Columbus, Ohio: Sudden Cardiac Death, Left Ventricle Hypertrophy and Dilation, Cardiac Disease, Cardiac Failure and Cardiac Disease Associated with Obstructive Sleep Apnea. Dental Sleep Medicine, Oral Appliances and CPAP Reduce the Risk. WWW.IHATECPAP.com

January 9, 2009

Sleep apnea is known to cause increases in blood pressure and a six-fold increased risk of heart attacks and strokes. This study shows that sleep apnea and especially low oxygen saturation may be a risk factor for sudden cardiac death. CPAP and oral appliance therapy can lower increased risks.

COLUMBUS, OHIO, January 09, 2009 /24-7PressRelease/ -- Mayo Clinic cardiologist Apoor Gami, M.D., the lead researcher on the study, presented his findings at the American Heart Association's Scientific Sessions 2008 in New Orleans. "Nighttime low oxygen saturation in the blood is an important complication of obstructive sleep apnea," according to Virend Somers, M.D., Ph.D., the study's principal investigator. "Our data showed that an average nighttime oxygen saturation of the blood of 93 percent and lowest nighttime saturation of 78 percent strongly predicted SCD, independent of other well-established risk factors, such as high cholesterol. These findings implicate OSA, a relatively common condition, as a novel risk factor for SCD."

Dr Mark Levy, a Columbus, Ohio dentist sites the above study and another study; Int J Cardiol. 2008 Aug 18;128(2):232-9. Epub 2007 Aug 28. Showed that moderate to severe obstructive sleep apnea is linked to left ventricular hypertrophy, left ventricular dilatation or elevated natriuretic peptides in patients without overt cardiovascular disease. Significant changes in NT-pro-BNP values indicate an improvement of cardiac function following effective oral-appliance therapy. This is vital information according to Dr Levy who helps patients who do not tolerate CPAP but care about their health.

Stroke victims who have obstructive sleep apnea die sooner than stroke victims who do not have sleep apnea or who have central sleep apnea, according to Swedish researchers, who will presented their findings at the American Thoracic Society's 2008 International Conference in Toronto on May 19. The results were independent of age, gender, smoking, body-mass index, hypertension, diabetes, atrial fibrillation, cognitive ability and how dependent patients were on help in their daily lives.

Cardiac disease, cardiac failure as well as increases in high blood pressure, diabetes and decreased quality of life are all associated with obstructive sleep apnea. Many studies have shown improvement with CPAP and studies are now showing similar improvements in outcomes with oral appliances. Information about oral appliance available at http://www.ihatecpap.com

Sleep apnea is recognized as deadly but until recently patients were offered only treatment with CPAP. This was unfortunate because while CPAP is considered the Gold Standard of treatment most patients are not able to tolerate it. Various studies have shown that only 23-45 % of patients prescribed CPAP actually tolerate it. Many patients are not offered alternatives to CPAP when they have demonstrated CPAP intolerance. Oral appliances have been shown to be a highly effective alternative to CPAP. Surgery is also an alternative to CPAP but has a relatively high morbidity and low success rate for treating sleep apnea. The surgical bi-maxillary advancement procedure is an exception that is highly successful. See the Sleep and Health Journal article comparing Oral appliances to Surgery: http://sleepandhealth.com/modules.php?name=News&file=article&sid=55&tid=22

Dr. Levy - a lifelong resident of Columbus- has been practicing dentistry for almost 30 years, and has studied with some of the world's leading practitioners in the field of Dental Sleep Apnea. He is a graduate of The Ohio State University College of Dentistry and is the senior partner of StoneRidge Dental Care, which he co-founded in 1996.

He is an active member of D.O.S.A. (Dental Organization for Sleep Apnea), A.A.D.S.M. (The American Academy of Dental Sleep Medicine), and A.A.S.M (American Association of Sleep Medicine). Additionally, Dr. Levy was the first dentist in Central Ohio to be trained in the discipline of combining aesthetic dentistry and neuromuscular dentistry to provide esthetics as well as function in the treatment of temporomandibular dysfunction (TMJ).

Dr. Levy is also a graduate of the world renowned Las Vegas Institute for Advanced Dental Studies (LVI), where he was asked to return as a Clinical Instructor teaching advanced techniques required for modern, aesthetic dentistry. Dr. Levy has also served as a Clinical Instructor at The Ohio State University College of Dentistry.

Dr. Levy continues to stay cutting edge and is a member of several professional organizations, some of which are I.C.C.M.O. (The International Congress of Cranio-Mandibular Orthopedics)), N.E.O.N. (Northeast Ohio Neuromuscular Dental Group,) I.A.C.A. (The International Association of Comprehensive Aesthetics). In addition, Dr. Levy has been a member of the American Dental Association, the Ohio Dental Association, the Columbus Dental Society and Alpha Omega.

Chicago dentist, Dr Ira Shapira is a pioneer of dental sleep medicine who formed I HATE CPAP LLC a company dedicated to promoting the dangers of sleep apnea and the role of dental sleep medicine in improving patients lives. Dr Shapira is clear in stating that he does not HATE CPAP which is still the gold standard for treatment. He formed the company and its website http://www.ihatecpap.com in response to what patients reported. The most common statements he heard from his patients were "i hate the mask" , "I hate The machine", "i hate CPAP!" and that was how the name came about. While some consider it provacative it resonates with patients unable to tolerate CPAP treatment. Thousands of patients who had abandoned CPAP have returned to treatment because they felt an emotional connection to the sentiment.

Most patients offered a choice between oral appliances and CPAP chose the appliances due to increased comfort and ease of use. Compliance, or patients continued use of therapy is much higher with oral appliances than CPAP.

Patients with untreated sleep apnea have a six fold increase in motor vehicle accidents and are also more prone to poor performance and accidents at work. Trucking companies have shown that screening for sleep apnea and insuring treatment have lowered insurance costs and accident rates. Short term memory loss is one of many intellectual defects associated with untreated sleep apnea. The problem is that many patients prescribed CPAP are not offered a choice and if they cannot tolerate treatment with CPAP then go without treatment.

There is an urgent need to help all patients diagnosed with sleep apnea find treatment modalities that work and that the can tolerate and use on a long-term basis. There will be a net reduction in overall medical expenses if all patients who do not tolerate CPAP are offered oral appliances as an alternative. Patients with mild to moderate sleep apnea should be offered oral appliances a a first line treatment along with CPAP according to the new parameters of care of the Academy of Sleep Medicine.

The National Heart Lung and Blood Institute (NHLBI) of the National Institute of Health (NIH) considers sleep apnea to be a TMJ Disorder. There were two articles published in Cranio by Shimshak et al that showed a 200-300% increase across all medical fields in patients carrying a diagnosis of TMJ disorders. This is vital information for those hoping to rectify problems with our current healthcare system. Their report CARDIOVASCULAR AND SLEEP-RELATED CONSEQUENCES OF TEMPOROMANDIBULAR DISORDERS NHLBI WORKSHOP was based on research by the National Heart, Lung and Blood Institute (NHLBI) , NHLBI Division of Heart and Vascular Diseases (DHVD) and the NHLBI National Center on Sleep Disorders Research (NCSDR).

The entire report can be reviewed at: http://www.nhlbi.nih.gov/meetings/workshops/tmj_wksp.pdf

Patients interested in learning more about oral appliances used to treat obstructive sleep apnea will find information at: http://www.ihatecpap.com/oral_appliance.html

Additional information about TMJ disorders cn be found in Sleep and Health Journal at: http://sleepandhealth.com/modules.php?name=News&file=article&sid=237&tid=22 or at http://www.ihateheadaches.org

Organizations involved in treating sleep apnea include The American Academy of Dental Sleep Medicine, DOSA the Dental Organization for Sleep Apnea, The American Academy of Cranifacial Pain, ICCMO the International College for CranioMandibular Orthopedics.

The American Academy of Sleep Medicine states that doctors treating sleep apnea with oral appliances should be well versed in all aspects of dentistry especially in treating TMJ disorders

About Sleep and Health Journal

Dr Ira L Shapira is an author and section editor of Sleep and Health, President of I HATE CPAP LLC, President Dato-TECH, and has a Dental Practice with his partner Dr Mark Amidei. He has recently formed Chicagoland Dental Sleep Medicine Associates. He holds several patents on the collection of stem cells during removal of wisdom teeth. The early minimally invasive removal of third molars will make the benefits of stem cell technology almost universally available according to Dr Shapira.