Friday, November 19, 2010

“Let’s Get Together:” New Treatment Combo Tag Teams Sleep Apnea

Doctors recommend continuous positive airway pressure (CPAP) as the gold standard of sleep apnea treatment. But 25 to 50 percent of patients do not use the treatment on a regular basis because they can’t tolerate the pressure produced by CPAP. To increase compliance and effectiveness of CPAP, some doctors are combining CPAP treatment with oral appliance therapy.

New research in the journal Sleep and Breathing shows that combination therapy normalized breathing disturbances in sleep apnea patients who were otherwise intolerant to CPAP. When CPAP was used with an oral appliance, patients were able to tolerate their treatment better than CPAP by itself.

Typically, the two treatments are given separately. Oral appliances are fitted by dentists trained in dental sleep medicine. These devices fit like sports mouth guards and move the jaw and tongue forward to open the airway. Oral appliances are most effective with mild to moderate sleep apnea patients.

This study included 10 OSA patients who didn’t tolerate CPAP. They were using oral appliance therapy but still experiencing pauses in breath during sleep.

The patients were taken off oral appliance therapy for one week. They then wore CPAP and an oral appliance together for three nights. Oxygen levels were recorded during a sleep study and patients took the Epworth Sleepiness Scale. A free version is available here.

Results show that the oral appliance/CPAP combination was well tolerated by all participants.

The number of times patients stopped breathing per hour of sleep was reduced from 11 times per hour to three times per hour after combination therapy.

Before treatment, the average sleepiness score was 12. After oral appliance therapy, their average score was reduced to 9. After combination treatment, the score was further reduced to 7. This decrease shows that they had more energy during the day due to combination therapy.

Image by Elliot Margolies

Thursday, November 11, 2010

State Rep. Robert Donatucci’s Death Related to Sleep Apnea

The Philadelphia Inquirer reports that Pennsylvania's State Representative Robert Donatucci’s early death was caused by untreated sleep apnea.

State Rep. Robert C. Donatucci, 58, received 84 percent of the vote last week in being elected to his 16th House term. He died asleep in his bed in South Philadelphia early Tuesday, his family said.

His death was related to sleep apnea, for which he was being treated, said his brother Ronald, the city register of wills.

He found the mask uncomfortable and did not complete the test, but had resolved to lose a few pounds, his brother said. He had no history of heart problems.

Fire rescue personnel were called to the house when his wife, Marie, discovered he was not breathing.

"Bobby's style was very simple," his brother said. "His word was his reputation. If he was for something, you could go to sleep on it."

Like Representative Roberts, 25 to 50 percent of OSA patients do not use their CPAP machine. Sleep apnea is a serious medical condition and should not go untreated. Oral appliances are a safe and effective alternative.

Oral appliance therapy is recommended for patients with mild to moderate sleep apnea who cannot tolerate or comply with CPAP, or for severe patients who cannot tolerate CPAP.

More than 2,100 dentists belong to the American Academy of Dental Sleep Medicine. They are trained to screen for and treat sleep apnea. Find-a-Dentist in your area.

Friday, November 5, 2010

Fall Back Into Standard Time with an Extra Hour of Sleep

An article on WomensHealth.gov explains that when you turn your clocks back an hour this weekend, it might be a good opportunity to think about whether you're getting enough sleep.

The switch from Daylight Saving Time to Standard Time officially occurs at 2 a.m. Sunday morning, and it moves one hour of daylight from the evening to the morning.

While you'll appreciate the extra hour of sleep you gain by returning to Standard Time, it won't be enough to eliminate any major sleep debt you may have accumulated due to a hectic lifestyle, experts say.

Chronic sleep deprivation can affect attention levels, reaction time and mood, leading to decreased productivity at work, increased family stress, and potential health problems, according to the American Academy of Sleep Medicine (AASM).

"People tend to ignore the need for sleep in order to get other things done, but sleep is as important as what you eat, how much you exercise, and other healthy lifestyle practices," says Dr. Nancy A. Collop, director of the Emory Sleep Center and president-elect of the AASM.

"It's important to acknowledge the role that sleep plays in our daily lives, and recognize that how we feel, think and perform is all dictated by the amount of sleep we get."

The amount of sleep needed for good health and optimum daytime performance varies by age: preschoolers need 11 to 13 hours a night; school-age children should get 10 to 11 hours; teens must have at least nine hours; and adults should get seven to eight hours each night.

The AASM offers these tips for a good night's sleep:

•Don't exercise or have caffeine, alcohol, nicotine or heavy meals close to bedtime.
•It's fine to eat a small snack before bedtime to avoid going to sleep hungry.
•Follow a consistent bedtime routine.
•Keep your bedroom quiet, dark and cool.
•Don't sleep in on the weekends. That just makes it harder to wake up on Monday.

Read more at USA Today or check out this video by myFOXdetroit:

Disclaimer

The Official Blog of the American Academy of Dental Sleep Medicine (AADSM) is intended as an information source only. Content of this blog should not be used for self-diagnosis or treatment, and it is not a substitute for medical care, which should be provided by the appropriate health care professional. If you suspect you have a sleep-related breathing disorder, such as obstructive sleep apnea (OSA), you should consult your personal physician or visit an AASM-accredited sleep disorders center. The AADSM, and the American Academy of Sleep Medicine, as the managing agent of the AADSM, assume no liability for the information contained on the Official Blog of the AADSM or for its use.