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
Wednesday, June 29, 2011
Friday, June 3, 2011
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 20th 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 20th Anniversary Meeting.
The 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: 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 20th 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 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: 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
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