Chronic Fatigue Syndrome

Chronic fatigue is far more than just feeling tired. It’s a condition characterized by severe fatigue lasting six months or longer that does not have an obvious cause. Those with chronic fatigue syndrome may experience a group of symptoms, including:


  • Fatigue that interferes with daily activities
  • Poor memory and concentration
  • Headaches and muscle pain 


Many people diagnosed with chronic fatigue also frequently suffer from sleep disturbances, difficulty getting to sleep, or not feeling rested after sleeping. It’s a serious condition that, if left untreated, can negatively impact your productivity, your overall health, and your enjoyment of life.

What Causes Chronic Fatigue?

Often, people with chronic fatigue syndrome explain away their symptoms as “stress” or feeling “burned out” in life. The problem is that the symptoms of sleep disorders will continue even if you take the longest, most relaxing vacation imaginable!  


After many years of being misunderstood by family, friends and even doctors, some people with chronic fatigue syndrome are learning that the root of their problem is sleep apnea. In fact, recent studies are finding previously undiscovered connections between daytime sleepiness and sleep disorders. In one study, 46% of chronic fatigue patients suffered from obstructive sleep apnea. Other studies had similar results. 


If you have chronic fatigue syndrome with no other underlying medical conditions that your doctor can find, you should schedule a consultation with Dr. Maryam Seifi to see if obstructive sleep apnea is the cause. 

Medical Risks of Chronic Fatigue

Chronic fatigue syndrome doesn’t just mean you have to deal with excessive daytime sleepiness. Your body needs to rest, and it needs to enter the deep sleep phase in order to keep you healthy. Without good quality sleep, you can face more trouble than bags under your eyes and yawning all day. In fact, sleep disorders increase your risk of serious medical problems such as: 



  • High blood pressure
  • Diabetes
  • Heart attack or stroke
  • Heart failure
  • Heart disease


If you are suffering from chronic fatigue syndrome, you should schedule a consultation with Dr. Maryam Seifi to see if sleep apnea may be the cause.

Social and Professional Risks of Chronic Fatigue

Not only does chronic fatigue sleep apnea lead to increased risk of medical problems, but it can also negatively affect your social and professional life. Think about it: are you at your best when you’re exhausted? Definitely not! While chronic fatigue will affect your health and wellbeing the most, it can also affect your relationships with others. This is because people who deal with chronic fatigue tend to experience: 



  • More accidents at work
  • Forgetfulness
  • Impaired judgment
  • Poor job performance
  • Reduced sex drive
  • Weakened immune system
  • Increased weight gain
  • Depression or anxiety
  • Paranoia
  • Irritability and mood swings


Chronic fatigue can also cause you to miss out on important family events or social gatherings because you are simply too tired to muster up the will to attend. This social isolation can impact your relationships with your friends, family, and coworkers unless you get a handle on your excessive daytime sleepiness. 

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What Is Sleep Apnea?

Sleep apnea is a type of sleep disorder that causes you to periodically stop breathing when you are asleep. This can happen dozens of times each night—and each time it happens, your body wakes up to get the oxygen it needs to survive. Even if you don’t remember waking up multiple times per night, it can still interfere with the quality of your sleep.

Different Types of Sleep Apnea

There are three different types of sleep apnea that can range from mild to severe. In each of these types of sleep apnea, your body will jolt awake dozens of times per night because it isn’t getting the oxygen it needs to stay alive. But as soon as you go back to sleep, the problem happens again, which leads to poor sleep, reduced health, and chronic fatigue.

  • Obstructive Sleep Apnea

    The most common type of sleep apnea is called obstructive sleep apnea (OSA). This occurs when your muscles relax during sleep. In people with OSA, the throat muscles can relax too much and make the airway too narrow for you to breathe freely. The over-relaxation can also cause your tongue to fall back against your airway and suffocate you. 

  • Central Sleep Apnea

    With central sleep apnea (CSA), your body simply forgets to breathe. This can be caused in one of two ways:  either your brain does not send the signal to your lungs to stimulate breathing, or your lungs simply ignore this signal. Either way, the result is the same—waking up repeatedly throughout the night because you’re suffocating. 

  • Complex Sleep Apnea

    Complex sleep apnea is a combination of both OSA and CSA. It typically happens when a person receiving treatment for OSA suddenly develops CSA. In other words, you’ve managed to keep your airway open, but your body is now struggling to regulate your breathing when you’re asleep. 

The Relationship Between Chronic Fatigue Syndrome and Sleep Apnea

While chronic fatigue syndrome and sleep apnea are not the same condition, it’s an interesting fact that chronic fatigue is one of the most noticeable symptoms of sleep apnea. The reason for this is simple: you need several hours of deep, uninterrupted sleep to feel well-rested and ready to face the day. 


With sleep apnea, your body startles you awake multiple times each night because it can’t breathe. As a consequence, you don’t get that deep and restful sleep you need for your overall health and wellbeing. You’ll start to notice that, over time, you feel like you have less and less energy no matter how much sleep you get—in other words, chronic fatigue!


How Do I Know if I Have Sleep Apnea?

When it comes to sleep apnea, chronic fatigue syndrome is not the only sign you could have a sleep disorder. If you have one or more of the following symptoms, you should schedule a consultation with Dr. Maryam Seifi to see if sleep apnea is the cause of your chronic fatigue syndrome: 


  • Chronic fatigue syndrome
  • Loud snoring when you sleep
  • Headaches in the morning
  • Inability to fall asleep or stay asleep
  • Exhaustion after physical or mental activity
  • Sleep interrupted by gasping or choking multiple times per night 
  • Sudden short temper or irritability
  • Depression or anxiety
  • Difficulty concentrating during the day
  • Unusually low sex drive
  • High blood pressure 
  • High cholesterol levels 
  • High blood sugar 

Is There Any Way to Prevent Sleep Apnea?

Not only can sleep apnea cause chronic fatigue syndrome, but it can increase your risk of other troubling medical issues the longer you delay treatment. The good news is that there are steps you can take at home to reduce your risk of developing sleep apnea or lessen the severity of your symptoms if you have already been diagnosed with sleep apnea. 

  • Maintain an Active Lifestyle

    Obesity is one of the main risk factors associated with sleep apnea. This is because excess fat on your body (especially around your neck) can make it much more difficult for you to breathe when you lie down. This is because the added pressure on your neck from that weight can lead to airway obstruction. 


    Improving your diet and exercise routine can reduce your risk of developing sleep apnea and help you get a great night’s sleep! And even if you are at a healthy weight, you can still greatly improve your heart health and quality of sleep by eating nutritious foods and implementing exercise time in your daily routine. 

  • Watch What You Put in Your Body

    Smoking, drinking alcohol to excess, and using opioid medications can all increase your risk of developing sleep apnea. Smoking can cause inflammation and swelling in your nose and throat, which makes your airway smaller and increases the risk of an obstruction while you sleep. 


    Drinking alcohol and using opioids both cause your muscles to relax, but if they relax too much, your airway can get obstructed. What makes alcohol and opioid use even more dangerous is that both increase your arousal threshold, or how easy it is for you to wake up. An increased arousal threshold means that you won’t be able to wake up as fast when your body starts to suffocate, which increases your risk of developing the medical complications that follow sleep apnea. 

  • Visit Your Dentist Regularly


    This may sound strange at first because your dentist is a tooth doctor, not a sleep doctor. But what many people don’t realize is that your dentist can see the signs and risk factors of sleep apnea in your examination. These can include: 



        Worn down enamel from tooth grinding

        A small airway or jaws

        Improper jaw alignment

        Redness in your throat from snoring



    As a sleep apnea dentist, Dr. Maryam Seifi is experienced in recognizing the symptoms of sleep apnea in her patients. While she cannot give you an official diagnosis, she can tell you the likelihood that sleep apnea is causing your chronic fatigue syndrome. If she thinks it’s necessary, Dr. Seifi will refer you to a sleep specialist to get an official diagnosis and begin your sleep apnea treatment right away.

Sleep Apnea Treatment Options

If sleep apnea is the cause of your chronic fatigue syndrome, there are several different treatment options available. The right treatment for your needs will depend on the type of sleep apnea you have. 

A continuous positive airway pressure (CPAP) machine is one of the most common treatments for moderate to severe obstructive sleep apnea. A CPAP machine exerts continuous pressure through your airway while you sleep via a face mask. This helps to ensure your airway stays unobstructed during sleep. 


Some people find CPAP machines to be too loud, or the masks too uncomfortable to wear while sleeping. However, many people are able to successfully improve their sleep and decrease their obstructive sleep apnea symptoms using this machine. 

A bilevel positive airway pressure (BiPAP) machine is another common method of treating severe obstructive sleep apnea and central sleep apnea. Instead of using one continuous level of pressure like a CPAP machine, a BiPAP machine fluctuates between two amounts of pressure: one for when you inhale, and one for when you exhale. 


Just like a CPAP machine, a BiPAP machine can be too noisy and requires you to wear a mask while you sleep, which can be uncomfortable for some. However, many people have successfully improved the quality of their sleep by using a BiPAP machine to treat their sleep apnea symptoms. 

There are different surgical procedures that can help relieve severe obstructive sleep apnea symptoms. One involves removing tissue from your mouth and throat to widen your airway and reduce the risk of obstruction while you sleep. Another involves surgically altering the shape and position of your jaw to increase the size of your airway. 


While surgery can be an effective treatment option, some people are wary of the cost, the long recovery time, and the risk of complications like infections post-treatment. 

Oral appliances look similar to retainers, but instead of aligning your teeth, they align your jaws. Since obstructive sleep apnea is caused by too little space in your mouth, wearing an oral appliance to bed can correct this by shifting your lower jaw forward. This gives your tongue the room it needs and prevents your airway from getting obstructed when you sleep. 


Dr. Maryam Seifi recommends the Vivos system of oral appliances to treat sleep apnea in her patients. This is because it is an FDA-approved, nonsurgical treatment for obstructive sleep apnea that not only relieves the symptoms of your sleep apnea, but it can completely handle the cause of your sleep apnea in 12-24 months. And the best part is, it’s not a lifelong treatment like airway pressure machines. Once you finish your treatment with the Vivos system, you’ll be able to sleep without using the oral appliance!

Sleep Apnea Treatment in North Bethesda, MD

Dr. Maryam Seifi at Breath of Life Dental (BOLD) is a strong advocate for oral appliance therapy to treat sleep apnea in both adults and children. This is because she has seen firsthand how powerful and life changing this treatment is for patients in her care. When you see Dr. Seifi for a sleep apnea treatment consultation, she will help you find the best oral appliance for your health and comfort. 


Our dental office in North Bethesda, MD offers the following types of oral appliances to manage and treat sleep apnea symptoms: 

The Vivos System


Dr. Seifi highly recommends the Vivos System of sleep apnea oral appliances because it is a comfortable, nonsurgical, proven treatment for sleep apnea. This incredible new technology is FDA-approved for the treatment of sleep apnea in both children and adults. When you use the Vivos System and follow Dr. Seifi’s treatment plan, you can reduce or even completely handle your sleep apnea symptoms. 


Depending on the results of your consultation, Dr. Seifi may recommend one of two different Vivos oral appliances: 


  • The Daytime-Nighttime Appliance (DNA), which expands your hard palate and reshapes your jaw to increase the size of your airway.

  • The Mandibular Repositioning Ni    ghttime Appliance (mRNA), which reshapes and shifts the position of your lower jaw to increase the size of your airway.


Sleep Apnea Mouth Guards


If you’ve tried a CPAP or BiPAP machine and found them too noisy or uncomfortable, come see Dr. Seifi about a sleep apnea mouth guard. These are simple oral appliances that look like sports mouth guards. However, instead of protecting your teeth from impact, they instead shift your lower jaw forward while you sleep to increase the size of your airway. 


We offer a variety of different sleep apnea mouth guards at our dental office in North Bethesda, MD, so you can find the one you like best. Schedule your consultation with Dr. Seifi today to get the good night’s sleep you deserve!

Can the Vivos Appliance Help You?

Call our office to reserve a seat at our next educational seminar or request a personal consultation with Dr. Maryam Seifi. Call (301) 818-2653 , email info@breathoflifeteam.com or submit an online request .

Frequently Asked Questions

Still have questions about chronic fatigue syndrome? Check out some common questions and answers below. If your question isn’t answered here, call us at (301) 818-2653 to schedule a consultation with Dr. Seifi to get the information you need.

  • Is sleep apnea the only thing that can cause chronic fatigue syndrome?

    While sleep disorders can definitely cause chronic fatigue, there are other underlying medical conditions that can lead to this syndrome, including but not limited to: 


    • Anemia
    • Vitamin deficiencies
    • Eating disorders
    • Autoimmune disorders
    • Hormonal imbalances
    • Cardiovascular issues
    • Viral or bacterial infections

    If you’ve seen a qualified doctor who ruled out these underlying medical conditions and you still have chronic fatigue, you should schedule a consultation with Dr. Seifi to see if sleep apnea may be causing your symptoms. 

  • How do I know if it’s chronic fatigue or regular tiredness?

    Fatigue is a much stronger word than “tired.” You feel tired when you stay up too late or have a hard day at work. But with fatigue, you barely have the energy or motivation to do anything at all—and you don’t know why. Plus, with fatigue, resting or sleeping doesn’t help to relieve that exhaustion. It’s called chronic fatigue because it lasts for a long time, usually six months or longer. 


    If you’ve tried improving your lifestyle habits like going to bed on time, eating healthier, and getting routine exercise but you still feel fatigued, you should schedule an appointment with your primary care physician to rule out any underlying health conditions that may be causing your symptoms. 

  • What can I do to try to handle my fatigue?

    In addition to scheduling your consultation with Dr. Seifi to see if sleep apnea is causing your chronic fatigue, there are other steps you can take to hopefully lessen the severity of your symptoms: 


    1. Exercise regularly, but don’t overexert yourself. Too much or too difficult exercise can worsen your fatigue. Try taking a daily walk around your home or work to stay active without overdoing it. 
    2. Eat nutritious foods. A diet with a healthy mix of protein, complex carbohydrates, and vitamins will help ensure your body has the fuel it needs to stay energized. Try to avoid sugary foods and drinks because these can quickly sap your energy. 
    3. Take steps to reduce your stress levels. Stress can lead to trouble relaxing and sleeping, which can further lead to chronic fatigue. Try regular exercise, massages, or other relaxing activities to lower your stress levels. 
    4. Follow a healthy bedtime routine. Many people stay up in bed playing on their phones or watching TV, but the blue light from these screens can trick your brain into thinking it’s day time when it’s night time. This will make it much more difficult for you to fall asleep. Try to avoid screen time for at least an hour before bed and use blue-light filters on your phone and computer after sunset. 

  • How is chronic fatigue syndrome diagnosed?

    To get an official diagnosis of chronic fatigue syndrome, you will need to see a qualified medical doctor. They will want to know about any other symptoms you may be experiencing relating to your fatigue. The general criteria for diagnosis is twofold: 


    1. Other medical conditions that can cause fatigue have been ruled out.
    2. Your chronic fatigue has lasted for 6 months or longer.

    To rule out other medical conditions, your doctor will likely perform a variety of diagnostic tests (such as blood or urine tests) to ensure your body is otherwise healthy. 

  • How is chronic fatigue syndrome usually treated?

    Chronic fatigue is usually managed as much as possible by treating the underlying medical condition. For example, if your chronic fatigue syndrome is caused by a vitamin deficiency, your doctor may recommend you take vitamin supplements. If your chronic fatigue syndrome is caused by sleep apnea, then handling the sleep apnea will help treat the chronic fatigue.  

  • What are the symptoms of sleep apnea in children?

    Children with sleep apnea can have all the same symptoms as adults. But children have their own unique symptoms that often get misdiagnosed as behavioral issues, bad manners, learning disabilities, or other problems. In addition to gasping/choking during sleep or chronic fatigue, children can experience other sleep apnea symptoms like: 


    • Bedwetting
    • Chronic illness
    • Poor academic performance
    • Trouble focusing or solving problems
    • Poor memory
    • Stunted growth
    • Behavioral problems

    Many of these symptoms are simply a result of not getting enough deep, restful sleep at night. If your child is showing any of these symptoms, schedule a consultation with Dr. Seifi today to see if sleep apnea might be the cause.