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.

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“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.