U.S. Army Finds Adjustable Oral Appliances a Good Treatment Option for OSA

Patients with mild to moderate obstructive sleep apnea (OSA) may consider adjustable oral appliances (OAs), devices that fit within the mouth to prevent upper airway collapse, as an effective first-line treatment, according to two studies conducted by sleep medicine specialists from Walter Reed National Military Medical Center (WRNMMC) in Bethesda, Md.

The retrospective, peer-reviewed studies, published in the December 2011 issue of CHEST and in the current issue of the Journal of Clinical Sleep Medicine (JCSM), provide findings on OAs from the largest patient populations studied to date.The studies found that adjustable OAs are nearly as effective as continuous positive airway pressure (CPAP) treatment for patients with a mild form of OSA and are more effective than fixed oral appliances, particularly in patients with moderate to severe OSA.

"Historically, CPAP has been the primary treatment for OSA, but only half of patients tolerate this therapy, which requires wearing a face mask hooked to a machine each night," said Lt. Col. Christopher Lettieri, M.D., one of the studies' authors, an Army medical director and the chief of sleep medicine in the pulmonary, critical care and sleep medicine department at WRNMMC. "This new data offers a fresh look at adjustable oral appliances as an initial treatment for OSA in both the military and civilian sectors." Eighteen million Americans, or 4 percent of men and 2 percent of women, suffer from sleep apnea, which can cause daytime sleepiness and has been linked to high blood pressure, heart attack, and stroke.

The military is interested in the potential of adjustable OAs, also called mandibular advancement devices, as alternatives to CPAP systems since some active duty service members deploy to austere environments where electricity needed to run CPAP machines is not always available. In these cases, reliance on CPAP may result in duty restrictions or separation from service.

The study in CHEST, titled "Efficacy of an Adjustable Oral Appliance and Comparison to Continuous Positive Airway Pressure for the Treatment of Obstructive Sleep Apnea Syndrome," evaluated and compared results of overnight sleep studies in which patients used adjustable OAs or CPAP devices. Results were measured by the apnea-hypopnea index (AHI) score, used to assess the severity of sleep apnea based on the total number of complete cessations (apnea) and partial obstructions (hypoapnea) of breathing that last for at least 10 seconds per hour of sleep. Researchers found that a significantly higher percentage of patients using an adjustable OA experienced successful reduction of their AHI score to below five apneic events per hour in this study compared to past reports (62.3 percent versus 54 percent).

In the JCSM study, "Comparison of Adjustable and Fixed Oral Appliances for the Treatment of Obstructive Sleep Apnea," patients were treated with either adjustable or fixed OAs and a sleep evaluation was conducted before and during treatment with the devices. Patients using adjustable OAs had a greater reduction in obstructive events (AHI), revealing that adjustable OAs had a greater efficacy than fixed devices (57.2 percent vs. 46.9 percent) among this patient cohort.

A total of 497 patients were prescribed adjustable OAs in the CHEST study and 602 patients in the JCSM study. The studies included patients who participated in an overnight sleep study at the sleep disorders center at Walter Reed National Military Medical Center.

Article by Advance for Respiratory Care & Sleep Medicine

Real-life testimonial: CPAP machine user converts to new, oral appliance for treatment of sleep apnea

“Dear Dr. Blumenstock:

As someone who has struggled with coronary artery disease, sleep apnea and chronic snoring for over several years, I write to express my deepest gratitude for equipping me with an oral repositioning appliance. It is truly a godsend and the clinical results have already far exceeded my hopes and expectations.

As you are aware, following triple bypass surgery in May, 2006 and a subsequent stent for a collapsed graft, my longstanding sleep apnea became an even more serious concern and threat to my health. For the second time, I tried in earnest to adapt to a CPAP machine. Struggling for weeks and never being able to keep the mask on, or adapt to that mode of treatment, I had given up on any effective means of treating the sleep apnea. It was then that I discovered you and your services at Central Jersey Dental.

As you introduced me to the potential benefits of wearing a dental device as a means of treating sleep apnea, I must confess that I was initially somewhat skeptical. But, after only a few weeks of using the device and experiencing its benefits, I am a true "convert!" My wife became immediately (and gratefully!) aware that all snoring had ceased. Consequently, we can now both sleep in the same bed with total comfort. Within days, I was also aware of better energy and less daytime sleepiness (particularly in the afternoons); what a blessing that has become. But, perhaps most important of all, I have watched my blood pressure reduce approx. 10-12 points - both diastolic and systolic.

Needless to say, my cardiologist and primary care physician are delighted with this development and assure me that it bodes extremely well in curbing further cardiac disease and enhancing my longevity. While I cannot say enough for these clinical enhancements in my life, I also want to take this opportunity to share my deep appreciation for the many ways you and your staff have treated me as a "whole person" throughout this process, continually providing helpful education, personal care and emotional support in introducing me to this invaluable new intervention and treatment.

If I can ever be of any help in "coaching" or supporting other patients as they are introduced to the oral repositioning device, please do not hesitate to call upon me. Again, many thanks for introducing me to this invaluable, effective means of treating sleep apnea and for your ongoing care.”


- Rev. Donald Stiger
Somerset, NJ

Sleep Apnea Treatment May Lower Heart Risks

Study: CPAP Can Lower Many Risk Factors for Heart Disease, Stroke
By Salynn Boyles
WebMD Health News
Dec. 15, 2011 -- In addition to improving sleep, an effective treatment for sleep apnea can also improve blood pressure and other risk factors for heart attack, stroke, and type 2 diabetes, new research shows.

Continuous positive airway pressure therapy, or CPAP, helps patients with sleep apnea breathe better during sleep by pushing air into the nose through a mask to keep airways open.

The treatment has been shown to improve daytime sleepiness and reduce blood pressure, but its impact on heart disease, stroke, and diabetes risk factors that are common in patients with sleep apnea has not been well understood.

Results from a study published in the Dec. 15 issue of the New England Journal of Medicine suggest that CPAP is associated with a lower risk for metabolic syndrome, a cluster of symptoms that increase the risk for heart disease, stroke, and diabetes.

Researcher Surendra K. Sharma, MD, PhD, of the All India Institute of Medical Sciences in New Delhi tells WebMD that along with weight loss and lifestyle modification, treatment with CPAP may be an important way to lower heart attack, stroke, and diabetes risk in patients with sleep apnea.

A Visual Guide to Sleep Disorders

Sleep Apnea, CPAP, and the Heart

More than18 million adults in the U.S. have sleep apnea, according to the National Sleep Foundation, and a significant percentage of them are overweight or obese.

Other than weight loss, CPAP is considered the most effective nonsurgical treatment for patients with moderate to severe sleep apnea.

The new study included 86 patients with sleep apnea, including 75 who had metabolic syndrome.

Study participants were treated with either CPAP or a fake therapy for three months, followed by a month of no treatment and three additional months of the opposite treatment.

Before and after each phase of the study, researchers recorded the participants’ blood pressure, blood sugar, blood fats called triglycerides, hemoglobin A1c levels, neck artery thickness, abdominal fat, and insulin resistance, which measures the body's ability to use insulin efficiently.

When compared to the fake therapy, three months on CPAP was associated with significantly lower blood pressure, total cholesterol, triglycerides, and LDL cholesterol, the so-called bad cholesterol.

Treatment with CPAP was also associated with a significant decrease in abdominal fat and body mass index (BMI).

It was also associated with a significant decrease in hemoglobin A1c values, which indicate average blood sugar levels over the past two to three months. And 1 in 5 patients with metabolic syndrome before starting CPAP treatment no longer had the condition after three months of treatment.

Lack of Sleep and Chronic Disease

Sleep specialist Meir Kryger, MD, of the Yale University School of Medicine and the VA Connecticut Health System, tells WebMD the findings highlight the growing recognition that sleep disturbances play a significant role in chronic disease.

Kryger is a board member with the National Sleep Foundation.

“It is now clear that patients with heart disease or a metabolic disease like type 2 diabetes should be asked about their sleep habits, and they should be treated if they have sleep apnea,” he says.

Cardiologist Tara Narula, MD, of Lenox Hill Hospital in New York City, says sleep issues have not been a major focus in cardiology in the past. But she says this is changing.

“We are seeing more and more studies linking sleep disorders and stress to [heart disease and stroke risk],” she tells WebMD. “This study suggests that a simple, effective treatment for sleep apnea may help reverse the abnormalities that lead to heart attack and stroke.”

While CPAP may be simple and effective, Kryger acknowledges that most patients don’t like wearing a mask while they sleep.

But he adds that CPAP technology and masks have improved dramatically over the last few years. Most new machines are even able to monitor how often the treatment is used and how well it is working.

Sleep apnea patients avoid treatment: CPAP device intolerance

Despite the growing number of Americans who suffer from sleepless nights, snoring, and serious medical consequences (estimated at over 15 million Americans), studies show that sleep apnea sufferers are avoiding treatment, and running serious health risks in the process.

Although the CPAP machine has proven itself to be almost 100% effective at treating sleep apnea, scientists are discovering that the catch phrase that goes along with that statistic is “if used properly”.  It’s common knowledge that data can be interpreted in many ways, and often is misleading.  In the case of the CPAP machine (continuous positive airway pressure machine), the numbers don’t lie.  It is hands-down the most effective machine for treating sleep apnea, if it can be used as intended.  To illustrate the point, check out the photo under “CPAP machine” on the “treatments” page on Dr. Blumenstock’s web site:  http://www.sleep-apnea-dentist-nj.info/sleep_apnea_treatments.htm.  If you have not looked, I will describe it for you here: a cousin to the World War II gas mask, with a band strapped around the head and neck, a plastic mask similar to those worn by hospital patients, connected to a large, fairly rigid plastic tube, all leading to the machine itself, which must be placed beside the bed and is about the size of a small humidifier.  Though sleep apnea patients suffer from sleepless nights and oxygen deprivation, it’s hard to imagine that their quality of sleep is much improved when strapped to such apparatus, and it is doubtful that they don’t wake just as often by discomfort and hampered movements due to the cumbersome parts of the machine.  Some patients complain that it also produces noise and chafes the skin intolerably.

Perhaps this explains the new CPAP machine effectiveness data:  50% or less.  While many Americans are just beginning to realize that their “snoring problem” is really a more problematic health issue, with serious, long-term ramifications, it seems that the traditional, or most common remedy (the CPAP machine), is frequently ineffective or intolerable.  Do not despair!  This is one of the reasons that Dr. Blumenstock invests his time in maintaining an internet presence, with up-to-date information and solutions.  It’s important for sleep apnea sufferers to understand that there are other treatments, and many patients are finding relief for the first time in years, based on advances in Dental Sleep Medicine.

If you are reading this article, odds are that you, or a loved one close to you, has been diagnosed with sleep apnea, or has symptoms of the condition.  Do not rely upon word of mouth to convince you that there is no effective remedy for your suffering.  Many diagnosed in the past were given the CPAP machine, and have either tolerated the machine, or given up on it in despair.  New technologies have produced oral appliances and a variety of other approaches to effectively treat sleep apnea.  Visit Dr. Blumenstock’s site today to learn more:  http://www.sleep-apnea-dentist-nj.info/  His patient testimonials attest to his and their success!

This holiday season, give yourself the gift of good sleep!

There are many things available for purchase each holiday season.  So many, in fact, that the shopping can be quite overwhelming.  In the whirlwind of trying to get everything on the list while scouring ads for “this year’s newest and best,” all at the lowest prices, sometimes it seems impossible to make a decision.  It’s always frustrating, too, to find that some hot item turns out to be dud.

Don’t let that be your experience this year.  One market that we see consistently advertised each year is the “sleep better” category.  Granted, there are a wide variety of items that make this claim.  From pillow-top mattresses, to herbal remedies, from nasal devices, to diet plans, from black-out curtains, to relaxation cd’s, the list is really quite varied.  While many of these things may have some positive effect on your sleep, some people have a much more severe situation, and only proper treatment will provide relief.

Sleep apnea: a condition that affects 20% of U.S. adults; 90% are undiagnosed.

If you have never heard of sleep apnea, but perhaps stumbled across this article because you’ve been having “sleep problems” or “snoring issues,” it’s worth taking a moment to learn more.  Especially if you fall into the group of people who’ve been buying “duds” every holiday, hoping that your sleep quality will improve, but finding no relief.

There are a great many reasons that people do not sleep well.  Sleep apnea is a specific condition in which the breathing airway actually becomes blocked during sleep, cutting off oxygen to the body.  One of the primary signs is snoring.  The body struggling or “gasping” for air is the snoring sound that is heard, and it is not a harmless nuisance.  Apnea episodes can occur from 6 to 100 times per hour, leaving people feeling exhausted when they wake up.  Irritability, headaches, and impaired thinking and memory are common complaints.  Unfortunately, more severe cases can lead to heart disease, stroke, depression and suicidal thoughts.  Apnea sufferers are also at higher risk throughout the day, as their motor skills are impaired from lack of sleep.

If you have concerns because you have any of these symptoms, have been struggling with snoring, or feel that you’re just not getting the sleep you need, do yourself a favor this holiday season.  Don’t buy another “dud”.  Invest in yourself by contacting your doctor about what could be a serious condition, sleep apnea.  Your family physician can help you decide whether you need to see a sleep medicine specialist.  Also, read more at:  http://www.sleep-apnea-dentist-nj.info/index.htm

Happy Holidays, from Central Jersey Dental Sleep Medicine! (732) 251-7766

From Central Jersey Sleep Medicine, Letter to Dr. Blumenstock (testimonials)

Dear Dr. Blumenstock:

I am writing this to let you know what a difference meeting you made in my life.

I am 48 years old. Sometime during the year of my 41st birthday I began to develop a problem with snoring that progressed slowly but by the time I was 47 the effect of the snoring on my lovely wife and children was becoming a severe aggravation. My wife Maria tried to adapt to my snoring by using ear plugs. This worked temporarily but ear plugs would get misplaced. The novelty effect of the ear plugs eventually wore off and they became a nuisance to her. Each morning my two sons would report to me about the volume of my snoring. It was very unpleasant for them. I resolved to relocate to the downstairs couch to sleep at night. While there I felt isolated from my wife and children.

I was in excellent physical condition, was not overweight, had recently completed the NY Marathon, and yet 2 sleep studies confirmed a sleep apnea and snoring problem. Because of the shape of my face and nose I was not a good candidate for a C-PAP device. Even if I was, I did not look forward lugging around a boxy electrical appliance for the rest of my life. I was getting used to feeling tired, I stopped running, and was letting myself get out of shape. After my last sleep study in December 2008 I was referred to you but hesitated to take action because I was still convinced I could work out this problem on my own. By February 2009 I was in poor physical condition. I had no more motivation to run because I burned myself out running and learned that all the running in the world could not help me eliminate the snoring. I resented sleeping on the couch away from my family. It began to “get to me,” and I was unpleasant to be with. I was becoming tempted to blame my family for my situation. Here I was blessed with a wonderful family yet I was feeling tired, resentful, and miserable all of the time.

In late March 2009 I finally decided I needed to see someone for help regarding the snoring. I made an appointment to see you in April. At the appointment I was impressed by the courtesy and professionalism of your staff. Even more important was when you and I discussed my problem. After I explained my situation you responded and I listened critically to what you had to say. By the time we were finished talking I was convinced that maybe someone like you, with your accumulated years of knowledge and experience in treating sleep apnea and the resulting issues, could help me.

By the next appointment you were fitting me with the EMA Appliance and by May I was no longer snoring. Not only did you provide me with an appliance that works and that I can carry around in a pocket but you also explained physiology of my particular problem and explained which sleeping positions would help me get the most out of the appliance. I resolved to do exactly what you told me to do. Armed with these tools I moved back upstairs with my family. I am not snoring any more. I feel refreshed when I awake each morning and once again I enjoy the sport of running. The quality of my life with my family is wonderful again and I have you to thank for it. Very truly yours, Daniel.

- Daniel T.

New Brunswick, NJ

Sleep apnea potentially life-threatening

Sleep apnea is a disorder that affects almost 18 million Americans. Unlike mild snoring, sufferers of sleep apnea stop breathing completely for 10 seconds or more while sleeping, 10-60 times in a single night. During these episodes, the brain briefly wakes up in order to restart breathing. This means that a person can be waking 10-60 times a night, in addition to suffering low oxygen levels from lack of breathing. Sleep apnea patients suffer fragmented, poor-quality sleep. In fact, studies have shown that sufferers of this disorder are so fatigued during the day that, when driving, their performance is similar to that of a drunk driver. Left untreated, sleep apnea can lead to impaired daytime functioning, high blood pressure, heart attack and stroke. To say that this disorder is life-threatening is no exaggeration.

Common symptoms of sleep apnea are: morning headaches, excessive daytime sleepiness, irritability and impaired mental or emotional functioning, snoring, choking or gasping during sleep, insomnia, and waking with a dry mouth or sore throat.

Who should you consult if you are worried that you may have sleep apnea?

If you suspect that you suffer from sleep apnea, discuss it with your personal physician. The symptoms listed above are common for sleep apnea, but can also be symptoms of other disorders and/or physical ailments. Visiting your personal physician first allows them to rule out other dangerous possibilities, and they can then refer you to a sleep medicine specialist (dentist) if they believe that sleep apnea is the issue. The sleep apnea specialist is able to conduct an overnight sleep study, in addition to studying your medical history and general medical background. The sleep study monitors heart rate and identifies sleep interruptions. If you are diagnosed with sleep apnea, most of the treatments are dental in nature, although for mild cases, a sleep apnea specialist may work with your physician to make modifications to lifestyle and diet that may be affecting the condition.

Is there any good news about sleep apnea? Yes.

Sleep apnea awareness has been growing and sleep apnea treatment is advancing each year. Specialists like Dr. Blumenstock focus specifically on the treatment of sleep apnea, and offer the most up-to-date and innovative treatments available. Many patients have been pleasantly surprised by the new dental devices that are available to alleviate sleep apnea. Previous therapy included appliances that were large, ungainly, uncomfortable and simply not user-friendly. Or, many sufferers believed that surgery was the only option. Newer appliances are compact and come in a variety of models so that your sleep apnea solution is custom-fit to your unique situation.

A Hard Turn: Big-Rig Drivers Focus on Getting Healthy

Enjoy Thanksgiving...but watch out for some of those truckers on the road, especially if they overeat like we all tend to do! You might want to read this ...

A Hard Turn: Big-Rig Drivers Focus on Getting Healthy

Beset by insurance costs and desperate to make sure that drivers pass health tests, trucking companies and industry groups are working to persuade them to change their habits.

“How do I know if my sleepiness is abnormal? Isn’t everyone tired these days?”

In the medical field, The Epworth Sleepiness Scale is used to determine the level of daytime sleepiness. A score of 18 or more is very sleepy. Download and print your own copy from Dr. Blumenstock’s site:

http://www.sleep-apnea-dentist-nj.info/sleep_apnea_questionnaire.htm

Or, test yourself now:

How likely are you to doze off or fall asleep in the situations described below, in contrast to feeling just tired?

This refers to your usual way of life in recent times. Even if you haven't done some of these things recently try to work out how they would have affected you. Use the following scale to choose the most appropriate number for each situation:

0 = would never doze

1 = Slight chance of dozing

2 = Moderate chance of dozing

3 = High chance of dozing

Situation Chance of dozing

Sitting and reading . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _____

Watching TV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. _____

Sitting, inactive in a public place (e.g. a theatre or a meeting) . . . . . . . _____

As a passenger in a car for an hour without a break . . . . . . . . . . . . . . . _____

Lying down to rest in the afternoon when circumstances permit . . . . . _____

Sitting and talking to someone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _____

Sitting quietly after a lunch without alcohol . . . . . . . . . . . . . . . . . . . . . . _____

In a car, while stopped for a few minutes in the traffic . . . . . . . . . . . . . _____

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _____

Score:

0-10 Normal range

10-12 Borderline

12-24 Abnormal

If you score 10 or more on this test, you should consider whether you are getting enough sleep and/or need to see a sleep specialist. Talk to your personal physician, or visit Dr. Blumenstock’s web site for more information: http://www.sleep-apnea-dentist-nj.info/sleep_apnea_questionnaire.htm

Signs of sleep apnea:

It is important to remember that most people with sleep apnea do not remember waking up during the night. Instead, family members often report or complain about the problem. These daytime symptoms may also be a clue:

• Morning headaches
• Excessive daytime sleepiness
• Irritability and impaired mental or emotional functioning
• Excessive snoring, choking or gasping during slee
• Waking with a dry mouth and/or sore throat

It’s important to understand that sleep apnea is a potentially life-threatening disorder. Those with sleep apnea are often so fatigued during the day that their performance while driving is similar to that of drunk drivers. When the condition goes untreated, it can lead to impaired daytime functioning, high blood pressure, heart attack and even stroke.

“Is it ever ‘just snoring’? It seems like everything these days is life-threatening!”

Actually, yes, there is just “plain old snoring”, and then there is “sleep apnea”. What’s the difference? Sleep apnea is a condition in which a person actually stops breathing for 10 seconds or more, between 10 and 60 times a night. This frequency can have a tremendous negative impact on a person’s health. There are actually two major types of sleep apnea-obstructive and central. With obstructive apnea, the walls in your throat relax while you are sleeping, so much so that the airway actually collapses and prevents air from flowing. Central apnea works entirely differently in that the brain mechanisms that control breathing are actually interrupting breathing during sleep. Obstructive apnea is the more common of the two.

“So how do you know the difference between snoring and sleep apnea?”

1. A classic sleep apnea pattern may sound like this: your spouse hears you snoring loudly, followed by silence, then a snort or choking sound as you resume breathing. The silence and the choking are important to notice, as this is when the body is not getting any oxygen at all, then it wakes itself to gasp for air.
2. See a sleep-apnea specialist, such as Dr. Blumenstock, who can perform a dental sleep disorder consultation and give you a conclusive response on whether you have a common sleep disruption, or the much more serious disorder, sleep apnea, which should be treated to protect your health.

“What if I have sleep apnea? What now?”

If you believe that you have sleep apnea, or have already been diagnosed with the condition, there are a number of solutions, depending on the severity of the condition. With mild cases, simple adjustments to your lifestyle may be suggested such as weight loss, sleep positioning, exercise, or cessation of smoking. For moderate to severe cases, there are oral appliances and/or the CPAP mask (read more about treatments), and oral surgery. Consult a dentist if you have concerns about sleep apnea. http://www.sleep-apnea-dentist-nj.info/index.htm

Sleep Apnea & Multi-Modal Transportation Conference in Baltimore

Dr. Blumenstock has attended the Sleep Apnea & Multi-Modal Transportation Conference in Baltimore on November 8-9, 2011. This event was sponsored by the American Sleep Society to promote and find solutions for transportation safety.

What are the alternatives to CPAP?

How effective is a treatment if you simply don’t use it? Studies show that up to 60% of sleep apnea patients abandon CPAP use. For this reason, Dr. Blumenstock has dedicated his practice to providing remedies to those who suffer from snoring and sleep apnea, offering a variety of oral appliances that are often more appealing and user-friendly than the CPAP. These appliances can be more effective, as patients find them more comfortable and easier to use.

Consider the wide variety of oral appliances offered by Dr. Blumenstock below (see photos), and make an appointment for your own consultation:

· SomnoMed

The SomnoMed MAS is a custom-made device, consisting of upper and lower dental plates with a unique patented fin-coupling component, which allows normal mouth opening and closing. An optional part provides incremental and adjustable levels of lower jaw advancement, which improves the effectiveness and comfort level of treatment as the jaw is moved only as far as is required to alleviate snoring and reduce apnea.

· Elastic Mandibular Advancement Appliance (EMA)

The EMA - Custom appliance is a simple, patient-friendly oral appliance created for noninvasive treatment of snoring and OSA. The primary treatment mechanism of opening the bite and gently moving the mandible forward is achieved with the use of interchangeable elastic straps that offer varying degrees of mandibular advancement. The flexibility of these elastic straps provides unsurpassed lateral movement and overall TMJ comfort. The 2 mm thick pressure formed bases offer orthodontic retention (resulting in no tooth movement) and maximum anterior tongue space because there are no projections in the palate.

· The Thornton Adjustable Positioner (TAP)

A custom-made adjustable oral appliance that is worn while sleeping. The appliance holds the lower jaw forward, preventing the tongue and soft tissue of the throat from collapsing into the airway. It is easily adjusted by the patient, as well as the patient’s spouse or significant other. The adjustment handle acts as a snoring volume control. As snoring is reduced, the airway is opened.

· Dorsal Appliance

Originally designed as a nighttime TMD splint, the Dorsal Appliance has evolved into one of the most popular choices for snoring and obstructive sleep apnea. The two piece construction allows for patient comfort and lateral jaw movement. The Dorsal fins on the mandibular appliance interface with inclines built into the buccal of the upper appliance to dictate a specific mandibular position. The appliance is traditionally fabricated with adjustable screws in the maxillary appliance to allow for further mandibular advancement. This appliance can be fabricated in a variety of materials including acrylic, dual laminate or thermal splint material.

· Silent Nite SL

Silent Nite SL positions the lower jaw forward using special S-shaped connectors that are attached to upper and lower trays. These trays are comprised of a soft inner layer with a hard outer layer that is durable and BPA-free. The new, improved connectors are stronger than those found on the original Silent Nite and are easily interchangeable by the patient. This intraoral appliance is indicated for patients with a minimum of eight teeth per jaw and a body mass index (BMI) of 30 or less.

· The SUAD™ Device

The SUAD™ Device is a premium dental sleep appliance developed for the treatment of snoring and obstructive sleep apnea. It is an effective, comfortable, and durable alternative to CPAP therapy or corrective surgery. By simply wearing The SUAD™ Device while sleeping, your lower jaw (mandible) will be moved forward into a comfortable position, allowing relaxation of the tissues at the back of your throat and ensuring the base of your tongue does not collapse and block your airway, giving you a safe and soundless sleep.

· Herbst, Herbst Telescopic, and SAUD Appliance

The Herbst appliance has been proven to be effective on chronic snoring and mild to moderate obstructive sleep apnea sufferers. This appliance allows patients to move laterally and vertically without disengaging the appliance. Also, if it is determined that the initial position does not provide the anticipated relief of the condition, the mandible can easily be moved forward by two options of adjustability. The Herbst is traditional hardware with limited range of adjustment. The Herbst Telescopic version allows greater flexibility of adjustment. The more robust SAUD version is made for the heavy grinder who might break other appliances.

· Oasys Sleep Appliance

The Oasys Appliance has a built-in nasal dilation so it works in a similar manner to Breathe Right Strips. The Oasys Oral/Nasal Airway System is the first dental device to be reviewed by both the dental and ENT divisions of the FDA. It has been approved as a dental device for treatment of snoring and sleep apnea through mandibular repositioning and also as a nasal dilator for reduction of nasal resistance and improved nasal breathing.

· Tongue Retaining Device (TRD)

The TRD is lab-constructed flexible polyvinyl material adapted to the general contours of the teeth and dental arches. It does not depend on teeth for retention. Rather, the tongue is held forward by the negative pressure created in the vacuum bulb on the front of the appliance.

The dental alternative to CPAP

From Sleep Apnea Video featuring Dr. Norman Blumenstock

Snoring can be described as gasping or snorting at night. These physical responses are actually forms of choking. While you sleep, your throat becomes relaxed and/or the weight of your tongue may block your throat. Your body’s method of self-preservation is to give you a shot of adrenaline to wake you up to stop the choking. Hence, the stop-and-start process of snoring, which may actually be sleep apnea or hypopnea, and can have severe health effects.

Sleep apnea and the sleep disorder hypopnea are closely related. With sleep apnea, your breathing airway closes between 80-100%, resulting in significantly decreased levels of oxygen in the blood. With hypopnea, there is a 50% air blockage and a 3-4% oxygen loss in the blood. With both disorders, you wake feeling exhausted or you simply don’t feel well. Snoring is the recognized calling card of sleep apnea; however, sleep apnea can be noticeable or can be silent. Some sufferers may find that their chief complaint may NOT be snoring. Instead, they cite simply feeling bad, they cannot function, can’t think, or feel like they’ve done an all-nighter. If you’re getting eight hours of sleep, but feel like you’ve only gotten two, you should consider a sleep apnea consultation.

The increased identification, diagnosis and treatment of sleep apnea do not necessarily signal that this is a new problem. It simply reflects the progress made within dentistry and the field of medicine in general. Prior to the 1980’s, the only answer to sleep apnea was a tracheotomy(!). Then, the cumbersome CPAP machine was invented and became the standby for sleep apnea sufferers. Further advances in the 1990’s led to surgery on the soft palate done by ENT doctors. Finally, oral appliances were invented, mimicking the simple concepts used in CPR: open the airways by tilting the head back (tightening the throat muscles) and pulling the jaw forward. From this non-invasive approach, a number of oral devices have been created to move the jaw forward, pulling the tongue forward and tightening the throat muscles at the same time. Sleep apnea dentists now can offer a variety of non-invasive, relatively small oral appliances that eliminate sleep apnea.

… Because of My Snoring!

“I knew something had to be done when my wife and I started sleeping in separate rooms…”

If you complete that sentence with “because of my snoring,” you owe it to yourself (and your wife!) to investigate a condition called sleep apnea. Much of our media is filled with gimmicks, hype and scare tactics, and most snorers have dismissed their condition as a common and incurable nuisance.

Perhaps you’ve already tried the latest remedy at the local drugstore in the hopes that you could find a cheap and easy solution to the nightly aggravation, but finally accepted the situation as “normal” when it didn’t work. While it’s true that snoring is fairly common, it is not correct to assume that it is benign or untreatable.

Over 12 million Americans suffer from a condition known as sleep apnea, and the #1 symptom of this condition is snoring. With sleep apnea, a person actually experiences oxygen deprivation during sleeping hours, and it can have long-term health effects. While it is common knowledge that long-term sleep deprivation is bad for your health, snorers often don’t make the connection to daytime symptoms of their serious long-term condition: difficulty with information processing, judgment, and short term memory, behavioral effects such as decreased vigilance and motivation as well as moodiness and aggressiveness.

While other sleep apnea patients suffer even more serious and acute health problems, they typically form the group of patients that are diagnosed, as their health complications force them to seek treatment.

The good news is, whether you have a mild snoring problem or diagnosed sleep apnea, effective remedies are available. Please feel free to research this topic more at our web site:

http://www.sleep-apnea-dentist-nj.info/index.htm

Or, read what our patients have to say:

http://www.sleep-apnea-dentist-nj.info/sleep_apnea_dentist_testimonials.htm

Medicare Coverage is available for Sleep Apnea Oral Appliance Treatment

Top News

New Oral Appliance Coverage Determination Released

In late November, the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) released a new local coverage determination for oral appliances. The policy, effective for claims with dates of service on or after January 3, 2011, states that a custom fabricated mandibular advancement oral appliance (E0486) used to treat obstructive sleep apnea is covered if certain criteria are met.

“The policy is a great step forward for both patients and providers. Choices in treatment are a must and treatment can now be personalized,” said Steve Moore, VP of sales and marketing for Airway Management Inc. “To say that everyone should have CPAP is like saying that everyone should wear the same type of shoes. Given the growing awareness that many people are not compliant with CPAP therapy, a second treatment option should increase the number of people who are successfully treated for obstructive sleep apnea.”

According to the policy:
A custom fabricated mandibular advancement oral appliance (E0486) used to treat obstructive sleep apnea (OSA) is covered if criteria A - E are met.

A. The patient has a face-to-face clinical evaluation by the treating physician prior to the sleep test to assess the patient for obstructive sleep apnea testing.

B. The patient has a Medicare-covered sleep test that meets either of the following criteria (1 or 2):
1. The apnea-hypopnea index (AHI) or Respiratory Disturbance Index (RDI) is greater
than or equal to 15 events per hour with a minimum of 30 events; or
2. The AHI or RDI is greater than or equal to 5 and less than or equal to 14 events per
hour with a minimum of 10 events and documentation of:
a. Excessive daytime sleepiness, impaired cognition, mood disorders, or
insomnia; or
b. Hypertension, ischemic heart disease, or history of stroke.

C. If the AHI >30 or the RDI >30 and meets either of the following (1 or 2):
1. The patient is not able to tolerate a positive airway pressure (PAP) device or
2. The treating physician determines that the use of a PAP device is contraindicated.

D. The device is ordered by the treating physician following review of the report of the sleep
test. (The physician who provides the order for the oral appliance could be different from the
one who performed the clinical evaluation in criterion A.)

E. The device is provided and billed for by a licensed dentist (DDS or DMD).

If all of these criteria (A-E) are not met, the custom fabricated oral appliance (E0486) will be denied as not reasonable and necessary.

“Patients can now have a custom appliance as first line treatment without the requirement to “fail” PAP therapy first,” Moore said. “If the patient has an AHI/RDI >30 events/hour, the treating physician must state that the patient is intolerant to PAP or that PAP therapy is contraindicated.”

Moore also pointed out that “strict requirements for devices must be met and only custom appliances that advance the mandible into a treatment position will qualify for payment. Custom appliances must be adjustable by the patient and advance the mandible in 1 mm increments,” Moore said. “Non-custom (boil and bite) appliances and tongue retaining devices are deemed medically unnecessary.”

Central Jersey Dental Sleep Medicine is proud to provide medical benefits for Sleep Apnea Treatment, to those patients who meet the Medicare qualifications. Visit our website for additional information on Sleep Apnea Treatments and Alternatives to CPAP at www.SnoreDentist.com. Call our office at 732-251-7766 to schedule an appointment with Dr. Norman Blumenstock, to find out if you qualify for benefits through Medicare or your personal insurance plan.

Trucking Accidents Caused by Undiagnosed & Untreated Sleeping Disorders

The first thing that comes to mind when you hear about trucking accidents is road rage or weather related road conditions. Although many trucking accidents are caused by road rage and stormy weather conditions, there are an increasing number of accidents caused by sleep apnea.

According to the U.S. National Highway Traffic Safety Administration, there are 100,000 accidents caused by driver fatigue. The good news is sleep apnea can be detected through medical testing.

In addition to mandatory drug testing by trucking companies, truck drivers must undergo screening for sleep disorders, such as sleep apnea. Trucking companies that fail to comply with government regulations could be fined heavily.

Sleep apnea while driving doesn’t just affect truck drivers, it also affects motor vehicle drivers. The more people are educated about the harmful effects of sleep apnea, the fewer accidents will occur on the road.

Do you have sleep apnea?

The only way a person can tell whether or not they have sleep apnea is by getting a diagnosis from a doctor. Here are a few common symptoms of sleep apnea:

• Loud snoring (severe)
• Day-time drowsiness
• Episodes of not breathing during sleep
• Tossing and turning during sleep
• Nighttime choking
• Memory loss
• Moodiness
• Headaches (morning or night)
• Frequent urination at night
• Chest pain and sweating while sleeping

There are a variety of treatment options for sleep apnea suffers. One of the most effective treatments is the oral appliance. Oral appliances have helped many patients regain control of their sleep. There’s nothing more satisfying than getting a good nights sleep.

Central Jersey Dental Sleep Medicine is proud to provide medical benefits for Sleep Apnea Treatment, to those patients who meet the Medicare qualifications. Visit our website for additional information on Sleep Apnea Treatments and Alternatives to CPAP at www.SnoreDentist.com. Call our office at 732-251-7766 to schedule an appointment with Dr. Norman Blumenstock, to find out if you qualify for benefits through Medicare or your personal insurance plan.

Obstructive Sleep Apnea Can Effect On the Job Work Performance

Often times, an employer will automatically label an employee who has a poor job performance as lazy and unmotivated. That is not always the case. Did you know that untreated Obstructive Sleep Apnea (OSA) can affect a person's job performance? People who suffer from this type of sleep disorder are more likely to have a higher percentage of lateness’s and absences. They are also more likely to fall asleep on the job.

In the corporate work environment, workers who suffer from sleep disorders are more likely to make costly errors. In a blue-collar work environment, OSA is not only hazardous to one’s health; it can also be a hazard to other workers, especially if the job requires operating machinery. Many on the job injuries are a direct result of undiagnosed and untreated sleep disorders.

Study Proves OSA Can Effect Work Performance

Recently, the University of California San Francisco Sleep Disorders Center, conducted a sleep apnea study in 150 workers from various fields. All the participants were in their mid-forties. The overnight sleep study results indicated that 83 of the participants had sleep apnea. The results also concluded that work productivity suffers when employees suffer from sleep apnea and daytime fatigue.

So, what are companies doing to prevent on the job accidents and work performance issues caused by OSA? They’re educating their employees about the dangers of untreated sleep disorders.

Sleep disorders can also prevent a person from getting promoted on the job and it can even cause a person to lose their job. Once a person is treated for Obstructive Sleep Apnea, they can live a more healthy and productive life.

Central Jersey Dental Sleep Medicine is proud to provide medical benefits for Sleep Apnea Treatment, to those patients who meet the Medicare qualifications. Visit our website for additional information on Sleep Apnea Treatments and Alternatives to CPAP at www.SnoreDentist.com. Call our office at 732-251-7766 to schedule an appointment with Dr. Norman Blumenstock, to find out if you qualify for benefits through Medicare or your personal insurance plan.

3 Common Causes of Sleep Apnea

Over 12 million Americans suffer from sleep apnea, according to the National Institutes of Health. Why is this number so high? The numbers are high because so many people are misdiagnosed or they're not diagnosed at all. Some people take sleep for granted – until they begin to slowly experience the negative side-effects of losing sleep. Here are three common causes of sleep apnea:

Central Sleep Apnea

Common symptoms are daytime fatigue and snoring. People who suffer from Central Sleep Apnea tend to have difficulty staying asleep at night or wake up with shortness of breath. This form of sleep apnea happens when the brain fails to send signals to the muscles that control breathing. If left untreated, it could lead to heart disease and strokes.

Obstructive Sleep Apnea

People with this form of sleep apnea tend to make loud snorting sounds during their sleep. For some, this may occur every few minutes. This is considered one of the most common forms of sleep apnea. It happens when your muscles in the back of your throat relax as you drift off to sleep. This causes the airways to close while blocking the passage of air. As a result, your brain triggers you wake up in the middle of sleep in order to reopen your airway.

Complex Sleep Apnea

This is considered a rare sleeping disorder. It is often called ‘mixed sleep apnea’. This is when your upper airways are obstructed. As a result, your breathing patterns demonstrate lapses or gaps in breathing.

Treatment for Sleep Apnea

If you suffer from a very mild form of sleep apnea, your physician my suggest changes in your diet or even quitting smoking. If you suffer from a severe form of this disorder, your physician may recommend an Oral Appliance. With an oral appliance, you will be able to sleep easier without interruption.

Want To Know What It Feels To Sleep Again?

We all want to feel rested and mentally sharp every day. Our productivity depends on it. But not having a good night's sleep affects far more than just our ability to stay focused or have a day full of energy.

Not having enough sleep directly affects our brain and our cognitive function and may even cause depression. Sleep apnea, if left untreated, can lead to serious conditions but also its effects can severely interrupt daytime cognition.

If this is your case, Dr. Blumenstock can help you! Identifying and treating sleep apnea is the first step for knowing what it feels to sleep again. Sleep apnea can be treated and you can sleep again.

Read more on sleep apnea

Oral appliance therapy improves craniofacial growth direction and snoring

AADSM Public Relations

Tuesday, May 31, 2011

EMBARGOED FOR RELEASE: June 11, 2011, at 1:45 p.m. CST

DARIEN, Ill. – According to new research that will be presented Saturday, June 11, at the 20^th Anniversary Meeting of the American Academy of Dental Sleep Medicine (AADSM), children with enlarged tonsils and adenoids who wore an oral appliance for six months experienced more favorable craniofacial growth, enlargement of pharyngeal dimensions, and improved breathing and snoring during sleep.

Enlarged tonsils and dental malocclusion have a strong relation with sleep disturbance in children. Its consequences can include abnormalities of craniofacial growth and facial morphology more suitable to the development of obstructive sleep apnea (OSA).

Forty children from the waiting list for adenotonsillectomy at the ENT Department of the University of São Paulo Medical School were included in the study. The children ranged from 6 to 9 years of age. All of them presented snoring, tonsil and adenoid enlargement grades III and IV, and dental malocclusion (constricted maxilla and/or jaw deficiency). Patients were divided into two randomized groups: 24 patients were treated with the Bioajusta X dental appliance and 16 were controls.

The researchers evaluated the craniofacial growth in children with enlarged tonsils and adenoids, after dental appliance (Bioajusta X) treatment. They also compared the prevalence of snoring before and after treatment.

“The primary finding of the study was the positive influence of this treatment on snoring in children with enlarged tonsils and adenoids and narrow maxillary arch,” said principal investigator Walter R. Nunes Jr., DDS, MS, who is affiliated with the Otolaryngology Department of the University of São Paulo Medical School in Brazil.

“This method of treatment acted on the normalization of the respiratory function and sleep, which reflected positively on the quality of life of those children and their families, and also resulted in a better pattern of craniofacial growth,” said Nunes. “This normalization on the growth pattern may possibly reduce the incidence of obstructive sleep apnea in the future.”

Cephalometric analysis was used to access the growth direction comparing the vertical jaw relationship according to the angle of the palatal plane with the mandibular plane (ANS-PNS / ML). The parents filled out a questionnaire about respiratory symptoms. They were re-evaluated and compared after six months.

Cephalometry showed in the treated group a reduction on the palatal x mandibular angle of - 2,75 º : Media at T1 = 30.08 º (sd 3.8) ; Media at T2 = 27.33 º (sd 3.4) and an increase of this measurement in the untreated group of +1,25 º : Media at T1 = 28.38 º (sd 3.8) ; Media at T2 = 29.60 º (sd 3.5) at the untreated (p<0.001).

This abstract will receive the Graduate Student Research Award at the AADSM 20^th Anniversary Meeting.

The 20^th Anniversary Meeting will bring together nearly 800 international clinicians and researchers in dental sleep medicine to present and discuss new findings and developments related to sleep-related breathing disorders, including obstructive sleep apnea (OSA), upper-airway resistance syndrome (UARS), and primary snoring. This three-day scientific meeting will be held in conjunction with SLEEP 2011, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society in Minneapolis, Minn.

Abstract Title: Snoring children treatment with orthodontic and orthopedic appliance – randomized clinical trial

Presentation Date: Saturday, June 11, 2011

Category: Graduate Student Research Award

Abstract ID: 009

Study finds excellent agreement between subjective and objective compliance with oral appliance therapy

AADSM Public Relations

Tuesday, May 31, 2011

EMBARGOED FOR RELEASE: June 11, 2011, at 11:30 a.m. CDT

DARIEN, Ill. – According to new research that will be presented Saturday, June 11, at the 20^th Anniversary Meeting of the American Academy of Dental Sleep Medicine (AADSM) in Minneapolis, Minn., objective compliance measurements agree with subjective compliance estimates in patients with obstructive sleep apnea (OSA) undergoing oral appliance therapy (OAT) – a finding that is not apparent in patients using continuous positive airway pressure (CPAP) therapy.

Results show that the objective mean wearing time in the whole group was 6.8 hours per night. Among 21 patients who filled out the subjective compliance diary, both the objective and subjective mean wearing times were 7.0 hours per night.

“The results of this study suggest that the use of an objective instrument to measure oral appliance compliance during treatment of obstructive sleep apnea is feasible and, therefore, should be implemented in future studies dealing with oral appliance therapy for obstructive sleep apnea,” said principal investigator and lead author Olivier M. Vanderveken, MD, PhD, a staff-member consultant ENT, head and neck surgeon at the Antwerp University Hospital, and faculty lecturer at the Faculty of Medicine of the University of Antwerp in Belgium.

“These results contrast with the finding in literature on compliance during CPAP treatment revealing that self-reported daily compliance with CPAP significantly overestimates the actual daily use of CPAP as assessed by objective measurement of CPAP compliance,” said Vanderveken.

This four-week clinical trial compared active measurement of Mandibular Repositioning Appliance (MRA) compliance with patients’ self-reports. The study involved 23 men and women with an established diagnosis of sleep-disordered breathing (SDB) who had an average apnea-hypopnea index (AHI) of 14.8 breathing pauses per hour of sleep. They had an average age of 47 years. Compliance was measured during MRA treatment by establishing a mean rate of use, using an active built-in microsensor thermometer (TheraMon®) with on-chip integrated read out electronics. The sampling interval of the recording by the active microsensor was done at a rate of 1 measurement per 15 minutes (every 900 seconds). The subjects were unaware that their MRA use was being measured objectively.

The read-out of the data was performed at a one-month interval. During the follow-up visit, patients were asked to fill out a questionnaire about MRA wear during the last four weeks (mean hours/night, mean nights/week). The objective measurement of MRA wear time was based on the assumption that the MRA has been worn when the chip records a temperature intraorally > 89.6 °F. To compare the subjective estimates of the patients with the objective data from the microsensor, a Wilcoxon signed rank test was performed.

“The removable nature of an oral appliance warrants an objective assessment of the effective use and compliance with overnight oral appliance treatment for obstructive sleep apnea,” said Vanderveken.

This abstract will receive the Clinical Excellence Award and Clinical Research Award at the AADSM 20^th Anniversary Meeting.

The AADSM 20^th Anniversary Meeting will bring together nearly 800 international clinicians and researchers in dental sleep medicine to present and discuss new findings and developments related to sleep-related breathing disorders, including obstructive sleep apnea (OSA), upper-airway resistance syndrome (UARS), and primary snoring. This three-day scientific meeting will be held in conjunction with SLEEP 2011, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society, in Minneapolis, Minn.

Abstract Title: Comparison of Subjective and Objective Measures of Oral Appliance Compliance During Treatment of Sleep-Disordered Breathing.

Presentation Date: Saturday, June 11, 2011

Category: Clinical Excellence Award and Clinical Research Award

Study finds that combination therapy reduces pauses in breathing caused by obstructive sleep apnea

AADSM Public Relations

Tuesday, May 31, 2011

EMBARGOED FOR RELEASE: June 11, 2011, at 1:30 p.m. CDT

DARIEN, Ill. – According to new research that will be presented Saturday, June 11, at the 20th Anniversary Meeting of the American Academy of Dental Sleep Medicine (AADSM), in Minneapolis, Minn., the apnea-hypopnea index (AHI) in patients with severe obstructive sleep apnea (OSA) was more improved by a combination treatment of a mandibular advancement splint (MAS) and positive airway pressure (PAP) therapy than by continuous positive airway pressure (CPAP) therapy alone.

Results show that without lowering the pressure substantially, CPAP tolerance can be improved and severe OSA can be effectively treated using a MAS that physically supports and stabilizes the position of nasal pillows (TAP®-PAP).

The study involved data from 10 male and female patients who were first treated for severe OSA. Polysomnogram (PSG) data were obtained from patients’ initial diagnostic CPAP titration, and combined MAS-PAP titration studies. The seven patients who completed the study had a mean AHI of 66 breathing pauses per hour of sleep prior to treatment, 4.4 events per hour with CPAP therapy alone, and 2.6 events per hour with combined MAS-PAP. Epworth Sleepiness Scale (ESS) scores were also obtained to measure excessive daytime sleepiness. ESS scores decreased from 10.1 to 7.9 to 4.9, respectively.

“The primary finding of the study is that patients with severe OSA who were non-compliant with CPAP and suffered from effects of nightly hypoxia and poor quality of sleep are now compliant with MAS-PAP,” said lead investigator John White DDS, D. ABDSM.

Home sleep tests (Watch-Pat™) were obtained prior to MAS delivery, after MAS titration, and with combined MAS-PAP. The patients’ mean AHI was 54.4 events per hour before MAS delivery, 40.2 events per hour using MAS alone, and 10 events per hour with combination therapy. The amount of sleep time during which oxygen saturation was less than 90 percent decreased from 20.8 percent to 11.5 percent to 3 percent, respectively.

Patients reported reasons for intolerance using a 13-item checklist. With traditional CPAP therapy, each patient reported two to six reasons for intolerance. Most commonly reported reasons were: ‘can’t keep in place’ (85.7 percent), ‘unconsciously remove’ (57.1 percent); ‘mask uncomfortable,’ ‘mask leaks,’ and ‘claustrophobia’ (42.9 percent each). With combination therapy, only two patients reported a single negative experience: ‘unconsciously remove,’ ‘pull of hose applies force to teeth.’

“These results are important because a patient with severe OSA who is unable to comply with CPAP has no other viable treatment options,” said White. “This therapy offers patients a significant improvement in quality of sleep, which leads to improved moods, performance, and overall outlook on life.”

This abstract will receive the Clinical Research Award at the AADSM 20th Anniversary Meeting.

The AADSM 20th Anniversary Meeting will bring together nearly 800 international clinicians and researchers in dental sleep medicine to present and discuss new findings and developments related to sleep-related breathing disorders, including obstructive sleep apnea (OSA), upper-airway resistance syndrome (UARS), and primary snoring. This three-day scientific meeting will be held in conjunction with SLEEP 2011, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society, in Minneapolis, Minn.

Abstract Title: Efficacy and tolerance of combination therapy using MAS supported nasal pillows.
Presentation Date: Saturday, June 11, 2011
Category: Clinical Research Award
Abstract ID: 015

Loud Snoring: First Sign of Sleep Apnea

For years, loud snoring has been a go-to joke in movies and television shows and many families have been affected by the "loud snorer" in the household. In fact, family members and friends are commonly the first people to realize that someone snores loudly, which can lead to denial and arguments. But loud snores may not just be a joke or an irritation: loud snoring may be the first sign of sleep apnea, a medical condition where breathing temporarily stops.

Sometimes, loud snoring may occur because there is a blockage of some kind in the upper airway. The air that is able to pass results in a loud 'snoring' sound. The resulting silence after a period of snoring is when the sleep apnea, lack of breathing, takes place. This happens because very little or no air is passing through the airway. When the snoring starts again, it usually begins with gasping or a sharp snort as the body tries to take in air around the blockage once more.

There are other factors involved in sleep apnea, but loud snoring can be one of the first signs, if not the first. People can have sleep apnea for years without knowing it. If you have any reason to believe that you are a "loud snorer", or have a loved one who snores loudly through the night, fill out our questionnaire and find out if an appointment with Dr. Blumenstock would be beneficial.

Read more on snoring solutions

Sleep Apnea & Sleep Disordered Breathing

Dr. Norman Blumenstock presented another well received, 2 hour lecture on Sleep Apnea & Sleep Disordered Breathing Tuesday evening to General & Specialty Dentists at the Livingston Dental Study Club, in the New Brunswick / Somerset area. Become a fan of our FB page , or visit my website at www.SleepApneaDentistNJ.com to learn more about what Dental Sleep Medicine treatments can do for Sleep Apnea or Snoring.

Helping a loved one with sleep apnea

When a relative or a loved one is diagnosed with sleep apnea, they can feel somewhat isolated. Often, friends and family want to provide support and help to their friends, families and loved ones, but sometimes they are unaware of how to do so. Here are a few things to do to support a loved one with sleep apnea:

1. Educate yourself about sleep apnea. Many friends and families of people with sleep apnea aren't sure what the condition is or what can be done about it. Make sure to have a working knowledge of sleep apnea so that you will be ready to help further.

2. Attend doctor appointments with the friend/family member. This allows you to help your loved one remember questions he or she has for the doctor, as well as helping him or her remember what the doctor says later on. You can ask your own questions as well.

3. Help the loved one follow through with the doctor's orders. This may mean encouraging a good diet or paying attention to sleep patterns.

4. Make yourself available to talk. Being there emotionally for your friend or family member can give them the support they need to feel good about their health and to continue with treatment. You can help your loved one know they aren't handling this alone.

Dr. Blumenstock and his staff can provide additional guidance for anyone dealing with sleep apnea, why not give us a call today?

Read more on alternative to CPAP NJ

Real Solutions for Sleep Apnea

Our goal at the Central Jersey Dental Sleep Medicine is to help sleep disorder sufferers find REAL solutions to their sleep problems. No one wants to live with never getting a full night's rest, and we would like to help you sleep better. There are many solutions to sleep apnea, but the first step is to get diagnosed. If you visit us then you will receive an objective medical assessment by a team of physicians, neurologists, pulmonologists, and ear, nose, and throat specialists.

Following their referral, Dr Blumenstock will examine you and discuss all options to solve your sleep apnea. One common solution is an oral appliance, but often changes in behavior will also affect your sleep apnea. Get diagnosed and treated with a real solution for your sleep apnea.

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Sleep Apnea Treatments

If you have sleep apnea you know that a lack of quality sleep can take a huge toll on your life. Sleep apnea patients often complain of a lack of energy, poor concentration, decreased productivity, slowed metabolism, poor attitude. In addition to disadvantages associated with loss of sleep, sleep apnea can lead to high blood pressure, heart attacks, strokes, and even sudden death. It affects your sleep, your quality of life, and your health. Sleep apnea is obviously not a condition to take lightly. Diagnosis and treatment can have a huge impact on your future.

What treatments are there for sleep apnea? Once you have been diagnosed, Dr. Blumenstock will discuss the best options for your condition. Options for treatment include: oral appliances, behavioral adjustment, CPAP machine, and surgery. Keep in mind that a follow up visit will be necessary to ensure that the treatment option chosen is successful in restoring your sleep.

Read more on Sleep apnea treatment Monroe Township NJ