So, you have sleep apnea? You have tried CPAP therapy but just cannot tolerate the machine, the noise, the mask, or the inconvenience of traveling with the CPAP machine? Is the CPAP living under your bed or in the back of the closet? Have you ever been told that there is an alternative to the CPAP therapy? Or maybe you wonder why you snore and suspect you may have a problem. You are tired all the time. Add to that perhaps, high blood pressure, family or personal history of heart disease, stroke or obesity. You may know people with sleep apnea and you know about the sleep studies, the CPAP machine and you want no part of it. Well, good news. Today, with recent advances, sleep studies can be done from the comfort of your own home and if you are diagnosed with mild or moderate sleep apnea, FDA registered oral appliances are available and may be used to treat sleep apnea when administered by a qualified dentist trained in Dental Sleep Medicine. Dr. Mark Levy has used oral appliance therapy to treat sleep disordered breathing since 2005 in the Central Ohio area. He has treated hundreds of cases, ranging from the simplest to the most complex and provides oral appliances as an alternative to or in combination therapy with CPAP.
As a member of both the American Academy of Dental Sleep Medicine and the Academy of Clinical Sleep Disorders Disciplines, Dr. Levy has completed hundreds of hours of continuing education, assuring you an exceptional level of education, training, and experience in the use of oral appliances. He serves on the advisory board of Elite Dental Institute and has taught dental sleep medicine protocols to dental practices around the country. Dr. Levy also lectured to healthcare providers in Moscow and St. Petersburg, Russia and has plans to continue to teach abroad, bringing awareness of obstructive sleep apnea to the Russian medical community.
In 2006, The American Academy of Sleep Medicine released a position paper stating that oral appliances are a comparable treatment to CPAP for mild and moderate obstructive sleep apnea and a viable replacement therapy for individuals with severe apnea who cannot tolerate CPAP. So, what does this mean to you? If you are unable to wear CPAP for any reason, you now have an alternative therapy you can live with and tolerate.
A. Snoring is usually caused by loose or excessive tissue at the back of the throat which collapses into the airway during sleep. This tissue can vibrate as you breathe, causing the annoying and disruptive noise we all know too well.
A. No. Children who snore should be evaluated by an ENT for removal of tonsils and adenoids. Children with sleep apnea- yes they can suffer from this sleep disorder-are at a higher risk for ADHD, bed wetting, growth retardation, and other behavior issues. It is imperative that children be able to breathe so they can grow and develop normally. Dr. Levy will be happy to see your child for determination if a referral to an ENT or orthodontist for is needed.
A. Snoring is more frequent in men than in women, but as women near menopause, the hormonal changes and weight gain can result in a very loud snorer!
Snoring that is very loud and can be heard throughout the house is usually the first sign that there may be something else going on. And snoring like this is not just unhealthy for the snorer- inadequate sleep for the bed partner can lead to exhaustion and potential other ill effects. Many patients of Dr. Levy’s report sleeping in separate bedrooms. As a matter of fact, one of the new trends in custom built homes is the inclusion of 2 master bedrooms. Sad, but true. Very often, someone who snores does not realize or believe that they do so. Even when others complain about it, the snorer may still say “not me”. They also say things like “I can’t hear it so it not a problem”. It is important for both sides to remember that snorers cannot help the fact that they snore, but they should be willing to treat it so that the whole family can get a good night’s sleep.
A. Probably obstructive sleep apnea. It should be noted that this disease is very serious and has numerous health implications. It is imperative that the partner have a sleep study to determine if it is obstructive sleep apnea and be prescribed the appropriate therapy.
A. Sleep Apnea is a condition in which a person stops breathing many times throughout the night, sometimes for dangerously long periods of time. It is estimated that up to 10% of middle-aged men and women may suffer from sleep apnea. With sleep apnea, the airway becomes obstructed, usually by the back of the tongue. With the airway obstructed, a person does not breathe. Obviously, breathing is essential to life and our well being. Every time breathing stops, it cause dangerous low levels of oxygen in the body and heart rate and blood pressure increase. Sometimes this happens up to 80-120 times per hour. Imagine the toll it takes on your body. The gasping you hear at night is the person’s attempt to awaken and start to breathe again. The extreme tiredness is due to the constant awakening to catch a breath, never allowing them to get the deep restful sleep needed by the body.
A. Absolutely! Sleep apnea is linked to heart disease, strokes, high blood pressure, impotence, depression and night time urination. One of the most significant symptoms is excessive daytime sleepiness. Take the Epworth Sleepiness Test on this site to see how you score. It is estimated that excessive sleepiness can be as dangerous as drunk driving. Yet no one knows who is on the road suffering from sleep apnea and how many accidents they are causing. One more fact- it is estimated that untreated severe sleep apnea will take 10 years off of your life. Serious indeed!
A. CPAP is considered the “gold standard” for treating obstructive sleep apnea. It works! However, with long term compliance rates hovering at about 25%, there are a lot of diagnosed patients who are left untreated. In addition to patients who simply refuse to wear CPAPs, the acceptable compliance rate for CPAP therapy is 4 hours per night, 5 night per week. That’s a total of only 20 hours of sleep per week! Getting a good nights sleep is so important to our overall health and if you are only getting 20 hours of restful sleep per week, you are walking around exhausted.
Many of Dr. Levy’s patients have also had the surgery called UPPP which has limited usefulness with many patients. Long term success rates are just hovering at around 55% with many patients having relapses a year or two after surgery.
Medical research has shown that oral appliance therapy is very effective for mild and moderate sleep apnea, and very helpful for CPAP intolerant patients who are considered severe cases.
A. Boil and bite mouthpieces are ineffective at treating sleep apnea. Some of them may temporarily help with snoring, but the effect may be short lived. This is a serious medical condition and cannot be treated by a cheap piece of plastic that is being hawked on TV.
A. No. When selecting a dentist to treat you with an oral appliance, make certain that the dentist has the training, experience and knowledge necessary to treat your problem. Always ask the dentist about their credentials. Where have they trained? How long have they been doing this? How many patients have they treated?
A. Weight has a direct impact on both. The severity of sleep disordered breathing can change with weight gains and losses. However, sometimes it is all about anatomy. Dr. Levy has treated thin, athletic people who also suffer from sleep apnea.
A. Yes! Most policies cover oral appliances for sleep apnea. We file all insurance for our patients and strive to give our patients the most accurate estimate for any out of pocket expenses. Dr. Levy and his staff are committed to making this process as easy as possible for our patients who suffer from sleep apnea. If you have any other questions, please do not hesitate to contact us!
Oral appliances are very much like wearing a night guard or orthodontic retainer. Some describe them as being like an athletic mouthguard. The bottom line is that they are comfortable and relatively non-intrusive. There are currently over 100 FDA approved appliances. Dr. Levy uses about 5 of them and chooses the right one for you based on a number of factors like degree of snoring, mouth size, etc. While the principle behind these appliances is not new, they all do the same thing:
Move the lower jaw forward so as to open the airway, allowing the tongue to come forward and unblock the soft palate. Multiple studies in medical journals have shown that oral appliances are better tolerated by patients than CPAP therapy and that they have a far better compliance rate.
Some patients have very severe sleep apnea and are in need of hat we call combination therapy. That is, the use of an oral appliance and CPAP. By using the oral appliance, CPAP pressures can be turned down and patients better tolerate the flow of air. Dr. Levy has experience working with combination therapies and has helped many patients with severe sleep apnea better tolerate their CPAP machines.
If you feel you or someone you love may suffer from sleep apnea, or you experience any of the symptoms mentioned above, please contact Dr. Levy for a screening consultation.
Adobe Reader required. Download from here.
"Does this seem familar to you?"
"The passing of Reggie White."
"Might your child have sleep Apnea?"