Mar 13

How is Obstructive Sleep Apnea diagnosed and treated with a mouthpiece?

Sleep Studies Comments Off on How is Obstructive Sleep Apnea diagnosed and treated with a mouthpiece?

How is Obstructive Sleep Apnea (OSA) diagnosed?

Obstructive Sleep Apnea is a serious medical condition. It is a condition that is characterized by a person’s inability to breath when sleeping. This is due to a person’s airway being obstructed, usually by the base of the tongue or by the excessive soft tissue of the throat. Obstructive sleep apnea varies in severity, but is considered dangerous at any level. It must be diagnosed by a physician. Diagnosis is based on the results of an overnight sleep study, called a Polysomnogram (PSG). A PSG is usually carried out in a sleep center. Today the sleep centers resemble a nice hotel. These centers are readily available throughout the United States. When undergoing the PSG, or sleep study, several factors are being evaluated. These include: the level of oxygen in the blood, blood pressure, pulse rate, snoring sound levels, body positioning, and the stages of sleep. Once a proper diagnosis has been made the sleep physician will make a recommendation for the appropriate treatment. These treatments may include the use of a CPAP, or a sleep apnea mouthpiece that is made by a qualified dentist. The sleep apnea mouthpiece may be used for people that suffer from mild to moderate obstructive sleep apnea. A dental sleep apnea mouthpiece can also be used for those patients that can’t wear a CPAP for whatever reason. The dental sleep apnea mouth piece holds the lower jaw in a more forward position. This helps to open the airway and allows the patient to breath easier. A CPAP is the gold standard for patients that have obstructive sleep apnea, especially for those patients that suffer from severe obstructive sleep apnea. However, many patients cannot tolerate the use of a CPAP. These reasons vary from the noise that the mask makes as air leaks from around the mask, to the feeling of being confined and claustrophobic. Many patients also report that the CPAP makes it difficult for their partner to sleep in the same room. Nevertheless, I still recommend that my patients follow their physicians instructions, and at least try their very best to use their CPAP. If they still cannot tolerate it, then I will make them a sleep apnea mouthpiece.

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Mar 05

Dr Zach Hodgins will attend the American Academy of Dental Sleep Medicine’s Annual Conference held on June 4th – 6th 2010 in San Antonio, Texas. Topics covered during the educational session will include:

The Effect of Mouthpiece Use During Exercise on Cortisol, Lactate and Airway Openings
Speaker: Dena Garner, PhD,

Combination Therapy: When Oral Appliances meet CPAP
Speaker: Ronald Prehn, DDS

Marketing the Dental Sleep Medicine Practice: Aa New Direction for 2010 and Beyond
Speaker: Laurence Barsh, DMD

Clinical Management of Oral Appliance Therapy: Titration, Teeth and the TMJ
Speaker: James Metz, DDS

Improvements in Neurocognitive Function and Heart Rate Variability with Oral Appliance Therapy
Speaker: Djordje Popovik, MD, PhD

Treating Mild Obstructive Sleep Apnea with CPAP vs Oral Appliances: A Literature Review
Speaker: Jonathan Parker, DDS

Measuring Sleep: Using Monitors and Iimaging in the Dental Sleep Medicine Practice
Speaker: John Remmers, MD

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Mar 03

In my dental practice, I treat patients that suffer from snoring and obstructive sleep apnea. These conditions are treated in my office in Winter Park, FL by using a dental sleep apnea appliance. During every new patient examination, I screen my patients for these conditions. This involves asking questions regarding the quality of their sleep, examining their airway, and observing physical characteristics such as neck size and the weight of the patient. It’s always amazing to me that the most common comment that I hear is, “You know what? No one has ever asked me these questions, especially a dentist.” I think that sleeping and breathing disorders are being widely overlooked by the medical profession as a whole, and that a serious effort to screen and treat patients that suffer from snoring and obstructive sleep apnea needs to be put forth. At the very least, dentists and physicians should ask their patients if they snore, and if they don’t know, ask their spouse. It is such an easy thing to do, and this can have such a tremendous effect on the lives of so many people.

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Mar 01

We recently had a family member from out of town visit us here in Winter Park, FL this past week. Winter Park is located right outside of Orlando, FL. As always, it was so good to see him and catch up with what’s new in his life. As the week went on, I noticed that whenever we were watching TV and relaxing, that he would fall asleep while seated. He would snore, and even visibly stop breathing for long periods of time. When he would sleep at night i could hear him snore very loudly as well. The next day I spoke to him about my observations and mentioned that he was exhibited quite a few signs and symptoms of having obstructive sleep apnea. I mentioned to him that his neck was greater than 17 inches in diameter, he was overweight, he snored, and that he stopped breathing on several occasions that I witnessed. He has excessive daytime sleepiness as well. I told him that obstructive sleep apnea can kill you. It raises the chance of having a heart attack by 6 times that of healthy person. The same goes for having a stroke. You are 6 times more likely to have a stroke if you have obstructive sleep apnea. So, I recommended that he have a sleep study done. I have a Watch Pat 200, which is a home sleep monitor that is approved by the FDA. It measures total sleep time, pulse rate, body position, snoring volume, time in each phase of sleep, blood oxygen saturation, desaturation events, and calculates the 3 sleep indices. He took the test that night, and I uploaded his results to a sleep physician’s site for the sleep doctor to read the study and diagnose his condition. It turned out that he has severe obstructive sleep apnea. He stopped breathing 271 TIMES during one nights sleep!!! Can you imagine holding your breath 271 times in one night and getting a good nights sleep? No wonder he was falling asleep so often during the day. He was exhausted and didn’t even know it. This is so dangerous, and why automobile accidents that involve people that have sleep apnea are such a problem. Since he has severe obstructive sleep apnea, the sleep doctor recommended a CPAP to treat his apnea. He will give the CPAP a try, and if he can’t tolerate the CPAP, I can always make him a dental sleep apnea appliance here in Orlando, FL. I am strongly encouraging him to use the CPAP, as it is the best treatment for severe obstructive sleep apnea. I’m just so happy that he came to Winter Park, FL to visit, and that I was able to observe his problem. I’m sure that I saved his life! If you know someone that snores or stops breathing when they sleep, you owe it to them to educate them on the dangers of sleep apnea. They should see their physician to discuss this problem and come up with a solution for their sleep problem. You cold save the life of someone you love!

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Feb 04

brain-763982-11[1]On Friday February 1, 2010 the American Academy of Sleep Medicine sent out a news release that outlined new research that shows that people who suffer from severe Obstructive Sleep Apnea (OSA) have decreased concentrations of gray matter throughout the brain.

Gray matter is found in the brain’s cerebral cortex. This area of the brain is responsible for processing information, memory formation and many other crucial brain activities.

Dr. Seung Bong Hong, a professor of neurology at the Samsung Medical Center, Sungkyunkwan University School of Medicine, said in the news release that “Poor sleep quality and progressive brain damage induced by OSA could be responsible for poor memory, emotional problems, decreased cognitive functioning and increased cardiovascular disturbances.” He went on to say that “The use of continuous positive airway pressure therapy could stop further progression of brain damage in patients with severe OSA.”

This study illustrates how serious obstructive sleep apnea is, and how proper diagnosis and treatment is vitally important. CPAP is the gold standard for the treatment of obstructive sleep apnea. A dental appliance that repositions the jaw in a more forward position can also be very effective. Oral appliances are most effective in the treatment of mild to moderate sleep apnea, and people that cannot wear their CPAP.

Reference: American Academy of Sleep Medicine, news release, Feb. 1, 2010

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Feb 03

Wall Street Journal logoThe Wall Street Journal just published this fantastic article entitle “The New Face of Sleep”. It’s all about the dangers of sleep apnea . The author does a wonderful job of defining sleep apnea and the various types of treatments that are available to patients. The author also discusses the fact that obstructive sleep apnea is a treatable condition that is grossly ignored, even after being prescribed the proper treatment from their sleep physician or dentist. Treatments like CPAP and oral appliances made by a dentist are extremely effective. I hope that this article will help to enlighten people about the risks of sleep apnea.

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Jan 18

Recently a group out of the Universtity of Chicago reported, in the American Journal of Respiratory and Critical Care Medicine, that obstructive sleep apnea may adversely affect the body’s ability to control it’s sugar levels (glucose). This can lead to major problems with people that suffer from type 2, adult onset, diabetes.

Renee S. Aronsohn, MD, of the University of Chicago, said “for the first time that there is a clear, graded inverse relationship between [obstructive sleep apnea] severity and glucose control in patients with type 2 diabetes.”

John Heffner, MD, past president of the American Thoracic Society, said in a recent news release that at least 80% people with type 2 diabetes also have obstructive sleep apnea.

This study is encouraging because obstructive sleep apnea is a treatable condition. Hence, if the obstructive sleep apnea is treated the person’s ability to control his/her blood sugar levels would most likely improve.

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Jan 17

In April 2006, the Institute of Medicine released a 461 page report entitled “Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem” (http://nap.edu). According to the paper, an estimated 50-70 million Americans suffer from chronic sleep disorders, with the estimated prevalence of OSAS being 4 to 7% of the U.S. The term used to describe excessive sleepiness is hypersomnolence. The statistics regarding the damage caused by this problem are astounding. $150 Billion annually is lost in decreased productivity and accidents. The medical costs from daytime hypersomnolence alone cost another $48 billion. The most shocking of all the statistics listed within the paper is that 20% of all serious car accidents involve daytime hypersomnolence. This statistic is independent of those accidents involving alcohol.

The American Academy of Dental Sleep Medicine (AADSM) established “Dentists Against Drowsy Driving” in November 2008. It’s goal is to increase awareness throughout the health professions and the public about the dangers associated with undiagnosed and untreated sleep-related breathing disorders. Dr Zach Hodgins, a dentist practicing in Winter Park, FL, is an expert in treating patients that have been diagnosed by their physicians with OSA. “The problem with sleep-related breathing disorders is that it is a problem that is rarely screened for by most physicians and dentists”, says Dr. Hodgins. Dr. Hodgins recommends that any patient with any signs of sleep apnea see their physician for a proper diagnosis and treatment as soon as possible.

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Nov 10

A group of physicians from the Baylor College of Medicine are using video technology to get a closer view of a patient’s airway. In the past, surgery of the soft palate was used quite often to treat obstructive sleep apnea. This was not always a successful treatment. Unfortunately there are many other factors within the airway that can cause an obstruction. By using a video camera that is inserted into the patients nose while the patient is sleeping, a more definitive diagnosis of the cause of a patient’s apnea can be determined.

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Nov 10

This is a very interesting article about how sleep apnea can cause your golf game to suffer. When you are ready to improve your game you should talk to a Sleep Physician and Dentist that treats sleep apnea with an oral appliance!

http://www.dentiststudio.com/blog/science-says-a-dentist-can-improve-your-golf-game

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