ON MENTAL ILLNESS: CPAP, Teeth, and Optometry

By Jack Bragen
Thursday April 25, 2013 - 03:50:00 PM

When one's brain is regularly deprived of oxygen, it can impair the thinking ability. This is one of the problems introduced by sleep apnea. 

Sleep apnea is a disorder in which people stop breathing while asleep. Sometimes, excessive weight can worsen breathing, and sometimes there is an obstruction in the airway. If one is dealing with an airway obstruction, sometimes a special dental piece can pull out the lower jaw to open up the airway and thus allow easier breathing. However, this may not work as well as using a CPAP machine. 

Persons with mental illness are probably more susceptible to this disorder because of the sedation of medication as well as our tendency to be overweight (also due to being medicated.) The deprivation of oxygen to the brain caused by sleep apnea can worsen symptoms of mental illness and can make medication less effective. Cigarette smoking can also worsen sleep apnea. 

Before I was on a CPAP, my writing had inexplicably gone downhill. When I had been on the CPAP for a little while, I reviewed some of my recently submitted pieces, and realized that my sleep apnea had probably been harming my brain function. 

Before starting CPAP treatment, I was heavily fatigued during the daytime, and I took a long nap in my chair nearly every afternoon. I was on 300 milligrams of Wellbutrin but was still depressed. 

My wife suggested we both do a sleep study. A few years beforehand, I had previously been diagnosed with severe sleep apnea, and I had been noncompliant with using the mask. This was because it scared me, and also I didn't want to be dependent on a machine. When I finally did the sleep study the second time, the doctor said my sleep apnea was bad enough that it could kill me in the not too distant future, and said that I needed to start on the machine immediately to avoid heart damage. I took this seriously. 

My wife was diagnosed with sleep apnea as well, and we were both put on machines. As it turned out, we both required BiPAP's. This is a setting on the machine in which the air pressure eases up on exhalation. 

After about a month on the sleep machine, it was apparent to others that I was doing better. I began to get things done about which I had procrastinated. My naps became less frequent. I began to think more clearly, and this was a boost to the quality of my writing and to the effectiveness of my meditation practices. 

** Persons with mental illness are more susceptible to tooth decay compared to people in general. Medications can cause dry mouth, which in turn is bad for teeth. It is harder for someone with mental illness to take care of their teeth, because, for someone with mental illness, everything is harder. 

Medi-Cal doesn't pay for dental checkups or any dental work other than emergency extractions. Persons with severe mental illness who also live on SSI are extremely unfortunate if they can't pay out of pocket for a preventative dental visit. 

Medicare will pay for a thorough Optometry exam but won't pay for glasses. Getting an eye exam is worth doing, since eye diseases can be detected. In some cases, getting an eye exam can uncover a problem with the brain, such as a tumor or stroke. An Optometry patient is normally screened for glaucoma and other retinal problems. If you need glasses, they are fairly inexpensive at Wal-Mart. (Wal-Mart might be considered an evil empire by many progressives-however, if you are living below the poverty line, there isn't much choice.)