Obstructive sleep apnea affects around 20 million Americans and can lead to hypertension, heart attack, stroke, depression, muscle pain, fibromyalgia, morning headaches, and excessive daytime sleepiness.

Friday, August 13, 2010

Blog on problems with sleep apnea treatment.

Dr Shapira: Dear Angie: I understand your concerns about your sleep apnea treatment. I have been treating sleep apnea with oral appliances since 1982 and have been an Asst Professor at Rush Medical School and teach courses to Dentists learning about sleep apnea. I do not know if you are a good candidate for oral appliance therapy without an exam and review of your sleep study.

Oral appliances are very successful in treating mild to moderate sleep apnea and are frequently successful with severe sleep apnea. It is possible to have bite changes and/or tooth movement but it is rarely a serious problem.

Weekend courses are limiting especially because many are from appliance manufacturers primarily wanting to sell their appliance. Having multiple appliances is essential to treat different types of problems. I always do a full year of follow-up with doctors who take my course because a weekend course is insufficient.

Sleep Apnea is a TMJ disorder according to the NHLBI (http://www.nhlbi.nih.gov/meetings/workshops/tmj_wksp.pdf)

The AASM and AADSM recommend that dentists treating sleep apnea should be knowledable in treating TMJ disorders. It is a relatively small percentage of patients who experience problems usually from to rapid of an advancement of the mandible or poor appliance design.

Christy: Hello Angie I understand your concerns. I am forwarding this email to Dr. Shapira. He has been successfully treating sleep apnea and TMJ disorders over 25 years. He can best address your concerns.
I hope you are able to find a dental sleep specialist in your area but if not we would be happy to have you come to our office to be treated. We see many people for all around the country with similar problems.
Keep Smiling

Angie: Your reply is appreciated, but I did find this one on my own a while ago. I just didn't know how legitimate he is in including clenching and TMJ problems into his appliance. That concern comes from me going to xxxxxxxxx to another dentist (Dr. xxxxxxx) and it was a waste of my time because, although he claims to help with apnea and snoring, his appliance will not. He seems to be a regular dentist who took a couple of weekend seminars in Chicago and now tries to claim he can treat apnea. That's where my mistrust comes from.
Also, I'm hearing from the forums that these appliances eventually cause teeth problems and pain, so now I'm really confused. Any thoughts?

ANGiE: I am TIRED of clicking all over the internet and getting bounced around... can someone PLEASE narrow my search!

I live in XXXXXXXXXXX,XX and I've been to dentist in xxxxxxxx... can't help me. I have TMJ, clench teeth all day and I really do HATE my CPAP machine. I am MISERABLE in every way and tired ALL the time!

Please, help me focus on where to look. It will cost a LOT to get the appliance, drive to either St. Louis or Kansas City (how many times back 'n forth?) or stay overnight to get all work done... I feel SO hopeless. Can you make this less complicated?

posted by Dr Shapira at 9:46 AM