Cycles of Sleep
The same BOTOX that smooths facial wrinkles also prevents the muscle contractions that can trigger migraines.
BOTOX, highly diluted botulinium toxin, works to prevent migraine by blocking the release of a chemical in muscle cells that transmits the signal to contract to muscle fibers. Research into using BOTOX to treat migraines began after patients receiving it for other conditions reported improvement in their migraine symptoms. In 2010, after years of research and collecting clinical data, the FDA approved BOTOX for treating chronic migraines.
BOTOX is administered about every three months, relaxing the surrounding muscles so that they won’t compress the nerve and trigger a migraine. It is a potent drug, and we only recommend using it if other preventative treatment options haven’t helped you. It is generally only administered to patients who have at least 14 headaches a month, or don’t respond to other treatments.
You can now decrease teeth grinding (Bruxism) with BOTOX. Bite splints worn at night can protect the teeth and TM joints from the intensity of grinding at night. However, BOTOX injection into specific muscles has been shown to decrease the intensity itself, thus reducing pain.
TRIGGER POINT TREATMENT
Trigger points are focal, hyperirritable spots located in a taut band of skeletal muscle. These knots produce pain locally and in a referred pattern. Acute trauma or repetitive microtrauma may lead to the development of stress on muscle fibers and the formation of trigger points. Trigger points may lead to face, neck and shoulder pain, tension headache, tinnitus, and temporomandibular joint pain. Palpation of the trigger point will elicit pain directly over the affected area and/or cause radiation of pain toward a zone of reference and a local twitch response. Trigger point injections using a combination of Botox and local anesthetic have been shown to be one of the most effective treatment modalities to inactivate trigger points and provide prompt relief of symptoms.
This describes the stages and cycles of sleep. There are two main categories of sleep:
1. Non-Rapid Eye Movement (NREM)
2. Rapid Eye Movement (REM)
Non Rapid Eye Movement (NREM)
- Transitional Phase - Between wakefulness and sleep. This lasts for one to seven minutes and is 5% of the total sleep time.
- Light Sleep Phase - This is 50% of the total sleep time.
- Slow Wave Phase (Delta Phase) - A deeper and more relaxed sleep associated with 20% of the total sleep time.
Rapid Eye Movement (REM)
This is a period of deep, refreshing sleep. Eyes move side to side and the skeletal muscles are nearly paralysed which results in a loss of muscle tone in the upper airway. This represents 25% of the total sleep time and is the stage where dreaming occurs.
Excessive Daytime Sleepiness (EDS)
People who suffer from obstructive sleep apnea have a fragmented sleep architecture which causes them to spend an excessive amount of time in the lighter stages of sleep at the expense of the Delta Phase and REM stage. This causes them to have excessive daytime sleepiness due to their lack of sleep at night.
Apnea and Hypoapnea
Apnea is defined as a period of cessation of breathing during sleep for ten seconds or longer. If the patient has more than five episodes of apnea per hour of sleep, this is considered clinically significant and helps confirm the diagnosis of obstructive sleep apnea. Hypoapnea occurs when the decrease in airflow results in a 4% decrease in oxyhemoglobin concentration in the blood.