New Jersey Sleep Society, Inc - Annual Educational Symposium - Nov. 12 & 13, 2010

National Conference Center at the Holiday Inn East Windsor, NJ
399 Monmouth Street East Windsor, NJ 08520
(609) 443-8000

Course Program

Friday • November 12, 2010

2:00 — 3:00pm
REGISTRATION • VISIT EXHIBITS • REFRESHMENTS

3:00 — 3:10pm
Welcome
Lee J. Brooks, MD, President, NJSS

3:10 — 4:10pm
How Do Circadia Rhythms and Sleep-Wake Regulatory
Systems Affect Sleep Patterns?
Mary A. Carskadon, PhD
Learning Objectives: review circadian rhythms terminology and basics of circadian biology; examine sleep-wake homeostasis and how it affects sleep; describe how the circadian timing system and sleep-wakehomeostatic processes interact to enhance or interfere with sleep

4:10 — 4:45pm
REFRESHMENT BREAK • VISIT EXHIBITS

4:45 — 5:45pm
How Do Circadian and Sleep-Wake Regulation change During Adolescent Development?
Mary A. Carskadon, PhD
Learning Objectives: review developmental stages in adolescence and secular trends in puberty; describe how circadian phase is changed during adolescence; review changes in sleep-wake homeostasis that accompany adolescence; examine consequences of these developmental changes

5:45 — 6:45pm
Adult vs. Pediatric Respiratory Rules in Adolescents
Ignacio E. Tapia, MD
Learning Objectives: discuss the AASM respiratory scoring criteria; clarify which scoring criteria should be used in adolescents

6:45 — 7:30pm
PRE-DINNER RECEPTION • VISIT EXHIBITS

7:30 — 9:30pm
DINNER and Sleep in Astronauts
Erin E. Flynn-Evans, PhD, RPSGT
Learning Objectives: educate on the challenges of sleeping in extreme environments; educate on wake and sleep promoting countermeasures and their effectiveness during spaceflight

Saturday • November 13, 2010

7:00 — 8:00am
REGISTRATION • VISIT EXHIBITS • BREAKFAST

8:00 — 9:00am
Fatigue Management for All
Kingman P. Strohl, MD
Learning Objectives: discuss the warning signs of sleepiness and fatigue as a manifestation of brain function; list the factors that promote and countermeasures that reduce fatigue and sleepiness in medicine, nursing, and sleep technology

9:00 — 10:00am
Oral Appliance Therapy for Sleep Breathing Disorders
Steven D. Bender, DDS
Learning Objectives: discuss how to determine which patients may benefit from oral appliance therapy; explain how to appropriately titrate an oral device; discuss the benefit of combined therapy utilizing CPAP and oral appliances in patients with severe obstructive sleep breathing disorders

10:00 — 10:45am
REFRESHMENT BREAK • VISIT EXHIBITS

10:45 — 11:45am
Women and Sleep

Joyce A. Walsleben, RN, PhD
Learning Objectives: discuss the unique issues with women and sleep; discuss effective treatments for women with sleep issues

11:45 — 12:45pm
Sleep and Fatigue in Transportation Safety
Christopher A. Hart
Learning Objectives: highlight the major fatigue and sleep issues in transportation; catalyze thinking about how to address those issues

12:45 — 2:15pm
LUNCH • VISIT EXHIBITS

Membership Meeting and Elections


2:15 — 3:15pm
The Appropriate Treatment of Mild Sleep Apnea
David Schulman, MD, MPH
Learning Objectives: discuss using data gleaned from patient history and polysomnography to determine which patients with mild sleep apnea require therapy; recommend different therapeutic options to mild sleep apnea patients based upon anatomic factors and disease severity

3:15 — 4:15pm
Federal and New Jersey Regulatory Update
Martin L. Monaco, Jr., Esq.
Learning Objectives: update on New Jersey and Federal regulatory provisions; discuss suitable joint ventures permitted in New Jersey under the changes to the Codey law

What Should You Know About Sleeping Disorders

Sleep disorders can involve sleeping difficulties such as difficulty falling asleep, staying asleep, falling asleep at inappropriate times, excessive sleep, or abnormal behaviors associated with sleep. Dr. Blumenstock specializes in a sleeping disorder known as sleep apnea. Sleep apnea is a serious sleep disorder that occurs when breathing is interrupted during sleep. A person with this disorder may stop breathing repeatedly during sleeping hours. This could happen sometimes hundreds of times during one night of sleep. Ceasing breathing during any time means the brain and the rest of the body does not receive the oxygen they need to function.

Sleep apnea can affect anyone at any age, even children. You may be at risk for sleep apnea if you fall under one of the following categories: male in gender, being overweight, prone to snoring, over the age of forty, having a neck size of 17 inches or greater for men and 16 inches or greater for women, having large tonsils, large tongue, or small jaw bone, having family history of sleep apnea, having GERD, and any nasal obstruction due to deviated septum, allergies, or sinus problems.

Sleep apnea is a serious sleeping disorder. If you are suspicious or fall into any of the above categories, you should look into being tested. Make an appointment with Dr. Blumenstock today, and be one step closer to better sleep.

Read more on Sleep Apnea in NJ

Notes from an Interview with Dr. Blumenstock

An interview with Dr. Blumenstock on sleep apnea revealed some interesting facts. Dr. Blumenstock related that snoring which sounds like gasping is actually choking. The weight of your tongue can block your throat, or you muscles relax to cause gasping and choking of snoring. Jaw structure and tongue size also affect one's breathing at night, and creates the potential to suffer from sleep apnea.

He also mentioned that sleep apnea is also related to quality of life issues such as being diabetic, overweight, and having high blood pressure. Sixty percent of people that develop sleep apnea fall into one of the above categories. It is very important to make health a priority when it starts to affect your quality of sleep.

Sleep apnea is 1 of 3 sleep breathing disorders. With sleep apnea, the airway in the back of the throat closes eighty to one hundred percent. This leads to gasping/snoring and a decrease in oxygen in your blood flow. Snoring is often a good indicator of this sleeping disorder. However, just because you don't snore, does not mean you do not have a sleeping disorder. Sometimes one's throat may only close about fifty percent, which is not enough to cause snoring. This issue causes people to wake up tired, irritated, and feel like they have stayed awake all night.

Sleep apnea is a serious disorder, and should be treated as such.

Read more on Sleep Apnea Dentist Dr. Norman Blumenstock

Dr. Blumenstock and Sleep Apnea

Did you know that Dr. Blumenstock is your dental sleep expert in New Jersey and surrounding areas? He has taken hundreds of hours of postgraduate education, as well as his 20-year plus focus on sleep medicine. He is passionate about what he does and can help improve your overall health.

Central Jersey Dental Sleep Medicine cooperates with medical doctors to make sure your individual situation is fully addressed with an objective medical assessment. Dr. Blumenstock and his staff work with physicians and specialists such as neurologists, pulmonologists, and ENT physicians to help with this initial medical assessment.

Snoring and obstructive sleep apnea are medical problems, and should be treated by qualified professionals. We have your best interest in mind.

Once you receive a referral from a physician, you will obtain a thorough oral examination by Dr. Blumenstock. From there the best plan for your specific situation will be discussed and implemented.

Our services do not end there, however, we recommend a follow-up evaluation to ensure your satisfaction and to objectively document the effectiveness of the therapy. Are you ready to sleep better and wake up feeling refreshed? Give us a call for more information on how you can get started.

Read more on oral appliance therapy for sleep apnea in NJ

Sleep Apnea Therapy

There are several different options to the treatment of sleep apnea. One common treatment is behavioral therapy. Behavioral changes are an important part of treatment, and in some cases behavioral therapy may be all that is needed. Use of alcohol, tobacco, and sleeping pills should be avoided because they make the airway more likely to collapse during sleep and prolong the apneic periods. Patients who are overweight can benefit from losing weight, and even 10 percent weight loss can reduce the number of apneic events for most patients. For those with mild sleep apnea, breathing pauses occur only when they sleep on their backs. In such cases, using pillows and other devices to aid sleeping in a side position has proven beneficial.

Nasal continuous positive airway pressure (CPAP) is a common effective therapy for sleep apnea. With the CPAP, the patient wears a mask during sleep, and pressure from an air blower forces air through the nasal passages. The air pressure can be adjusted so that it is just enough to prevent the throat from collapsing during sleep. The pressure from the CPAP is constant and continuous. Variations in this therapy are available to minimize side effects such as nasal irritation, facial skin irritation, abdominal bloating, mask leaks, sore eyes, and headaches. The variations can be changing the air pressure to coincide with a person's breathing pattern. Although the CPAP has been proven a successful therapy of sleep apnea, patients regularly complain about its lack of comfort.

Fortunately oral sleep appliances and therapy have proven to be a viable alternative to CPAP. For those who are accustomed to the use of CPAP, but would rather not travel with the machine, it is possible that oral appliances can be used just as effectively. Oral appliances are also a good alternative for those individuals who are intolerant to CPAP.

Read more on Sleep Medicine

Sleep Apnea Facts

Sleep apnea is a serious condition that is far more common than generally understood. It was first described in 1965, and was characterized by brief interruptions of breathing during sleep. In Greek, the word "apnea" means, "want of breath." Generally, there are two types of sleep apnea: central and obstructive. Obstructive sleep apnea is the most common type and occurs when air cannot flow in or out of the nose or mouth although efforts to breathe continue. The less common type, central sleep apnea occurs when the brain fails to send the appropriate signals to the breathing muscles that cause respirations.

In a given night, the number of involuntary breathing pauses or "apneic events" may be as high as 40 per hour. These pauses are almost can be accompanied by snoring, although not everyone who snores has this condition. In addition to snoring, sleep apnea can also be characterized by choking sensations. The frequent interruptions of deep, restorative sleep leads to early morning headaches, excessive daytime sleepiness, and irritability.

Early recognition and treatment of sleep apnea is important because it is a potentially life-threatening condition. Sleep Apnea can be associated with irregular heartbeat, high blood pressure, heart attack, and stroke. Get diagnosed, and get treatment today.

Read more on Obstructive Sleep Apnea Treatment

Information Behind the CPAP Machine

The most common treatment of sleep apnea is a CPAP machine. CPAP stands for Continuous Positive Air Pressure. It uses a constant flow of air to keep the breathing passages open. A patient wears a mask that receives the airflow from a machine located next to the bed. When used efficiently, the CPAP machine has close to 100% effectiveness for sleep apnea. But, there is a 50% success rate due to patient's inability to tolerate the machine. Many complain that it is noisy, restricts movement, and causes side effects such as dry throat and raw skin where the mask is worn.

Fortunately there are alternatives to the CPAP machine. Oral sleep appliances and therapy have proven to be a viable alternative to CPAP. For those who like the use of CPAP, but would rather not travel with the machine, it is possible that oral appliances can be used just as effectively. Oral appliances are also a good alternative for those individuals who are intolerant to CPAP. There is now a hybrid therapy with CPAP causing the air pressure of the CPAP to be lowered to a more comfortable level and to eliminate air leaks and tight masks. Finally, adjunctive usage means that there can be days off from CPAP usage like for camping and business trips. Some of the benefits of an oral appliance over the CPAP are: no uncomfortable masks or hoses, does not promote claustrophobia like the CPAP can, tolerated much better than CPAP, and no mask impression left on the face.

Dr. Blumenstock has treated many patients who have not been able to tolerate the CPAP, and seek alternative treatment. Within 4-6 treatments you can be fitted with an oral appliance, which is an effective solution for most sleep apnea cases. The biggest benefit is that you and your spouse can actually sleep in the same bed!

Read more on oral sleep appliances