I HATE CPAP!®
By Ira L. Shapira, DDS FICCMO
Sleep apnea is a serious medical condition that can decrease the quality and quantity of your life if it is not treated. Apnea comes from the Greek and means want of breath. Sleep apnea is the periodic cessation of breathing during sleep. There are two types of apnea, central and obstructive. The majority of patients have obstructive sleep apnea which is usually characterized by snoring, dry mouth, morning headache and excessive daytime sleepiness. It is most commonly diagnosed when the significant other observes the patient periodically stopping breathing and then gasping for air.
According to the Journal of the American Medical Association (JAMA) snorers have three times as many motor vehicle accidents as non-snorers and untreated apneics have slower reaction times than someone who is legally drunk. Studies have shown that untreated apnea can lead to up to a six fold increase in heart attacks and strokes. One study showed that people with untreated apnea had a 36% decrease in 8 year survival.
The good news is that sleep apnea is easily treated. The most commonly prescribed treatment is CPAP or continuous positive airway pressure. Again, the good news is that it is almost 100% effective. The problem is that according to studies, compliance is very poor with only 23 to 45 % of patients using it on a regular basis.
Oral appliances have been available for treating snoring and apnea for over 20 years. The February 2006 issue of the Journal of Sleep has issued new parameters of care for sleep apnea treatment that declare oral appliances a first choice of treatment for mild to moderate apnea and snoring and for severe apnea for patients who cannot tolerate CPAP. There are over 60 FDA approved appliances.
Oral appliances can be used as an alternative to CPAP or merely to control snoring. Many patients who like CPAP will use appliances to make travel and vacations easier.
Patients interested in oral appliances can contact the Academy of Dental Sleep Medicine (www.dentalsleepmed.org) and, if possible, seek out a diplomat of the American Board of Dental Sleep Medicine.
Ira L. Shapira DDS, FICCMO, ABDSM, practices General and Reconstructive Cosmetic Dentistry incorporating dental sleep medicine. He is a founding member of the Sleep Disorder Dental Society, which has become the Academy of Dental Sleep Medicine, a charter member of DOSA, the Dental Organization for Sleep Apnea and a Fellow of ICCMO, the International College of Craniomandibular Orthopedics. He was a frequent lecturer at A4M, the Academy of Anti-Aging Medicine and has a chapter on anti-aging dentistry in a text of anti-aging medicine. He is a dental editor and columnist of Sleep and Health, Director of Dental Sleep Medicine at the Sleep and Behavioral Medicine Institute and on the Advisory Board of the Sleep Medicine Center of Excellence.