Effective New Treatment for Patients with Sleep Apnea

Tens of millions of people around the world today are suffering from a potentially life-threatening health disorder known as sleep apnea. In the US alone, some 20 million sufferers experience varying degrees of choking and gasping for breath every time they fall asleep, yet most fail to seek medical help.

While treatment is available, a lack of awareness among both healthcare professionals and the general public means that approximately 90% of all cases remain undiagnosed – and therefore untreated – with potentially fatal consequences. Up to 38,000 cardiovascular deaths each year in the US are either directly or indirectly attributable to sleep apnea.

Until recently, traditional treatments for those who were lucky enough to be diagnosed had limited success. Some of these treatments failed to comply with standard therapies, while the most effective treatment was with a device called a Continuous Positive Airway Pressure (CPAP) machine.

The CPAP machine uses a face mask connected to tubes that blow air down a patient’s throat to keep the airway open while they sleep. Even though it is widely regarded as the most effective of the traditional treatments, fewer then 50% of patients successfully completed treatment with the CPAP machine because they found it too cumbersome, noisy and uncomfortable.

For severe sufferers of sleep apnea, the only accepted alternative to the CPAP machine was surgery, which can be effective but only if performed competently and in precisely the correct anatomic site – something that varies greatly between each patient.

Today, an effective new treatment is available for the treatment of sleep apnea.

This new alternative is proving far more appealing because it is less intrusive, less expensive and easier to use. The Thornton Adjustable Positioner (TAP) is a much smaller appliance that fits easily inside the mouth. The TAP works by gently pushing the lower jaw forward and can be adjusted with a small key.

In extensive clinical tests in the US, the TAP has proven to be a resounding success for sleep apnea sufferers. Doctor Paul Mclornan, B.D.S., the lead investigator in an 18-month survey, explained that patients who used the TAP showed marked improvements during the study.

“We saw patients who began the study with severe sleep apnea end the study with very mild or no sleep apnea,” Dr. Mclornan reported. “They reported sleeping better, feeling more rested in the morning and altogether more rested,” he continued before adding that this was vital for both the medical and dental communities.

Sleep apnea is a fast-growing problem that, if left untreated, can lead to an increased risk of high blood pressure, heart attacks, strokes, obesity and diabetes. In the past, a lack of awareness and inconvenient treatments have been factors in low diagnosis and treatment levels. Fortunately, the TAP has changed all that.

Denta-Joy is a certified dental clinic providing dental appliances for the treatment of sleep apnea. While we do not provide the TAP device, it is one type of oral appliance therapy that is available at Denta-Joy.

If you think that you may have sleep apnea; if you experience interrupted sleep because of choking or gasping for breath; or if you are constantly tired, contact Denta-Joy to find out more and take action before the condition worsens and places your life at risk.

Reference:
New Study Shows Dental Appliance Successful in Treating Patients with Severe Sleep Apnea
The University of Texas Health Science Center at San Antonio
02/23/2009

Dentists Against Drowsy Driving

Dentists Against Drowsy Driving (DADD) was established to increase awareness amongst both healthcare professionals and the general public of the healthcare risks and economic impact of the many undiagnosed and untreated sleep-related breathing disorders (SBDs).

SBDs leave sufferers feeling tired and irritable during the day. However, if left untreated, these mild conditions can worsen with potentially fatal consequences. Unfortunately, a lack of awareness amongst healthcare professionals often leads to SBDs remaining undiagnosed and consequently untreated.

SBDs are caused by a blockage of the airways during sleep, resulting in reduced blood oxygen levels reaching the brain, heart and other vital organs. A common warning sign of this condition is snoring, and daytime symptoms include general sleepiness, cognitive impairment, memory loss, morning headaches, irritability, depression, decreased libido and impaired concentration. If the SBD is undiagnosed and untreated, it can lead to more serious and even life-threatening conditions such as hypertension, strokes, cardiovascular dysrhythmias, myocardial infection and, in extreme cases, sudden death during sleep.

One of the most prevalent SBDs in the world today is daytime hypersomnolence syndrome (DHS), a condition that affects up to 7% of the population. In the US alone, DHS costs $150 billion dollars annually in lost productivity and general mishaps.

A further $48 billion is lost in medical costs related to road accidents caused by DHS. This situation is commonly known as “drowsy driving” and it is estimated that 20% of all motor vehicle accidents in some countries are caused by drowsy driving due to exclusively to DHS.

The traditional number one treatment has been with a device know as the Continuous Positive Airway Pressure (CPAP) machine, which uses a face mask connected to tubes that blow air down a patient’s throat to keep the airway open while they sleep. Even though it is widely regarded as the most effective of the traditional treatments, fewer then 50% of patients successfully completed treatment with the CPAP machine because they found it too cumbersome, noisy and uncomfortable. Another alternative is surgery, although this was only effective if performed with great accuracy and precision.

Increased understanding and professional training amongst dental professionals is beginning to have a positive effect on both the diagnosis and treatment of SBDs and DHS.

Dentists have been very active in developing effective new treatments for SBDs known as Oral Appliance Therapy (OAT). OAT involves the selection, fabrication, fitting, adjustments and long-term follow-up care of patients using custom-designed oral devices worn during sleep.

OAT has been so successful not only because it is effective in keeping the patients’ airways open during sleep, but also because it offers an easy, convenient  and less expensive alternative to the CPAP machine or surgery.

Dentists and sleep physicians are increasingly working together to treat SBDs such as DHS. While sleep physicians take on the primary role of diagnosing SBDs, the specialized knowledge and expertise that all dentists have in upper airway anatomy and physiology is essential in understanding and effectively treating SBDs.

If you snore during sleep or if you experience drowsiness during the day, you may be suffering from SBD. Contact Denta-Joy for more information about this potentially life-threatening disorder. We can advise you on your symptoms, refer you to a sleep physician for diagnosis, and provide OAT treatment to help your recovery.

Contact Denta-Joy today to find out more and put your mind at ease.

Reference:
American Academy of Dental Sleep Medicine, Dentists Against Drowsy Driving (DADD)
http://www.aadsm.org/DADD.aspx

Comparison of custom-made and thermoplastic oral appliance

From the department of Otorhinolaryngology, Head and Neck Surgery, Pulmonary
Medicine and Dentistry, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium; and the department of Orthodontics and Pulmonary Medicine, Ume University, Ume, Sweden

Position paper on the use of mandibular advancement devices in adults with sleep-related breathing disorders (Requires PDF reader.)

Susanne Schwarting & Ulrich Huebers & Markus Heise &
Joerg Schlieper & Andreas Hauschild

A position paper of the German Society of Dental Sleep Medicine (Deutsche Gesellschaft Zahnaerztliche Schlafmedizin, DGZS)

Oral Appliances for Snoring and Obstructive Sleep Apnea: A Review (Requires PDF reader.)

Kathleen A. Ferguson, Rosalind Cartwright, Robert Rogers, Wolfgang Schmidt-Nowara

Division of Respirology, University of Western Ontario, London, Ontario, Canada, Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, Department of Dental Medicine, St. Barnabas Medical Center, Gibsonia, PA, University of Texas Southwestern, Sleep Medicine Associates of Texas, Dallas, TX

Oropharyngeal collapse predicts treatment response with oral appliance therapy in obstructive sleep apnea. (Requires PDF reader.)

Ng AT, Qian J, Cistulli PA
Department of Respiratory Medicine, St. George Hospital, Belgrave Street, Kogarah, NSW 2217, Australia.

We conducted an evidence-based review of literature regarding
use of oral appliances (OAs) in the treatment of snoring and obstructive
sleep apnea syndrome (OSA) from 1995 until the present. Our structured search revealed 141 articles for systematic scrutiny, of which 87 were suitable for inclusion in the evidence base, including 15 Level I to II randomized controlled trials and 5 of these trials with placebo-controlled treatment.

SLEEP. 2006;29(5)666-71.

Oral appliance therapy reduces blood pressure in obstructive sleep apnea: a randomized, controlled trial.

Gotsopoulos H, Kelly JJ, Cistulli PA.
Department of Respiratory & Sleep Medicine, St George Hospital, The University of New South Wales, Sydney Australia.

Sleep. 2004 Aug 1;27(5):934-41.

Treatment of the Obstructive Sleep Apnea/Hypopnea Syndrome: the Effect on Blood Pressure.

Douglas NJ.
Respiratory Medicine, University of Edinburgh, Scotland, UK

Comment on Gotsopoulos H et al. Oral appliance therapy reduces blood pressure in obstructive sleep apnea: a randomized controlled trial.

Sleep. 2004;27(5):934-41.

Effect of Oral Appliance Therapy on Upper Airway Collapsibility in Obstructive Sleep Apnea.

Ng AT, Gotsopoulos H, Qian J, Cistulli PA
Department of Respiratory Medicine, St. George Hospital, Belgrave Street, Kogarah, NSW 2217, Australia.

Am J Respir Crit Care Med. 2003 Jul 15;168(2):238-41