Physician Did Not Want To Wear CPAP. Oral Appliance Working Well For Several Years

Physician Did Not Want To Wear CPAP. Oral Appliance Working Well For Several Years 

See The Video:  https://www.youtube.com/watch?v=B3kPBSzTjTQ

Sleep Apnea Treatment:  Oral Appliance Testimonial 

Tap Appliance and now Micro O2 appliance

Bill has worn the TAP 1 appliance for several years and loved it.
His od appliance is working great and is worn on a daily basis but was interested is seeing other types of appliances. He started with the MICRO O2 appliance and is very pleased.

There are many new appliances available and the Micro is one of the easies to keep clean and maintain. It is cadcam manufactured leading to a very high quality composition ideal for patients with chemocal sensitivities or allergies.

The TAP 1 appliance is considered the single most effective appliance due to design and ease of titration. Titration is the fine tuning of an appliance to eliminate residual apneas. TAP 1 treatment is ideal for the most severe apneic patients. Once apnea is well controlled and the final positions been titrated patients can change appliances to their personal preferences.

The SomnoDent Appliance by Somnomed has a stronger and more versatile new version. The new Dream TAP is ideal for heavy bruxers and clenches and has a very wide range of adjustments.

The Micro O2 is actually a system of CAD-Cam manufactured appliances in multiple adjustment levels that gradually move the mandible foward by a series of different appliances.

This Chicago Sleep Apnea Testimonial is only one of the thousands of patients Dr Shapira has treated over the last 35 years vastly improving quality of life.

Ira L Shapira DDS, D,ABDSM, D,AAPM, FICCMO
Chair, Alliance of TMD Organizations
Diplomat, American Academy of Pain Management
Diplomat, American Board of Dental Sleep Medicine
Regent & Fellow, International College of CranioMandibular Orthopedics
Board Eligible, American Academy of CranioFacial Pain
Dental Section Editor, Sleep & Health Journal
Member, American Equilibration Society
Member, Academy of Applied Myofunctional Sciences
www.ThinkBetterLife.com
www.DelanyDentalCare.com
www.IHateCPAP.com
www.iHateHeadaches.org
www.SleepandHealth.com
www.SphenopalatineGanglionBlocks.com
www.northshoresleepdentist.com

Chicago: Comfortable Alternative to CPAP for Treating Sleep Apnea and Snoring

CPAP is the Gold Standard for Treating Sleep Apnea.  It is a wonderful invention of  Professor Colin Sullivan  PhD, BSc (Med), MB, FRACP in Australia and it has saved thousand of lives and improved the quality of life for millions.

When CPAP treatment is successful it is amazing treatment but unfortunately it fails 60% of the patients who are prescribed CPAP.

The good news is that oral appliances are an excellent alternative to CPAP that are preferred by 95% of patients offered a choice.  It is so successful that even Professor Colin Sullivan who invented CPAP personally utilizes an oral appliance both for comfort and efficacy!

Information on Chicago Providers of Oral Appliance treatment for CPAP is available at the end of this post.  I have opened a Chicago North Shore office dedicated to treating Sleep Apnea, Snoring and TMJ disorders that is conveniently located on the Metra a very short walk from the Fort Sheridan Metra Station.
North Shore Sleep Dentistry
3500 Western Ave #100, Highland Park, IL 60035
847-533-8313

Almost every complaint patients have with CPAP can be improved or eliminated with a professionally fitted well designed appliance that is patient specific.

Failure of CPAP is almost 100% a patient compliance issue.  Patient complaints about CPAP include:

I HATE CPAP!  I Hate the Mask!, I hate the hose!

Claustrophobic feelings from the CPAP  mask and hose.

Dermatologic problems includung facial sores, ulcers and CPAP related acne.

CPAP noise is a complaint from both CPAP users and their bedmates.

Infections in the sinus regions from CPAP use.  (partially Cleaning issue)

Asthma issues from CPAP  (partially Cleaning issue)

Bronchitis from CPAP  (partially Cleaning issue)

Pneumonia from CPAP   (partially Cleaning issue)

Problems with travel related to CPAO

CPAP Mask Discomfort

CPAP Mask leaks

Headache, neckache and backache issues from CPAP related to sleep position,

Dry Mouth

Dry Eyes from CPAP mask leakage

CPAP inconvenience

Don't like cleaning mask and hose

Pain to travel with CPAP

REGARDLESS OF THE ISSUES WITH CPAP AND CPAP MASKS IT IS ESSENTIAL THAT SLEEP APNEA BE TAKEN SERIOUSLY AND TREATED.

UNTREATED SLEEP APNEA CAN BE DEADLY RESULTING IN HEART ATTACKS AND STROKES.  WHEN SUPREME COURT JUSTICE ANTHONY SCALIA DIED IT IS SUSPECTED IT WAS A DIRECT RESULT OF NOT USING HIS CPAP FOR ONE NIGHT!

One study has shown that patients with moderate sleep apnea patients who are not treated have a 36% decrease in 8 year survival compared to those who were treated.

Patients with untreated apnea aresix times more likely to have motor vehicle accidents and often have trouble at work, school and home.  Marital strife is common due to excessive daytime sleepiness and poor cognition in patients with untreated sleep apnea.

I have been treating sleep apnea for over 34 years.  When I first became an Assistant Professor at Rush Medical School back in 1985 the average patient was an older male usually weighing 250-600 pounds and Severely ill.

Over the last 34 years I did research at Rush Medical School in the 1980's until 1991.  I returned in the 1990's and treated patients at Rush Sleep Service until early this century.  I have taught Dental Sleep Medicine to hundreds of dentists in the US and Internationally.  My most recent course was at Advocate Good Samaritan Hospital on February 29, 2016.  Other recent courses were at the International College of CranioMandibular Orthopedics in both the US and Argentina.

Currently, most of the lectures I give are on the common developmental aspects of TMJ, Sleep Apnea, ADD, ADHD, Dyslexia and working to catch children as early as possible prior to permanent changes in physiological development and brain development/ maturation.

It is now possible to decrease and  prevent many of these problems by early epigenetic orthodontic / orthopedic treatment.  It is also sometimes possible to offer permanent cures of sleep apnea in adults by utilizing Epigenetic Orthodontic treatment with the DNA Appliance and the mRNA version of the DNA Appliance.

Today we know that sleep apnea affects old and young, male and female obese and non-obese patients and that it frequently affects children and infants and then carries with them through life.

Short Term memory loss is associated with untreated sleep apnea and when there is a family history of Alzheimers or Dementia it is recognized in can cause more rapid onset of symptoms at a younger age with more profound disease.

Fro Sleep Apnea Treatment in the Chicago Metropolitan area:

I practice in Gurnee, Il at Delany Dental Care.  847-623-5530
310 S Greenleaf, Gurnee 60031    www.DelanyDentalCare.com

In Highland Park   at 3500 Western Ave   847-533-8313

www.NorthShoreSleepDentist.com

www.ThinkBetterLife.com

Medicare and Tricare coverage for oral appliances

Medicare, Tricare and other government insurances should cover oral appliances but that does not mean it will be easy. Medicare requires dentists form a DME, then pays poorly, See question from Eduardo received 8/31/12

Question from Eduardo: Why has my dentist taken so long to see if I can get an oral appliance for sleep apnea and snoring. Also I need to know if most of your Dentist take medicare and Tricare for life, I need to get something going.The doctor I have is taking too long I aplied back in May 2012 and still nothing

Dr Shapira response: Unfortunately while covered by medicare most docs won't take it. Medicare requires that an the dentist has a DME and choice of appliances is very limited. I do not accept medicare and have opted out and medicare patients pay my fee. My office is near great lake navak base but tricare has never paid for an appliance.

The good news is that CPAP is very successful if you can tolerate it. If not you must be proactive with Tricare and/or medicare that they find you a provider.

My suggestion is just to pay out of pocket if you can afford it otherwise get on CPAP while waiting for approval.

The good news about untreated sleep apnea is that it can kill you......the bad news is that it can cause a stroke!

IRA L SHAPIRA DDS, D,ABDSM, D,AAPM, FICCMO

There are several questions when it comes to Medicare coverage. First is whether medicare can afford to take on the cost of oral appliances considering the majority of seniors have some sleep disordered breathing. The requirement that dentists form DME's for each office is ridiculous, expensive and cumbersome. The proper approach is for Medicare to contract with Medicare approved labs that make appliances for sleep apnea and to pay the lab cost directly to the manufacturer. The dentist professional fee should be governed by standard Medicare B pay codes and fees. The alternative is that dentists opt out and patients make private arrangements for professional services.

Medicare should cover appliance manufacturers for the appliance based on specific appliances. My personal feelings is that there should be a minimal qualification of the dentist to have medicare cover the lab costs. A good idea might be to use diplomate status in the AADSM. Dentists who do not meet requirements would just do private contracts for the full amount. The dentist would not need to participate in Medicare but could if they desired.

Labs would have to meet Medicare standards for coverage, a difficult to define and ever changing target. Because labs serve thousands of dentists it would be financially effective.

It should be clearly understood that medicare would limit the number of appliance types.

In Illinois, Southern Wisconsin I personally treat patients with medicare after an opt out is signed. Patients who opt out of medicare can use the appliance of their choosing but must pay for it themselves.

Resistant Hypertension? New Article in Hypertension Identifies Sleep Apnea As The Most Common Secondary Cause Of Resistant Hypertension

Treatment of Sleep Apnea is extremely important with hypertension. Effective treatment with oral appliances or CPAP is extremely important in patients with resistant hypertension. The abstract can be found below.

Treatment of Sleep Apnea is essential. If you or your loved one are one of the 60% of patients who do not tolerate CPAP call today to schedule an appointment for a comfortable oral appliance.



Hypertension. 2011 Nov;58(5):811-7. Epub 2011 Oct 3.
Obstructive sleep apnea: the most common secondary cause of hypertension associated with resistant hypertension.
Pedrosa RP, Drager LF, Gonzaga CC, Sousa MG, de Paula LK, Amaro AC, Amodeo C, Bortolotto LA, Krieger EM, Bradley TD, Lorenzi-Filho G.
Source
Sleep Laboratory, Pulmonary Division, Heart Institute, Av Enéas Carvalho de Aguiar 44, São Paulo, Brazil. geraldo.lorenzi@incor.usp.br.
Abstract
Recognition and treatment of secondary causes of hypertension among patients with resistant hypertension may help to control blood pressure and reduce cardiovascular risk. However, there are no studies systematically evaluating secondary causes of hypertension according to the Seventh Joint National Committee. Consecutive patients with resistant hypertension were investigated for known causes of hypertension irrespective of symptoms and signs, including aortic coarctation, Cushing syndrome, obstructive sleep apnea, drugs, pheochromocytoma, primary aldosteronism, renal parenchymal disease, renovascular hypertension, and thyroid disorders. Among 125 patients (age: 52±1 years, 43% males, systolic and diastolic blood pressure: 176±31 and 107±19 mm Hg, respectively), obstructive sleep apnea (apnea-hypopnea index: >15 events per hour) was the most common condition associated with resistant hypertension (64.0%), followed by primary aldosteronism (5.6%), renal artery stenosis (2.4%), renal parenchymal disease (1.6%), oral contraceptives (1.6%), and thyroid disorders (0.8%). In 34.4%, no secondary cause of hypertension was identified (primary hypertension). Two concomitant secondary causes of hypertension were found in 6.4% of patients. Age >50 years (odds ratio: 5.2 [95% CI: 1.9-14.2]; P<0.01), neck circumference ≥41 cm for women and ≥43 cm for men (odds ratio: 4.7 [95% CI: 1.3-16.9]; P=0.02), and presence of snoring (odds ratio: 3.7 [95% CI: 1.3-11]; P=0.02) were predictors of obstructive sleep apnea. In conclusion, obstructive sleep apnea appears to be the most common condition associated with resistant hypertension. Age >50 years, large neck circumference measurement, and snoring are good predictors of obstructive sleep apnea in this populati
Can J Cardiol. 2011 May-Jun;27(3):319-38.