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Stress often contributes to a headache, but it can also come out of nowhere. Either way, it might seem like you are constantly battling a headache. We understand how frustrating and painful that can be, but it is important to understand more about your headache–it might be more than just a common ache.  Whether you suffer from a headache or a migraine, the underlying cause of your pain might be related to your temporomandibular joint (TMJ). Here are some steps you can take to reduce your risk as well as what treatment might help provide you relief from your pain. Eliminate these risk factors  To take steps to alleviate your headache, it is important to reduce the number of risk factors present. Some common causal factors might include: Supporting your bite.Improving sleeping habits.Avoiding certain smells.Drinking less or eliminating alcohol use.Increasing exercise and losing weight.Controlling teeth grinding.Avoiding yeast and preservatives in food.Improving posture. If you can eliminate some or all of these risk factors, you will be taking a big step in the right direction for eliminating your pain. Look to these treatment options First, we will need to determine the type of headache you are suffering from. Once we determine […]

We know that cutting calories and exercising can help you lose weight. But what about sleep? If you don’t get enough sleep, some people might have a harder time getting rid of excess body fat. When you want to lose weight, it is important to make sure you do not lose out on sleep during the week because there is no such thing as catching up on sleep during the weekend. Let’s take a closer look. The connection between sleep loss and obesity If you are suffering from sleep deprivation, it is linked to an increased risk of obesity. And as we mentioned above, inadequate sleep has been linked to difficulties with weight loss. Without sleep restriction, people typically got about seven hours of sleep each night. Those that had sleep restriction got about six hours of sleep during the week and about eight hours on the weekends.  If you are trying to lose weight, you should aim for about seven or eight hours of sleep each night. More sleep isn’t necessarily to lose weight. However, people who typically get less than this might want to begin to get more rest if they are overweight or obese. To learn more […]

Have you found that you suffer from headaches more often than you don’t? Sometimes headaches can be so disruptive that you lose out on some of your tasks that need to be accomplished for the day. If you do suffer from headaches, it is important to understand the underlying cause. But it is also important to visit your dentist because they can provide treatment options that can help relieve your pain. How can your dentist help? Tension headaches typically come from muscle strain that develops in the jaw and mouth. Your dentist can check to see if this strain is actually the result of a misalignment of your jaw, which would cause incorrect biting.  If your jaw or teeth are not aligned properly, it can lead to muscle strain that eventually causes headaches and painful migraines. Your dentist can recommend proper treatment to relieve your pain and improve your jaw alignment. Additionally, misalignment might be causing you to grind your teeth at night. This can cause you to wake up in the morning with a headache, which is never something you want to deal with when waking up.  Contact us at AZ Sleep and TMJ Solutions to learn more about […]

If you or someone you know has been diagnosed with sleep apnea, it is important to know the dangers of leaving it untreated. Sleep apnea occurs when your airway is momentarily blocked during sleep, leaving your breathing interrupted. Sleep is one of the most important parts of a healthy lifestyle, right up there with regular exercise and heart health!  Telltale signs of sleep apnea The most common type of sleep apnea is obstructive sleep apnea (OSA). This occurs when the airway is blocked. One of the most obvious signs is the snoring accompanied by the disease. This is often noticed by the partners of those with OSA. People with sleep apnea may notice unexplained fatigue and irritability. This is due to the interruptions in their sleep, preventing them from getting a full night’s rest.  These added obstacles in the day can be dangerous. These symptoms can affect a person’s driving, performance at work, and alertness in class. It is imperative to your life and others that once diagnosed with sleep apnea, you find the proper treatment that works best for you.  Risks along with sleep apnea Studies have shown that other life-threatening diseases are associated with sleep apnea. Diseases such […]

When you think of botox, your mind may go to plastic surgery and celebrities. However, botox is actually quite successful in reducing the pain of chronic migraines. This treatment is not for everyone, so it is important to discuss your options with a doctor before proceeding.  Who is eligible?  Botox injections are only available to those with chronic migraines, meaning people who have a headache 15 days or more per month. The more headaches per month, the more effective the botox injections will be. Patients must be 18 years or older to receive botox treatment. For anyone younger than 18, insurance companies may not pay for it.  How does Botox help migraines?  First, it is important to understand botox as a treatment. Botox is a form of botulinum toxin which is a neurotoxin. When this toxin is purified and used in tiny doses, it will effectively reduce muscle contractions for 3 months! This is a great thing to hear for those with chronic migraines.  When injected around the pain fibers that cause headaches, the botox will block the release of chemicals involved in pain transmission. Botox injections may take a couple times to become effective in preventing migraines, but once […]

If you are suffering from jaw pain or temporomandibular joint disorder (TMD), it can interrupt your daily life. However, there is another treatment option available that can help you find relief from your pain: prolotherapy. Let’s take a look at what prolotherapy is and how it can help relieve your jaw pain.  What is prolotherapy? Prolotherapy, also known as regenerative injection therapy, requires the use of an injection of a diluted dextrose solution into the jaw joint. In doing so, it helps to promote healing. In fact, research has shown that this technique can be used to reduce pain originating from inflamed jaw joints. It can also help stabilize joints that exhibit hypermobility.  Injections will typically be performed in one or both joints, depending on the pain and your condition. These injections are often repeated at two week, six week and three month intervals. Again, this will depend on your condition and the severity of the pain.  After prolotherapy Once your prolotherapy is complete, you may experience mild to moderate pain at the injection site for a couple of days after. This may be due to the activation of the immune system and the trigger of a reparative healing response.  […]

There are more than 200,000 cases of sleep apnea each year in the United States. Sleep apnea is a sleep disorder where the airway becomes blocked while you are asleep, causing your breathing to stop and start repeatedly. A good night’s sleep is essential to a healthy lifestyle, so we must ensure that it is uninterrupted and safe. Newfound research In a recent study conducted by Bradley Phillips, director of UGA’s Biomedical and Health Sciences Institute, researchers investigated the connection between Obstructive Sleep Apnea (OSA) and autoimmune diseases. An autoimmune disease occurs when the immune system accidentally attacks healthy cells. Some autoimmune diseases include rheumatoid arthritis, lupus, and multiple sclerosis. Unfortunately, these autoimmune diseases aren’t reversible, they are just something you have to learn to cope with. The correlation between sleep apnea and autoimmune diseases has been known for sometime, but the research hasn’t been strong enough to reach any conclusions. What the research shows Researchers began by looking at four different inflammatory cytokines, particularly cytokines that were higher in individuals with autoimmune disorders. With many different variables evaluated, the research showed that the cytokines in the airways treated for OSA were drastically different than the levels in those with […]

As more research is done, we learn more about other connections with sleep apnea. This shows that it is important to seek treatment for sleep apnea. The latest connection that researchers have uncovered is a link between dementia and sleep apnea. Here is what we know about the link between sleep apnea and dementia.  What is the link? Obstructive sleep apnea can lead to an increased risk of dementia. A study published in the Journal of Alzheimer’s Disease found that severe sleep apnea is linked to an increase in a protein called, “beta-amyloid.” This protein builds up on the walls of the arteries in the brain and increases the risk of dementia.  The researchers looked at 34 individuals with untreated sleep apnea and 12 who were asymptomatic for sleep disorders. For those with sleep apnea, there was a higher amyloid burden, poorer sleep efficiency and less time spent in stage N3 sleep, which is a regenerative period where your body heals and repairs itself. While more research is needed, this will allow us to explore in more detail the true implications of treating sleep apnea for reducing dementia risk.  Seek treatment for sleep apnea Knowing this connection means it is […]

This pandemic is causing a lot of stress and anxiety on everyone. However, that added stress has led to a significant rise in orofacial and jaw pain, as well as jaw clenching in the daytime and teeth grinding at nighttime.  Women are suffering more Research has found that women suffered more from jaw clenching and teeth grinding than men. In fact, those between the ages of 35 and 55 suffered the most. This shows that the distress felt by the middle generation is suffering the most because they are at home with young children, are missing the usual help from grandparents, worry about their elderly parents, face financial problems and are often required to work from home under trying conditions. The rise in jaw clenching and teeth grinding is due to the added stress that everyone is feeling, which means it is important to find ways to calm that added anxiety and stress. This can help to prevent further complications, such as temporomandibular joint disorder.  Focus on what you can control One way to overcome added stress is to focus on what you can control. For example, while you can’t control the impact of the COVID-19 pandemic, you can take […]

We continue to learn new information about COVID-19 as we navigate this pandemic. While things remain unknown, we have learned that people with COVID-19 and obstructive sleep apnea (OSA) may be at an increased risk for complications, according to a study published in Sleep Medicine Reviews.  What the study found In this study, researchers looked through databases through June 2020. They searched for papers that included data on COVID-19 and sleep disorders. What they found were 18 studies that looked at both pieces.  These studies examined comorbidities that are associated with poorer COVID-19 outcomes, including diabetes, hypertension, lung diseases and cardiovascular diseases. Those conditions led to higher instance rates among patients with OSA.  Two studies also found that more than 20% of patients in the ICU for COVID-19 also had sleep apnea. In fact, one study found that individuals with OSA and diabetes had an increased risk for death on day seven. We understand that is alarming, but what can help is seeking treatment not only for conditions like diabetes and hypertension, but sleep apnea as well. Treating sleep apnea The most common treatment for OSA is the continuous positive airway pressure, or CPAP therapy. However, CPAP therapy is an […]

The short answer is, “Yes.” When you vape, it does impact your sleep, and not in a good way. There seems to be an ongoing battle between health and use of electronic cigarettes. But all signs point to the negative impact that vaping has on a person’s health, extending to sleep.  Understanding e-cigs Teenagers and adults find electronic cigarettes to be all the rage these days. Many have chosen vaping as a way to quit. However, most still continue to use e-cigs long after they decided they wanted to quit smoking. Unfortunately, though, many believe that they are inhaling lower levels of nicotine, making it safer. It is not. Anyway you look at electronic cigarettes, vaping is not good for you and it should be avoided. While lower nicotine levels might seem good, the nicotine is still in your system, which can lead to negative outcomes.  How is it connected with sleep? There still remains a lack of research around the nicotine delivery system of e-cigarettes. Additionally, there is also a lack of regulation of the ignition components and the nicotine-infused liquids that are heated to create the smoke or “vape.”  One possible effect is on your sleep. In a […]

We continue to learn more and more every day about COVID-19. As new information becomes available, we encourage you to visit the Centers for Disease Control and Prevention’s (CDC) website to remain up-to-date on important COVID-19 information.  While people of any age can catch SARS-CoV-2, the virus that causes COVID-19, certain medical conditions increase your risk for severe illness. Let’s take a look. These medical conditions increase risk for severe illness Regardless of your age, if you have one of the following medical conditions, you are at an increased risk of severe illness from COVID-19, according to the CDC: Cancer. Chronic kidney disease. Chronic obstructive pulmonary disease. Immunocompromised state (weakened immune system) from solid organ transplant. Obesity (body mass index [BMI] of 30 or higher). Serious heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies. Sickle cell disease. Type 2 diabetes. What is important to note is that several of these conditions also increase your risk of developing sleep apnea: obesity, type 2 diabetes and heart conditions.  Who else might be at risk? Because COVID-19 is a new disease, we do not know everything. However, there is speculation from researchers and the medical community that people with the […]

This is an important question to ask. During the COVID-19 pandemic, there has been a lot of new information emerging on a daily basis. We want to make sure you have all the up-to-date and important information regarding your health and well-being as a patient with sleep apnea.  From stay-at-home orders to mask mandates across the country, it can be confusing and stressful to understand what is allowed and what is not. We completely understand that and hope we can help ease your fears during these unprecedented times. We are all still on high alert due to COVID-19, but we also need to pay attention to your health and current conditions, such as sleep apnea. If you do have a sleep apnea diagnosis, here are some things to keep in mind to continue to protect yourself and manage your condition. Address feelings of anxiety As the pandemic continues, it is vital for patients with sleep apnea to continue their treatment–whether it is with CPAP or an oral appliance. However, it is also key to pay attention to your anxiety. So many people are experiencing heightened anxiety about the pandemic, which can add to sleep troubles.  Additionally, if you are worried […]

Each night you slip into your pajamas and perform your nightly routine–whether you realize it or not. Then you hop into bed and snuggle up with your blankets. But is there such a thing as sleeping with too many blankets? There might be. It’s time to rethink adding that third or fourth blanket on top. This has a lot to do with being too warm as you fall asleep. While you don’t have to go to bed shivering, your body still prepares itself for sleep by cooling down. But if you have too many blankets on, in an already warm room, your body will have a hard time cooling you down, which will interrupt your sleep. To help, here are some recommendations you can follow. Keep your bedroom door open Many people sleep with their bedroom door closed. However, if you sleep with the door open it can improve your sleep. People who sleep with the door open have a better and longer night’s sleep than those who sleep with the door closed because it allows for improved ventilation.  Reconsider a hot shower before bed Another way to regulate your temperature is to rethink that pre-bed shower. If you take […]

If you are someone who sleeps with the TV on, you’re not alone. A National Sleep Foundation poll found that 60% of Americans watch TV right before bed, and according to an LG Electronics survey, 61% of Americans fall asleep with the TV on. Some people swear by it, others find it to be a complete and utter disturbance! So what’s the verdict on sleeping with the TV on?  Why do some need the TV?  For some, having the TV on in the bedroom can be comparable to a child who can’t sleep without their favorite blanket. The TV becomes a necessity for falling asleep because our bodies grow attached to it. People who suffer from insomnia often watch TV to divert their constant thoughts to something that is easy to digest and therefore allows their bodies to drift off to a heavy slumber. Without the TV, their mind would wander and wander all night long.  Others have simply formed a habit with the light or sound of the TV. Some children use the TV as a night light so they can rest easy knowing the monsters under the bed will stay put. Adults who have fallen asleep with the […]

June 2020 is migraine awareness month! Over 38 million people in the United States suffer from migraines. Migraines are not your typical headache, they are much more debilitating and excruciating. In order to understand the importance of awareness, let’s dig a little deeper into the root of migraines!  What exactly is a migraine? Migraines are commonly known as intense headaches with a sensitivity to light. Varying in pain levels, some people live with chronic migraines while others suffer from a migraine on occasion. Regardless of the frequency, migraines are no joke. The pain associated with a migraine is indescribable, as everyone’s tolerance is different.  There are many theories as to why a migraine happens in the first place. With a direct cause unknown, most research leads to an over-activity or an abnormal activity of brain cells and waves. This leads to miscommunication among the nerves, resulting in a migraine.  Do migraines have triggers? Some people know what causes their migraines, which is extremely helpful! They know to avoid certain triggers to prevent a migraine from setting in. For example, certain foods, drinks, hormone changes or emotional settings are known to trigger migraines. It varies for everyone, but extreme stress can […]

Temporomandibular joint disorder (TMD) affects over 10 million Americans, causing pain and dysfunction in the jaw–specifically the temporomandibular joint (TMJ). This disorder is associated with jaw clicking, lockjaw, pain while eating or swallowing, and inflammation throughout the jaw bone causing headaches. It is quite the painful disorder, with many Americans looking for a solution that fits their situation best. One option that has popped up recently is estrogen for TMD pain. Understanding estrogen In recent studies, it has become apparent that women are at a higher risk for TMD, specifically during their reproductive years. This is a relatively new discovery, but it is a discovery worth exploring further. Without getting too technical, understanding the role of estrogen in relation to TMD can be quite complex to understand. As many of us know, estrogen is the female hormone whereas testosterone is the male hormone. Though men and women possess both hormones, men are built with more testosterone, while women are built with more estrogen. It’s just part of what makes humans unique!   What role does estrogen play in TMD? Unfortunately, an abundance of estrogen can play a big role in the inflammation aspect of TMD. Estrogen is made up of two […]

Sleep is one of the most fundamental aspects of a healthy lifestyle. Without it, your days can drag, your work can suffer, and your relationships will be grasping for attention. I understand, getting a good night’s sleep is easier said than done, we lead busy lives! However, with these simple tips and tricks, your days of counting sheep will be over.  Stick to a strict schedule/ritual It is important to try to establish a schedule for your body to follow on a regular basis. If you’re constantly on a roller coaster of sleep patterns, your body will never recognize when it’s time to go to bed for the evening. Take note of what time you seem to go to bed the most, and then make that time your designated “bedtime.” This may seem childish, but your body craves routine.  Create a bedtime ritual to keep things simple. For example, if you want to be asleep by 10 p.m., start your bedtime ritual by 9 p.m. Brush your teeth, wash your face, get your pajamas on, get into bed, and let your body relax. If you make this an everyday occurrence, your body will know what to do and when to […]

Have you noticed an increase in headaches? Is your standard Ibuprofen or Tylenol just not cutting it anymore? There may be an underlying issue that your dentist can help you resolve. Your headache pain may be stemming from something called temporomandibular joint disorder.  Temporomandibular Joint Disorder described Commonly referred to as TMD, this disorder can be quite painful. It may start off as a small clicking, which can sometimes go unnoticed. Eventually, the pain will become so pronounced, and you might even experience a locking sensation in your jaw. Take note of what causes the most pain, as your doctor will need all the details to make an informed diagnosis. Sometimes a simple toothache or sinus infection can disguise itself as TMD, so it’s important to take the necessary steps to determine the actual cause of your pain. Headaches are often debilitating, so getting this disorder under control as quickly as possible is crucial.  How do my teeth affect my head?  It may seem silly to think that your chewing can be related to your recurring headaches, but it’s quite common! The temporomandibular joint is a small yet very important part of your facial structure. This joint is responsible for […]

Who knew that we had fat in our tongues? It is definitely not a well-known fact among the general public, but it has become a topic of conversation in recent studies. Understanding the symptoms and causes of a larger tongue can help to determine whether or not it is affecting your sleep schedule negatively.  Where does this stem from? Obesity has been linked to sleep apnea, and typically people who have been diagnosed with obesity tend to have larger tongues. Thus, creating a restricted airflow while sleeping. With a larger tongue, the back of the throat is not as open as it should be. This causes people to stop breathing in their sleep, a condition known as sleep apnea. Sleep apnea is treatable, but if the problem lies in the size of your tongue, there may be different ways to fix your sleep apnea altogether.  How can you slim down the fat in your tongue?  Weight loss in general is difficult, so it’s hard to imagine cutting down the weight in your tongue. Seems humanly impossible, in some cases! There are no weights to lift to train your tongue and no aerobic exercises to keep your tongue slim and toned, […]

If you are experiencing pain that is interrupting your daily activities, there is a solution to treat temporomandibular joint (TMJ) disorder (TMD). And if your symptoms are not interrupting your daily schedule, and your pain can be described as a one or three on a ten-point scale, then you can also use self-care to help manage your pain. To help you better understand how to treat TMD, we have included some self-care options and professional treatments.  Hot and cold packs. An ice pack or cold compress applied to the affected area for 10 to 15 minutes will reduce swelling and inflammation. Moist heat applied to the area between 10 to 15 minutes can also improve circulation to the area and reduce pain. Facial stretching exercises. A doctor or physical therapist or may recommend stretches that can help reduce tension in the jaw. Perform prescribed exercises as directed to stretch the muscles of the jaw and relieve unnecessary muscle tension. Eat small and soft food. When foods don’t require much chewing due to small size or soft texture, such as soup, scrambled eggs, yogurt, beans and cooked, diced fruits and vegetables, will be easier to eat than foods that are hard, […]

We know that loud snoring can lead to bad jokes and middle of the night elbow jabs. These are two things we don’t want to experience. But it is important to know that snoring is no laughing matter. Loud, disruptive snoring can place a strain on relationships. However, it may also signal obstructive sleep apnea, which can lead to high blood pressure, heart attack, type 2 diabetes and even cause car accidents. Whether you snore or have been diagnosed with sleep apnea, it is important to understand the history behind this condition and what treatment is available. What is the history of sleep apnea? Do you know how many people in the U.S. suffer from sleep apnea? About 22 million adults. To make matters worse, about 80% of the cases of moderate or severe obstructive sleep apnea are undiagnosed. That means the majority of the people with sleep apnea don’t even know they have this condition. And when they are unaware, it can continue to add to the development of other  health conditions. It is important to receive the best treatment possible. Treating sleep apnea is important to find relief and live a healthier, happier life. After all, the amount […]

Have you ever woken up feeling like you didn’t have a wink of sleep last night? We’ve all been there before–probably numerous times throughout our lifetime. Our sleep habits have a significant impact on how well we sleep every night. If you are able to maintain a regular schedule while also avoiding behavior that promotes sleep disruption, you can minimize insomnia, allow for an adequate amount of sleep, and reduce sleep-related headaches. Ready to take charge of your sleep patterns in order to help you wake up feeling refreshed? Let’s take a look at a few tips that will help you create a healthy sleep regimen: Tired? Go to Bed!  When it comes to sleep, go to be when you are sleepy and not any earlier. If you attempt to go to bed before you are tired you will promote lying awake in bed, which can teach the brain to be awake in bed. And when you wake up refreshed, get up. Don’t linger in bed for too long.  It is also important to try to wake up at the same time every day, seven days a week. By maintaining a regular wake up time it will help you fall […]

The month of June was set aside as National Aphasia Awareness Month, which means making sure your patients are staying on top of their health by treating sleep apnea and other symptoms in prevention of stroke. As you are aware, stroke is the number five cause of death and the leading cause of disability in the United States. A stroke can have a variety of communication effects, one of which is aphasia. Stroke is the most common cause of aphasia, which is a language disorder that affects the ability to communicate.  Raise Awareness for Aphasia With June at an end, we can still continue to raise awareness for both stroke and aphasia. June was set as National Aphasia Awareness Month to help increase public education around this language disorder and to recognize the numerous people who are currently living with or caring for people with aphasia. The American Heart Association/American Stroke Association continues to increase awareness for aphasia by sharing communication tips, the effects of having aphasia, assistive devices for those with aphasia and more.  A Connection with Sleep Apnea Heart disease is the leading cause of death for men and women. But what you may not realize is that […]

Many people who can’t sleep will wonder if they suffer from some sort of sleeping disorder. Occurring in many people, sleep disorders prevent or limit sleep, which can lead to disruptions in daily behavior patterns while hindering a person’s ability to work. Restless leg syndrome, which is a sleep disorder that involves the nervous system and causes an urge to move your legs, affects approximately 10% of the U.S. population. Since this usually interferes with sleep, it is considered a sleep disorder. What are the symptoms of restless leg syndrome? If you suffer from restless leg syndrome, you might experience the following symptoms: Uncomfortable sensations in their legs. Irresistible urge to move their legs and relieve the sensations. Restless leg syndrome often feels like uncomfortable itchy, pins and needle sensations in the legs. These sensations are typically worse while at rest, especially while lying or sitting with symptoms worse in the evening and at night. As a result, the lack of sleep can hinder a person’s day-to-day life. Contact AZ Sleep & TMJ Solutions in Scottsdale, AZ for more information on restless leg syndrome and other sleep disorders, including sleep apnea. By getting to the bottom of your sleep problems, […]

The American Academy of Dental Sleep Medicine (AADSM) has stated that oral appliance therapy is a recommended form of treatment for adults with obstructive sleep apnea (OSA) who are CPAP intolerant or prefer an alternative therapy options. While CPAP therapy is still the first-line option for treating OSA, oral appliance therapy is an effective alternative that is preferred by many patients. Despite the fact that treatment with a CPAP machine is extremely successful, there are a number of patients who cannot or choose not to wear the facemask with the attached air compressor. When patients are CPAP non-compliant, oral appliance therapy can be a good option. What are the benefits of oral appliance therapy? One of the leading benefits of oral appliance therapy is the increased mobility. Oral appliance therapy is extremely convenient and comfortable. Imagine traveling with a CPAP machine. Where do you store it? Do you have to pay extra for a carry-on? We understand that you need an option that is less intrusive, which is where an oral appliance comes into the picture. Oral appliances come in handy when it comes to the need for mobility. Overall, these devices tend to be more economical and are generally […]

Sleep apnea causes restless nights of sleep and exhaustion during the day, but did you know it can also affect other areas of your health? It can. Not only does sleep apnea negatively affect your sleep, but also it can play a role in Acid Reflux and Impotence. Let’s take a look at two health conditions that you may not know are affected by sleep apnea. Gastroesophageal Reflux Disease (GERD) (Acid Reflux). Many people who suffer from sleep apnea or nasal problems are unaware that they also suffer from reflux. And, many times, you might be experiencing the symptoms, but not knowing what it is. If you suffer from GERD, you might be more likely to experience reflux symptoms during periods of wakefulness at night. By waking up frequently, your lower esophageal sphincter relaxes and when you are awakened by an apnea episode, the event could trigger your reflux. Through treatment of sleep apnea, you can further decrease the incidence of GERD just as treatment of GERD can decrease your symptoms of sleep apnea. Impotence. Waking up exhausted might seem like enough of a problem, but you may have to watch out for something else—impotence (erectile dysfunction). You may be […]