Breathing Issues Related to Sleep Disorders May Affect 1 in 10 Children, Study Indicates

Breathing issues such as snoring and respiratory interruptions during sleep are most often associated with adults. But one recent study indicates that one in 10 children may suffer from breathing problems associated with sleep disorders, including obstructive sleep apnea (OSA).

Researchers from the University of Eastern Finland studied sleep disturbances among 512 children between the ages of 6 and 8. In addition to monitoring sleep disturbances, researchers reviewed children’s weight, craniofacial makeup and dental issues.

The findings of the study, which were published in the European Journal of Pediatrics, indicate that sleep disorders—such as sleep apnea—in children may not be linked with obesity, as it frequently is with adults. Rather, the study suggests that dental malocclusions such as crossbite can play a role in sleep-disordered respiration.

The message parents and physicians should draw from this research, according to the study’s authors, is that if children experience symptoms of sleep apnea or other sleep disorders, they should be examined for craniofacial issues or bite conditions. On the flip side, children with known craniofacial deformities or malocclusion should have the quality of their sleep evaluated.

The findings of the Finnish study echo figures provided by the American Academy of Otolaryngology, which state that breathing issues such as snoring occur in about 10 percent of all kids and that obstructive sleep apnea occurs in about 2 to 4 percent of children. In addition to causing daytime drowsiness, mood changes and difficulty focusing, OSA can contribute to an increased risk for severe health problems including heart disease, stroke and hypertension when not treated.

There are a number of dentists nationwide who specialize in the field of dental sleep medicine, which offers customized treatment for sleep apnea and other sleep disorders. If a child’s sleep disorder is the result of a bite condition, these dentists can also help restore a symmetrical bite through custom-made oral appliances or the use of orthodontics.

To locate a dentist near you who is qualified to treat sleep apnea, please contact IHateCPAP.com.

Morning Headaches? We Can Help!

Starting your day with a headache may affect your entire day.  Morning Headaches are usually easy to treat and address.  They are usually best treated without drugs.  The two most common causes of morning headaches are TMJ disorders and Sleep Apnea or Upper Airway resistance Syndrome.

Correction of the trigger that occurs in sleep can eliminate the morning headache or the one that occurs shortly after waking.  Frequently these same treatments can eliminate or minimize all headaches and migraines you experience.

This connection between sleep apnea, TMJ disorders and Headache has been examined by the National Heart Lung and Blood Institute in their report "Cardiovascular and Sleep Consequences of Temporomandibular Disorders"

An oral appliance can help you mmaintain your ideal airway, eliminate snoring and sleep apnea and associated morning headaches.  Neuromuscular Dentistry is exceptional at eliminating headache and migraine problems for most patients who do not have sleep apnea.  Combination therapy can give miraculous results for many patients without the use of dangerous drugs.

Combination therapy with a night apnea appliance and a daytime Neuromuscular Orthotic may be the single best treatment for many patients who want to regain their quality of life.

Additional information on Neuromuscular Dentistry Can be found at www.ihateheadaches.org and at Sleep and Health Journal @   www.sleepandhealth.com/neuromuscular-dentistry.

My website also has excellent information on Neuromuscular Dentistry and Sleep Apnea
www.delanydentalcare.com/neuromuscular.html

Study Suggests Link between Vitamin D Deficiency, Daytime Drowsiness and Sleep Apnea

A recent study indicates a significant link between daytime drowsiness and low levels of vitamin D, and it also suggests that those with a vitamin D deficiency may be at an increased risk for developing sleep disorders such as obstructive sleep apnea (OSA).

The study, which was led by a team with members from the Louisiana State University (LSU) Health Sciences Center and the LSU School of Medicine, focused on 81 participants who reported sleep problems and nonspecific pain. A majority of the patients were diagnosed with obstructive sleep apnea, and all of the patients were eventually diagnosed with some type of sleep disorder.

The findings of the study, which are published in the new issue of the Journal of Clinical Sleep Medicine, demonstrated that higher levels of daytime drowsiness directly correlated with lower levels of vitamin D. One unexpected, but not entirely surprising, result of the study was that it indicated the disparity between vitamin D levels and sleepiness was especially high among African-American participants; the study’s authors said this is logical, because increased skin pigmentation is a risk factor for vitamin D deficiency.

Like obstructive sleep apnea, a vitamin D deficiency can contribute to a heightened risk for cardiovascular disease and other health problems. Vitamin D is essential for, among other things, building and maintaining strong bones.

People can produce vitamin D naturally through exposure to sunlight, and vitamin D can also be ingested through certain foods such as fish and eggs, as well as foods and beverages fortified with vitamin D. Researchers involved in the LSU study said the relationship between a vitamin D deficiency, daytime sleepiness and sleep apnea needs deeper probing.

If you suffer from daytime drowsiness, chronic snoring or other symptoms of sleep apnea, a dentist who is experienced in the field of dental sleep medicine may be able to recommend a comfortable and effective treatment.

Please contact IHateCPAP.com to locate a qualified sleep dentist near you.

Study Indicates Women with Sleep Apnea Suffer more Brain Damage than Men

A recent study from the University of California at Los Angeles (UCLA) is an important reminder that women who snore regularly and/or have difficulty sleeping through the night should undergo an evaluation for obstructive sleep apnea (OSA), a common sleep disorder with potentially deadly risks.

Although snoring—the most common symptom of sleep apnea—is more strongly associated with men than women, and while men suffer OSA more frequently than women, research from UCLA shows that women with sleep apnea sustain more damage to their brain cells than men. Previous research has established that sleep apnea can result in brain cell damage, but the recent findings in the UCLA study indicate that women suffer more brain cell damage than men, particularly in the regions of the brain that help regulate moods and decision-making.

It is believed that more than 20 million Americans may suffer from obstructive sleep apnea, and that many of those are either entirely undiagnosed or do not receive treatment. While sleep apnea can occur regardless of gender or age, the American College of Physicians estimates that between 4 and 9 percent of middle-aged men have OSA, and between 2 and 4 percent of middle-aged women suffer from OSA.

If not treated, obstructive sleep apnea can result in a heightened risk for severe health problems including:

• Heart disease
• Stroke
• Heart attack
• High blood pressure
• Cardiac arrhythmia

There are a number of sleep apnea treatments available through the field of dental sleep medicine. Many patients are able to restore restful sleep to themselves and their partners through the use of custom-made oral appliances.

If you or a loved one experiences loud, chronic snoring or other signs of sleep apnea such as extreme daytime drowsiness, please contact IHateCPAP.com to locate a dentist near you with experience in the diagnosis and treatment of sleep disorders including sleep apnea.

Snoring and Obstructive Sleep Apnea

Snoring is sometimes merely a harmless if irritating (just ask your sleeping partner) habit, but it is often a symptom of the dangerous condition known as obstructive sleep apnea (OSA).

Loud, nightly snoring is the most common symptom of OSA, a potentially fatal sleep disorder characterized by episodes in which your breathing stops for upward of 10 seconds at a time multiple times per hour. If not treated, obstructive sleep apnea can increase your risk for a host of severe medical problems including hypertension, cardiac arrhythmia, heart attack and stroke.

There are a number of factors that affect whether you snore, but snoring itself is the result of an airway obstruction that forces your respirations through a narrowed passage, causing tissue in your mouth and throat to vibrate as you breathe in and out. Chronic snoring that is accompanied by a person waking up gasping and choking is a telltale symptom of sleep apnea.

Because people with OSA are often unaware that they snore or suffer interrupted sleep, it’s important to discuss snoring and sleep apnea with family members or other loved ones if they snore regularly. Although many people snore at least occasionally, snoring can also be a sign of a problem bigger than the annoyance of your sleeping partner and family.

If you believe you or a loved one may suffer from sleep apnea, please contact IHateCPAP.com to locate a dentist near you who specializes in sleep apnea diagnosis and treatment.

Brain Mechanism Related to Breathing Muscles Identified; May Provide Clues for Future Sleep Apnea Treatments

The brain mechanism that regulates breathing muscles during rapid eye movement (REM) sleep has been identified, and it may provide clues for developing new treatments for obstructive sleep apnea (OSA) and other sleep-related respiratory problems.

The research relating to the discovery of the brain mechanism will be published in the upcoming issue of the American Journal of Respiratory and Critical Care Medicine, which is the publication of the American Thoracic Society. During REM sleep, you experience inhibited muscle activity, including a near-paralysis of the muscles related to breathing, which can contribute to snoring and other breathing problems during sleep.

Among these problems are the breathing interruptions known as apneas, in which a person’s breathing stops for seconds at a time multiple times per hour. These episodes are the hallmark of OSA, a dangerous sleep disorder that can increase your risk for high blood pressure, stroke and heart attack, among other health concerns.

To determine the brain mechanism responsible for controlling breathing muscles, researchers studied rats through multiple sleep-wake cycles and focused on the brain region that controls the tongue during sleep. The tongue was key, because an active tongue can maintain an open airway while an inhibited tongue can slack during sleep and contribute to the airway blockage that contributes to sleep apnea.

The identification of the brain mechanism and chemicals that play a role in regulating breathing muscle activity may lead to new treatment methods that target the primary source of OSA and other breathing-related sleep disorders.

If you or your partner suffers from loud, chronic snoring or other sleep apnea symptoms, a dentist with experience in the field of dental sleep medicine can help you determine the source of the condition and recommend an individualized treatment plan, such as the use of a custom-made oral appliance.

Please contact IHateCPAP.com to locate a qualified sleep dentist near you.

Losing Weight, Belly Fat Can Improve Sleep, May Reduce Sleep Apnea Symptoms

The link between being overweight and an increased risk for developing obstructive sleep apnea (OSA) have long been known, but a recent study indicates that losing weight—particularly belly fat—can help you sleep better and may even reduce instances of apnea in those with OSA.

Researchers from the Johns Hopkins School of Medicine recently studied 77 overweight volunteers, many of whom suffered sleep disorders including sleep apnea. The volunteers were split into two groups, one of which engaged in a weight-loss plan that included dietary changes and supervised exercise while the other group followed only the diet.

Overall, the participants from both groups lost an average of 15 pounds over six months and reduced belly fat by 15 percent. According to the study, the findings of which were presented at the annual meeting of the American Heart Association, belly fat reduction was the best predictor of improved sleep, and patients with OSA reported fewer instances of interrupted breathing during sleep.

Although the study did not determine why reducing belly fat seems to be a key to improved sleep, the particular type of fat that accumulates around the abdomen—which is also known as visceral fat—has been linked to an increased risk for OSA, heart disease, diabetes, certain cancers and other health problems. Sleep apnea, in turn, can increase a person’s risk for conditions including high blood pressure and stroke.

If you or your partner suffers from loud, chronic snoring or other symptoms of sleep apnea, it’s important to undergo an evaluation as soon as possible. Although OSA is a potentially life-threatening condition, there are also a number of effective treatment options available through the field of dental sleep medicine.

Please contact IHateCPAP.com to learn more about sleep apnea diagnosis and treatment, and to locate a qualified sleep dentist near you.

Ingredients in Weight-Loss Drug May Aid in Sleep Apnea Treatment

The pharmaceutical company Vivus recently reported that clinical study data related to its weight-loss drug Qsymia indicates the medication may also help treat obstructive sleep apnea (OSA), a potentially deadly condition that affects tens of millions of Americans.

Qsymia received approval by the Food and Drug Administration (FDA) in July for the treatment of obesity. However, the findings of a recent study, which were published in the journal Sleep, demonstrate that two active ingredients in Qsymia—phentermine and topiramate—may also aid in the treatment of OSA.

The study was funded by Vivus, which is also conducting ongoing studies as it pursues approval for the potential use of Qsymia in OSA and diabetes treatment, and focused on 45 obese adults with OSA who were not undergoing continuous positive airway pressure (CPAP) therapy. The study found that patients who received phentermine and topiramate experienced fewer breathing interruptions and lower blood pressure during sleep.

There are currently no FDA-approved medications for sleep apnea treatment. If you or your partner suffers from loud, chronic snoring or other sleep apnea symptoms, a qualified sleep dentist can assess your condition, determine whether you need further testing, and devise a customized sleep apnea treatment plan for you.

In addition to CPAP, the field of dental sleep medicine offers a number of treatment options, including oral appliances.

Please contact IHateCPAP.com to locate an experienced sleep dentist near you.

Just Didgeridoo It; Instrument May Aid in Sleep Apnea Treatment

When it comes to sleep apnea treatment, many people find success using multiple options, such as a combination of oral appliance and continuous positive airway pressure (CPAP) device.

However, one Minneapolis man is trying an unusual blend of methods to treat his obstructive sleep apnea (OSA), a potentially life-threatening condition that affects approximately 20 million Americans. According to an article in the Star Tribune, he is battling his OSA with the use of a custom-made oral appliance and a didgeridoo.

Employing the didgeridoo to treat sleep apnea has been something of a fringe trend since 2006, when a Swiss study indicated that playing the Aboriginal Australian instrument decreased nighttime snoring and daytime drowsiness. The study suggested that playing the didgeridoo regularly strengthened muscles in the back of the throat, where tissue collapse during sleep can block the air passage and contribute to OSA.

The sporadically documented cases of patients who have tried it imply that it may be effective for those who have mild to moderate cases of OSA, especially when used in conjunction with another treatment, such as oral appliances similar to sports mouthguards.

Of course, while learning a musical instrument is encouraged, it’s also encouraged to seek medical advice if you believe you or a loved one suffers from sleep apnea before signing up for didgeridoo lessons alone. A dentist who is experienced in sleep apnea diagnosis and treatment can assess your individual condition and recommend a custom treatment plan.

Please contact IHateCPAP.com to locate a qualified sleep dentist near you.

Electronic Nose Could Sniff Out Sleep Apnea

A so-called “electronic nose” that can detect and analyze molecules in breath has shown promise in diagnosing obstructive sleep apnea (OSA), a potentially deadly sleep disorder suffered by tens of millions of Americans.

Currently, OSA is most often diagnosed through an overnight sleep test, which can be costly and, for many, intrusive and technically intensive. But according to the results of a study published in the Oct. 25 edition of the European Respiratory Journal, an electronic nose demonstrated it may be able to confirm OSA by detecting upper-airway inflammation, which is common among those with obstructive sleep apnea.

Electronic noses are already used to distinguish between some chronic diseases. The devices work by analyzing the nature of organic matter present in breath. In a test of 40 patients, researchers found the electronic nose effectively diagnosed OSA with about 93 percent accuracy.

In addition to being a useful diagnostic tool for sleep apnea, researchers found the device was also useful for ruling out OSA in some patients. The findings of the electronic nose could also be used by doctors to decide whether a patient should undergo more thorough evaluation for sleep apnea or other conditions.

If you or a loved one snores nightly or experiences other symptoms of sleep apnea, a dentist with experience in the field of dental sleep medicine can help you determine if you have sleep apnea as well as recommend a customized treatment option for you.

Please contact IHateCPAP.com to locate a qualified sleep dentist near you.

Body Language Says a Lot when it comes to Sleep Apnea

With the presidential debates in the national spotlight over the past few weeks, much has been made of body language. Although we primarily consider physical cues and what they convey in a waking state, certain body language indicators are also useful in the diagnosis of sleep disorders such as obstructive sleep apnea (OSA).

In fact, many individuals with OSA are unaware they are suffering from a dangerous sleep disorder until a partner recognizes physical symptoms of sleep apnea and encourages them to seek assessment from a qualified sleep dentist or other medical professional who specializes in sleep disorders. While it’s important to note that physical indicators are not the only signs of sleep apnea, they are often the starting point that spurs diagnosis and treatment.

Loud, chronic snoring is the most common symptom of sleep apnea. Snoring alone, however, does not mean a person has OSA; in those with sleep apnea, snoring is accompanied by other physical symptoms that may include:

• Frequent tossing and turning during sleep
• Mouth breathing during sleep
• Waking up choking or gasping

In addition to these bodily signs, people who suffer from OSA also tend to experience:

• Morning headaches
• Daytime drowsiness
• Difficulty focusing on tasks
• Anxiety
• Depression

If you or your partner snores regularly or demonstrates other symptoms of sleep apnea, please contact IHateCPAP.com to learn more about sleep apnea diagnosis and treatment and to locate a qualified sleep dentist near you.

Sleep Apnea Treatment May Improve Blood Pressure in Men, Study Indicates

Following physician-prescribed treatment for obstructive sleep apnea (OSA) can reduce blood pressure in men who suffer from hypertension, according to the findings of a recent study.

The study examined the impact of treating sleep apnea with the regular use of continuous positive airway pressure (CPAP) in male patients diagnosed with high blood pressure or type 2 diabetes who also experience OSA. The details of the study appear in the Oct. 15 Journal of Clinical Sleep Medicine.

Researchers monitored more than 200 men as they received routine sleep apnea treatment using CPAP devices, which help those with OSA maintain an open airway and breathe freely during sleep by funneling air to the user through a mask. In the study, researchers conducted follow-up evaluations with the men at three to six months after the initiation of treatment and again at nine to 12 months after the start of CPAP treatment.

The study indicated that systolic and diastolic blood pressure dropped substantially following treatment. Unfortunately, many people with sleep apnea who are prescribed CPAP treatment outside of a clinical study setting discontinue its use.

Patients often find the CPAP devices cumbersome and the masks too uncomfortable to continue the long-term use necessary to maintain positive results. However, there are an increasing number of comfortable and effective sleep apnea treatment options available through the field of dental sleep medicine.

If you or your partner snores regularly or displays other symptoms of sleep apnea, a qualified sleep dentist may be able to prescribe a custom-made oral appliance or other treatment option.

Please contact IHateCPAP.com to learn more about sleep apnea diagnosis and treatment or to locate an experienced sleep dentist near you.

Study Says Snoring Alone Not Linked to Heart Disease, but is a Warning Sign of Sleep Apnea

Much has been made about a recent Australian study that indicates snoring—independent of sleep apnea—does not increase an individual’s chance for developing heart disease, which is considered one of the major risk factors of those who suffer from obstructive sleep apnea (OSA).

They key phrase to remember when considering this study is “independent of sleep apnea.” Although snoring is among the most common symptoms of sleep apnea, those who snore regularly do not always have sleep apnea.

Prior to the study conducted via Australia’s Woolcock Institute of Medical Research, research indicated that chronic snoring was linked with sleep apnea and, thus, an increased risk of health problems including heart disease and stroke. While those with OSA do face a heightened risk of cardiovascular problems, previous studies had never focused directly on whether snoring alone—minus diagnosed sleep apnea—was a risk factor for heart problems.

The Australian study focused on 380 men and women and found that snoring alone did not contribute in an increased rate of cardiovascular disease. That said, if you or a loved one snores regularly, it’s advisable to undergo testing for sleep apnea, which can heighten your risk for cardiovascular disease and other health problems.

Treatment for sleep apnea continues to improve, and today there are a number of comfortable and effective options available through the field of dental sleep medicine.

If you would like to learn more about sleep apnea diagnosis and treatment, please contact IHateCPAP.com to locate a qualified sleep dentist near you.

Sleep Apnea Poses Risk to Pregnant Women, Infants, Study Indicates

Women who suffer from untreated obstructive sleep apnea (OSA) during pregnancy may face an increased risk for health problems, as could their babies, according to a study recently published in the journal Obstetrics & Gynecology.

Research focused on 175 pregnant women, who were tested for OSA at their homes using a portable sleep monitoring device. Approximately 15 percent of the women were diagnosed with OSA.

Women with OSA had higher weights and were more likely to show signs of high blood pressure than those without sleep apnea. Infants born to women with OSA were more likely to require admission to neonatal intensive care than babies born to women without sleep apnea.

Women with sleep apnea were also more likely to develop high blood pressure during pregnancy and to require delivery by Cesarean section.

The study further illustrates the importance of treating sleep apnea, regardless of gender. As awareness of sleep apnea’s dangers grow and the number of treatment options increase, so does the number of dentists who have become qualified in the field of dental sleep medicine.

Many dentists offer safe, comfortable and effective sleep apnea treatment options, including custom-made oral appliances. If you or your partner experiences regular snoring or other symptoms of sleep apnea, an experienced sleep dentist may be able to help.

Please contact IHateCPAP.com to locate a dentist qualified in dental sleep medicine near you.

Treating Sleep Apnea in Children may also Reduce Effects of ADHD

The link between sleep apnea and attention-deficit hyperactivity disorder (ADHD) in children has grown increasingly strong in recent years.

While it is not yet known to what extent sleep apnea and other sleep disorders may contribute to ADHD, it is known that many children diagnosed with ADHD are found to suffer from sleep disturbances. One study indicated that about half of the parents whose children suffer from ADHD reported their children had difficulty sleeping. Many of those parents also said their children felt tired upon waking, experienced daytime drowsiness or had regular nightmares, all of which are symptoms of sleep apnea.

Either alone or in conjunction with one another, sleep apnea and ADHD can pose problems for children beyond the lack of restful sleep. Children with sleep apnea or ADHD are often prone to obesity, have difficulty focusing, have behavior problems and demonstrate diminished cognitive skills.

The good news is that diagnosis and treatment for ADHD and sleep apnea have expanded with increased awareness of both conditions. Likewise, a number of studies have demonstrated that treating sleep apnea and other sleep disorders in children with ADHD can reduce the impairments associated with ADHD.

Because many symptoms of ADHD and sleep apnea are shared, it’s advisable to consult with a dentist who is qualified in the field of dental sleep medicine if there are indicators that your child may have ADHD.

To locate an experienced sleep dentist in your area, please contact IHateCPAP.com.

How can Dental Sleep Medicine Treat My Sleep Apnea?

Obstructive sleep apnea (OSA) is a dangerous sleep disorder that can increase your risk of developing a number of potentially fatal medical conditions if left untreated.

Continuous positive airway pressure (CPAP) devices have long been the standard for treating OSA. CPAP helps users maintain an unobstructed airway as they sleep via a mask that continuously circulates oxygen.

However, few people stick with CPAP long enough to enjoy the benefits because many people find the mask cumbersome or claustrophobic. In recent years, the field of dental sleep medicine has evolved to include effective and more comfortable means of helping those with OSA and other types of sleep apnea correct airway blockage and restore restful sleep for OSA sufferers and their partners.

In addition to CPAP, today’s sleep apnea treatments include the use of oral appliances similar to sports mouthguards. These appliances help users hold their jaw in proper alignment as they sleep, and they help prevent the tongue and soft tissue in the throat from collapsing and blocking the airway.

If you or your partner suffers from chronic snoring or other symptoms of sleep apnea, a dentist experienced in dental sleep medicine can help assess whether you have sleep apnea and recommend a treatment plan for you.

Please contact IHateCPAP.com to locate a qualified sleep dentist near you

American Academy of Pediatrics Recommends Sleep Apnea Testing for Children who Snore

According to new recommendations from the American Academy of Pediatrics, all children should be screened for snoring—and children who do snore should receive additional testing for sleep apnea.

The recommendations were published in the most recent issue of the medical journal Pediatrics and were based on a review of 350 studies on sleep apnea and children. “It is important for children exhibiting signs of [obstructive sleep apnea] to get a comprehensive diagnosis … If left untreated, [obstructive sleep apnea] can result in problems such as behavioral issues, cardiovascular problems, poor growth and developmental delays.”

In children, adenotonsillar hypertrophy is the leading cause of obstructive sleep apnea. The AAP recommends that children who suffer from this condition have their tonsils and adenoids removed.

Although snoring is common among those who suffer from sleep apnea, most people experience multiple sleep apnea symptoms, and not everyone who snores has sleep apnea. This, coupled with the dangers of sleep apnea, is why the AAP advises sleep testing for children who snore.

There are a number of comfortable and effective sleep apnea treatments available for both children and adults. A dentist with experience in the field of dental sleep medicine can help you determine if you suffer from sleep apnea and recommend a custom treatment option such as an oral appliance.

If you or a loved one snores or experiences other symptoms of sleep apnea, please contact IHateCPAP.com to locate a qualified sleep dentist near you.

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.

Study Suggests Sleep Apnea May be Extremely Underdiagnosed Among Women

Perhaps because regular snoring is its most common symptom, sleep apnea is often perceived as a problem that is greater among men. But an ever-growing array of evidence demonstrates that sleep apnea is a dangerous problem that does not discriminate by gender, age or race.

A recent study conducted by researchers at Uppsala and Umea University—the findings of which were published in the European Respiratory Journal—indicates that women experience obstructive sleep apnea (OSA) at rates nearly as high as those of males. In a study of 400 women from a sample of 10,000 women between the ages of 20 and 70, approximately half suffered from symptoms of obstructive sleep apnea.

In findings echoed by other sleep apnea studies, the research showed a higher rate of OSA among those with hypertension or who were obese.

Sleep apnea is already thought to go undiagnosed in millions of people. The study suggests the problem of undiagnosed sleep apnea may be especially great with women.

If you or your partner suffers from chronic snoring and other sleep apnea symptoms, it’s important to undergo an evaluation by a qualified sleep dentist. The field of dental sleep medicine offers a number of safe, comfortable and effective treatment options for OSA and other types of sleep disorders.

Please contact IHateCPAP.com to locate a dentist near you who specializes in sleep apnea diagnosis and treatment.

What is Dental Sleep Medicine, and How can a Dentist Treat My Sleep Apnea?

Dental sleep medicine is a specialized field of dentistry focused on diagnosing and treating the cause of snoring, which is often related to the dangerous condition known as obstructive sleep apnea (OSA).

Although many people occasionally snore, for tens of millions of Americans snoring is just one of the symptoms of OSA. While snoring alone is not necessarily harmful, sleep apnea can increase your risks for severe medical problems including heart attack, stroke, hypertension and cardiac arrhythmia among other conditions.

Dental sleep medicine addresses the cause of sleep apnea and treats it in an individualized manner. Sleep apnea treatment has long utilized continuous positive airway pressure (CPAP) machines; yet many patients find these devices uncomfortable and cumbersome, and discontinue their use.

Thanks to advances in technology and a deeper understanding of the airway blockages associated with obstructive sleep apnea, many patients who suffer from OSA find success with oral appliances. Oral appliances can effectively treat many cases of sleep apnea by stabilizing your jaw and tongue to help you maintain an open airflow during sleep.

Oral appliances are custom made for your individual bite condition, and they hold the jaw and tongue forward while allowing you to keep your jaw properly aligned as you sleep.

If you would like to learn more about sleep apnea diagnosis and treatment, please contact IHateCPAP.com to locate a qualified sleep dentist near you.

The Life-Threatening Dangers of Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a common and life-threatening sleep disorder thought to affect more than 20 million Americans. Yet its dangers are only beginning to be understood by the public at large.

OSA can affect children and adults regardless of gender or race. Recent public awareness campaigns backed by clinical research and an increasing number of treatment options available through the growing field of dental sleep medicine have helped educate people about the potential risks of OSA and other forms of sleep apnea as well as the importance of early diagnosis and treatment.

If not treated, obstructive sleep apnea can increase your risk for:

• Heart attack
• Stroke
• Hypertension
• Cardiac arrhythmia
• Diabetes
• Depression
• Impotence
• Anxiety disorders
• Gastric reflux
• Fibromyalgia

Some recent studies also suggest a link between sleep apnea and a risk for developing certain forms of cancer.

If you or your partner experiences nightly loud snoring or other sleep apnea symptoms, a qualified sleep dentist may be able to diagnose your condition and recommend a custom sleep apnea treatment. Continuous positive airway pressure (CPAP) devices are just one treatment option; for many patients, oral appliances are a comfortable and effective way of correcting the airway blockage that leads to OSA.

If you would like to learn more about sleep apnea assessment and treatment, please contact IHateCPAP.com to locate a dentist near you who specializes in sleep apnea diagnosis and treatment.

Sleep Apnea Symptoms Beyond Snoring

Loud, chronic snoring is the most common symptom of sleep apnea, but most people who suffer from obstructive sleep apnea (OSA) and other forms of this dangerous sleep disorder also experience other symptoms. And snoring alone does not mean you have sleep apnea.

With an increasing number of sleep apnea diagnostic tools and treatment options available through the growing field of dental sleep medicine, it’s important to schedule a consultation with an experienced sleep dentist near you if you or a loved one snores regularly and also has any of the following symptoms:

• Recurring daytime drowsiness
• Morning headaches
• Sudden weight gain
• Difficulty focusing/memory problems
• Regular morning dry mouth
• Recurring sore throats
• Depression
• Mood swings
• Waking up choking/gasping for breath
• Decreased sex drive

Left untreated, OSA and other types of sleep apnea can increase your risk for developing severe health problems, including hypertension, stroke, cardiac arrhythmia, diabetes and fibromyalgia among others. Fortunately, there are a number of comfortable and effective sleep apnea treatments available.

Although continuous positive airway pressure (CPAP) devices have long been the standby for treating sleep apnea, many patients benefit from custom-made oral appliances similar to mouthguards that allow you to maintain an open airway as you sleep.

If you would like to learn more about sleep apnea diagnosis and treatment, please contact IHateCPAP.com to locate a qualified sleep dentist near you.

Sleep Apnea Diagnostic, Treatment Market Could Double in 5 Years, Report Says

The global market for sleep apnea diagnostic devices and therapeutic devices is expected to more than double and be worth nearly $20 billion by 2017, according to a recent report by the Dallas-based market research firm Markets and Markets.

While this is certainly welcome news to those who manufacture sleep apnea assessment and therapy devices, as well as those who diagnose and treat sleep apnea, it may also be viewed as a positive sign by those who suffer from sleep apnea. The report indicates that worldwide awareness of the dangers of sleep apnea is increasing along with the available treatment options for this potentially deadly sleep disorder.

In recent years, the field of dental sleep medicine has grown as more dentists become qualified to assess sleep apnea symptoms and offer customized treatment options. Sleep apnea treatment methods have also evolved.

Continuous positive airway pressure (CPAP) devices were long the standard for treating obstructive sleep apnea (OSA), the most common form of sleep apnea. Although CPAP is effective when used regularly, many patients find the masks cumbersome and do not follow through on treatment.

Today, there are a number of comfortable and effective custom-made oral appliances that can be used to correct jaw and bite alignment problems and help those who suffer from OSA maintain an unobstructed airflow.

If you or your partner suffers from chronic snoring or other sleep apnea symptoms, an experienced sleep dentist may be able to help. Please contact IHateCPAP.com to locate a qualified dentist in your area.

Some Patients Misusing Medication Intended to Treat Symptoms of Sleep Apnea, Other Sleep Disorders

Provigil is a prescription drug approved by the Food and Drug Administration (FDA) to promote wakefulness for those who suffer from diagnosed sleep disorders including obstructive sleep apnea (OSA) and narcolepsy.

However, a recent segment on the television news magazine Nightline focused on people who are using the medication to maintain alertness and stimulate cognitive enhancement. The piece prompted responses from drug manufacturer Cephalon (a subsidiary of Teva Pharmaceuticals) and the American Academy of Sleep Medicine saying that Provigil should only be used as directed and for the approved treatment of daytime sleepiness associated with sleep apnea and other sleep disorders.

There is little evidence that Provigil and similar drugs enhance cognitive abilities, and all medications are accompanied by potential side-effects. As a schedule IV controlled substance, Provigil also has a risk for dependence and abuse.

Provigil is intended to help those with certain sleep disorders manage excessive daytime drowsiness, one of the most common symptoms of sleep apnea and other sleep-related medical conditions.

Although Provigil is not a replacement for sleep apnea treatment, it may be used in conjunction with options such as continuous positive airway pressure (CPAP) devices or custom-made oral appliances.

If you or a loved one suffers from chronic snoring, daytime sleepiness or other symptoms of sleep apnea, please contact IHateCPAP.com to locate a dentist near you who specializes in the diagnosis and treatment of sleep apnea and other sleep disorders.

I LOVE MY CPAP vs I HATE CPAP!

CPAP IS A LIFESAVER AND ABOUT ONE IN FOUR PATIENTS LOVE THEIR CPAP> THEY DO NOT UNDERSTAND WHY EVERYONE DOES NOT LOVE CPAP.

60% OF PATIENTS ABANDON CPAP AND THEY SHOUT FROM THE ROOFTOPS THAT

"I HATE CPAP!"

THERE ARE MANY REASONS PEOPLE DO NOT TOLERATE CPAP. IT IS IMPORTANT TO NOTE THAT STUDIES HAVE SHOWN THAT THE SINGLE MOST SIGNIFICANT WAY TO PREDICT IF SOMEONE WILL BECOME A LONG TERM CPAP USER IS HOW THEY DO IN THEIR FIRST MONTH WITH CPAP.

OVER 95% OF PATIENTS OFFERED A CHOICE BETWEEN CPAP AND ORAL APPLIANCES CHOOSE THE ORAL APPLIANCE. MANY PHYSICIANS DO NOT GIVE THEIR PATIENTS THE CHOICE. THEY MAY NOT KNOW THE RESEARCH ON ORAL APPLIANCE EFFECTIVENESS WHICH CAN BE CORRECTED WITH EDUCATION.

FREQUENTLY, PHYSICIANS OR A FAMILY MEMBER OWNS A DME THAT SELL CPAP MACHINES AND SUPPLIES AND IT IS ALMOST IMPOSSIBLE FOR THEM TO EVEN CONSIDER RECOMMENDING AN ORAL APPLIANCE.

I FREQUENTLY HAVE PATIENTS WHO "LOVE THEIR CPAP!" AND ONLY WANT ORAL APPLIANCES TO TRAVEL. I HAVE NO HARD NUMBERS BUT I ESTIMATE BETWEEN 60 AND 80 % OF THOSE PATIENTS WHO "LOVE CPAP" MAKE A SWITCH TO ORAL APPLIANCES. THEY LOVED HOW CPAP MADE THEM FEEL, THEY DID NOT LOVE THE CPAP MACHINE, MASK OR HOSE

Survey on Sleep Apnea for patients and physicians

Sarika Mahajan Sharma posted on I HATE CPAP's Wall "Hi everyone, We are MBA students at the University of Dallas in Irving, TX. We are currently conducting a study onObstructive Sleep Apnea (OSA), and the various treatment options available for it. Kindly take one of the surveys below if you are suffering from OSA, or if you are a physician that treats OSA patients. It will only take about 3 minutes of your time and will be an extremely valuable contribution to our study. We would appreciate it greatly if you can also forward this survey to anybody you know that has or treats OSA. If you are an Obstructive Sleep Apnea Patient, please take this survey -https://www.surveymonkey.com/s/sleepapfb If you are a physician treating OSA patients, please take this survey -https://www.surveymonkey.com/s/sleepdocs

New Study Suggests that Sleep Apnea Effects May be Worse in Cold Weather

The effects of obstructive sleep apnea (OSA) may worsen in cold weather, according to the findings of a recent study in Brazil.

Researchers from the Hospital de Clinicas Porto Alegre reviewed the results of sleep studies conducted on approximately 7,500 adults over a 10-year span. The researchers grouped data regarding apnea events (or periods in which a patient’s breathing stops during sleep), airflow, snoring and cardiac arrhythmia into four seasonal periods.

The review of data indicated that more patients sought diagnosis for sleep apnea symptoms in the winter months, and that instances of arrhythmia among those with OSA occurred more in winter than any other season. Previous studies have indicated that environmental factors such as atmospheric pressure, carbon monoxide levels and humidity can influence the severity of obstructive sleep apnea.

While this study—the results of which were published in the medical journal Chest—did not yield a conclusive link between sleep apnea and cold weather, researchers believe that the prevalence of upper-airway disturbances during the winter months can magnify sleep apnea symptoms and may be why more patients sought testing for sleep apnea in the winter.

In addition to continuous positive airway pressure (CPAP) devices, the field of dental sleep medicine offers a number of comfortable and effective treatment options for sleep apnea, including custom oral appliances.

If you or a loved one suffers from chronic snoring or other symptoms of sleep apnea, please contact IHateCPAP.com to locate a dentist near you who specializes in the diagnosis and treatment of sleep apnea.

Overweight and are unwilling or unable to use CPAP: Learn about new study

The majority of patients are unable to use CPAP and oral appliances are usually the single best treatment. Katy McNulty has informed me of a free study for overweight patients unable or unwilling to utilize CPAP. The study is done in Atlanta but you do not need to live in Atlanta. Morbid obesity is a contraindication to a comfortable oral appliance but merely being overweight is common and oral appliances are usually a comfortable and effective alternative to CPAP.

Please mention I HATE CPAP if you contact Katy and send me your feedback.

STUDY INFORMATION FOLLOWS:

We are conducting a clinical trial in Atlanta that your audience might find interesting. It's for people who are overweight and are unwilling or unable to use CPAP. I pasted the link to the study information below.

http://www.atlantasleep.com/osaovw

	Katy	McNulty
Contact Email:		kmcnulty@neurotrials.com
Contact Phone:		404-851-9934

DO I HAVE TO WEAR A CPAP ( BiPAP) MACHINE FOR THE REST OF MY LIFE?

This is a frequent question asked by patients with sleep apnea that is treated with CPAP> There are many answers to that question. Obviously the best alternative to CPAP is an oral appliance for most patients but there are also many other alternatives.

While the majority of patients complain about CPAP and 60% discontinue using it completely it is important to remember that one i four patients using CPAP love their CPAP machines, masks and hoses. They give them back their lives and these patients have no desire to be free from CPAP.

Their are alternatives to CPAP and Oral Appliances. Weight loss is very effective for some patients who see their obstructive sleep totally resolve with weight loss.

WEIGHT LOSS ALONE IS NOT EFFECTIVE FOR ELIMINATING OBSTRUCTIVE SLEEP APNEA FOR MOST PATIENTS. IT WILL ALMOST ALWAYS REDUCE THE SEVERITY OF SLEEP APNEA BUT THE TRUTH IS THAT MANY PATIENTS ORIGINALLY GAINED THE WEIGHT DUE TO SLEEP APNEA. METBOLIC SYNDROME IS WEIGHT GAIN DUE TO APNEA AND RELATED HORMONAL DISRUPTIONS.

MANY THIN AND/OR ATHLETIC PATIENTS HAVE SLEEP APNEA DUE TO THEIR ABNOMAL (pathologic) ORAL PHARYNGEAL ANATOMY.

PATIENTS WITH POSITIONAL SLEEP APNEA USUALLY RESPOND WELL TO WEIGHT LOSS THERAPY.

Positional therapy is excellent for patients who only have apnea episodes on their back (supine). A danger in this treatment is patients who no longer have apneas or hypopneas may now have UARS or RERAs.

Bimaxillary advancement surgery is the most effective long term surgical solution. i strongly suggest that prior to surgery an oral appliance trial be done. It will predict success but also increase success rates because the amount of advancement necessary can be determined prior to surgery.

Morbidly obese patients are not good canidates for oral appliances or jaw advancement surgeries. Bariatric surgery to first lose weight it probably a more reasonable first step. Any surgery is more dangerous in the morbidly obese and in patients with sleep apnea.

OBSTRUCTIVE SLEEP APNEA, WOMEN SNORE AND HAVE SLEEP APNEA OFTEN IN CONJUNCTION WITH TMJ DISORDERS

Jacque: I am a 51 year old woman and have snored most of my life. Sleep study said Chronic Obstructive blahblah and the doc told me I had the WORST sleep patterns he had ever seen. Tried CPAP...NO WAY...couldn't stand it. Had shots in the back of my throat...didn't work. Tried a mouth appliance about 5 years ago and it flared up my TMJ terrrrrribly. So I was just wondering what my options are or if you mouth devices don't flare up the jaw?

DR SHAPIRA RESPONSE: Sleep Apnea and TMJ disorders have the same underlying causes, functions and problems. Usually we treat patients with TMJ disorders with an appliance that is worn 24 hours/day 7 days a week. This is done to stabilize the jaw joints (Temporomandibular Joints, TMJ), relax the muscles and control facial pain, TM Joint pain, headasches, migraines, sinus pain, ear pain, stuffiness in the ears, tinnitus, and other numerous symptoms.

For sleep apnea patients we usually use an appliance that is only worn at night and give the patient exercises that return the jaw to its original pathologic position. The original position is pathologic because it does no perform the single most important function of maintaining a patent airway. This works well for the majority of patients without problems. Patients with TMJ disorders may need their appliances adjusted with design changes or alterations based on symptoms.

Long Term research has shown bite changes but not negative changes to the TM Joints. Most symptoms of TMD from oral appliances to treat sleep apnea will be only during initial treatment. Long term problems are rare.

The best treatment would be combining TMJD and Sleep Apnea treatment.

This is accomplished with a small comfortable diagnostic neuromuscular orthotic during the day and a MAD sleep apnea appliance at night. Most TMJ problems are caused by the jaw healing at night but the muscles resist going back to your original pathologic position in the morning. This combination treatment allows the jaw joints and muscles to heal at night and supports this healthier position during the day. It no longer requires the patient to return to their original pathologic position.

An interesting fact is the changes in bite seen with oral appliances is actually healing.

Dr Shapira Response:

"Life is not about waiting for the storms to pass - it is learning to dance in the rain!"

SEVERE SLEEP APNEA? BEST TREATMENT MAY BE AN ORAL APPLIANCE.

Donna:

I have severe sleep apnea I was tested and my breathing is interrupted or slowed 71 times during the sleep study. Will any of these alternatives work for me and do you take health insurance? Dr Shapira response: Donna, I have good news you are probably an excellent candidate for an oral appliance for treating sleep apnea. A total of 71 awakenings from sleep apnea over the course of a full night sleep would put you in the mild to moderate range of apnea where oral appliances and CPAP are considered a first line treatments of sleep apnea. Medical insurance will usually cover treatment with an orl appliance subject to deductibles and co-insurance. Most insurance companies understand that untreated sleep apnea is dangerous and treating the effects of untreated sleep apnea is more expensive than treating the sleep apnea.

Smartphone Application Helps Screen for Sleep Apnea Symptoms

Computer engineering students at the American University of Sharjah in the United Arab Emirates have developed an award-winning smartphone application that is intended as a preliminary diagnostic tool for obstructive sleep apnea (OSA).

Since it was unveiled in March, the Sleep Apnea Monitor (aka SAM) has won numerous international awards for its innovative use of built-in smartphone features to detect whether a person suffers from symptoms of sleep apnea. The easy-to-use application is designed to run on Windows and Android mobile phones and operate in the comfort of users’ homes.

SAM employs smartphones’ microphones and accelerometers to monitor snoring, record breathing patterns and detect movement during sleep. This data is then sent to a server, which uses statistical analysis software to assess the information for sleep apnea risks.

The results are sent back to the user’s phone and are also posted on a web interface, which allows authorized physicians to review the data. The purpose of the application is to help users and their physicians determine if more extensive—and expensive—testing is necessary.

The developers of the application are currently seeking capital to commercialize SAM for global use, and they hope to make it available as a free download. According to the World Health Organization, some 100 million people worldwide are thought to suffer from OSA.

Although obstructive sleep apnea can increase your risk for severe health complications including stroke and heart attack, there are a number of comfortable and effective treatment options available through the field of dental sleep medicine. If you or a loved one experiences chronic snoring or other sleep apnea symptoms, a qualified dentist may be able to determine the source of your condition and prescribe a custom oral appliance or other treatment method.

Please contact IHateCPAP.com to find a dentist near you who specializes in the diagnosis and treatment of sleep apnea and other sleep disorders.

Diabetics With Obstructive Sleep Apnea May Face Increased Risk for Painful Condition

Diabetics who suffer from obstructive sleep apnea (OSA) may face an increased risk for a painful condition known as diabetic peripheral neuropathy, according to a recent study conducted in the United Kingdom.

The research, the findings of which were reported in the American Journal of Respiratory and Critical Care Medicine, focused on 234 adults with a mean age of 57 years who have type 2 diabetes. Sixty-five percent of the patients were diagnosed with OSA, with 40 percent of patients suffering from moderate to severe OSA.

The prevalence of diabetic peripheral neuropathy—a nerve disorder that can cause pain or numbness in the hands, arms, feet and legs—was significantly greater in patients who suffered from sleep apnea. According to the study, 60 percent of the diabetic patients with OSA experienced neuropathy while only 27 percent of the diabetics without sleep apnea experienced neuropathy.

Although the role of sleep apnea in the development of diabetic peripheral neuropathy warrants further review, researchers noted that nitrotyrosine and lipid peroxide levels were elevated in patients with OSA.

This findings of this study demonstrate yet another reason why it’s important to undergo evaluation if you experience any symptoms of sleep apnea. Sleep apnea has been associated with numerous severe health problems if not treated.

Fortunately, the burgeoning field of dental sleep medicine provides a number of treatment options, including the use of comfortable, custom-made oral appliances.

If you or your partner suffer from chronic snoring or other sleep apnea symptoms, a dentist with experience diagnosing and treating sleep disorders may be able to help. Please contact IHateCPAP.com to locate a qualified dentist near you.

Sleep Apnea May Boost Carbohydrate Cravings Among Diabetics

Obstructive sleep apnea (OSA) may spur a dangerous craving for carbohydrates among people with type 2 diabetes, according to a recent study that was formally presented this week at the annual meeting of the Associated Professional Sleep Societies.

OSA has already been associated with an increased risk for diabetes, but this new study suggests that primary care physicians should consider screening for OSA in patients who have type 2 diabetes, according to the study’s authors.

“Previous studies have shown that sleep deprivation may lead to changes in hormones that regulate appetite and hunger,” said Dr. Mahmood Siddique, a clinical associate professor of medicine at the Robert Wood Johnson Medical School in New Jersey, in a news release. “These hormonal changes can lead to significant craving for high-calorie carbohydrates such as cookies, candy, breads, rice and potatoes.”

Unrestricted carbohydrates of this nature can be especially harmful to diabetics. Researchers found that diabetics with diagnosed sleep apnea were almost two times more likely to have high carbohydrate cravings as patients without sleep apnea.

The study focused on 55 people who were tested for diabetes, OSA and carbohydrate cravings. More than half of the group had type 2 diabetes, and 82 percent of the diabetics suffered from OSA; the diabetic patients sampled had nearly double the risk of carbohydrate cravings.

Although the research did not establish a direct cause-and-effect link, the study did indicate the importance of considering sleep apnea as a key risk factor in regulating blood sugar among those with diabetes.

Obstructive sleep apnea has been associated with a wide range of health problems, but the field of dental sleep medicine offers a number of treatments beyond the traditional continuous positive airway pressure (CPAP) devices. Many patients have found success with oral appliances, which are more comfortable to wear than CPAP.

If you or a loved one suffers from chronic snoring or other sleep apnea symptoms, a dentist experienced with diagnosing and treating sleep disorders may be able to help. Please contact IHateCPAP.com to locate a qualified dentist near you to learn more about sleep apnea assessment and treatment.