy of Sleep Medicine (AASM) recognizes the Diplomate status granted by the ABDSM. All Diplomate applicants must hold (at a minimum) a dental degree (D.D.S. or D.M.D.) or its equivalent and an active unrestricted license to practice dentistry in addition to completing an extensive application process, including presenting case studies and taking a written exam.

Arthur M. Strauss, D.D.S.

311 Park Avenue
Falls Church, VA 22046

Phone: 703-237-2350
Fax: 703-241-8414
Email: or

Office Hours

Tue, Wed, Fri: 9:00 am to 5:00 pm - Appointments
Monday - Friday: 9:00 am to 5:00 pm - Administration