These days, as many people turn to Google for medical information as turn to their doctor, if not more. How unfortunate, then, that the search engine should so routinely put up such misleading information about sleep apnea. Google’s sidebar that shows up as part of the results when people search for sleep apnea make it seem as if CPAP is the only viable treatment for sleep apnea, which is not at all true.
How Google’s Sidebar Misleads
The first thing that stands out about Google’s sidebar, located to the right of the normal search engine results, is that it includes a large picture at the top showing a representation of the condition. The picture has two images, a main image showing a woman looking at her sleeping partner while a nearby clock shows that it’s the middle of the night. Presumably, he’s snoring, although there is no caption.Then a second image, enclosed in a circle, shows a man getting ready to put on the mask of his CPAP machine, helpfully labeled with its full name.
Later down the sidebar explains that “Treatment often includes lifestyle changes, such as weight loss, and the use of a breathing assistance device at night, such as a continuous positive airway pressure (CPAP) machine.”
This might be excusable as an abridgement of treatment options, with more detailed information contained on the treatment tab, but if you click on the treatment tab, you see the same options, plus the inclusion of surgical options.
There is no mention of oral appliance therapy. Perhaps the closest it comes is a mention of “airway management,” which might be a reference to oral appliance therapy, which helps to keep your airway open. However, the text under airway management is completely unhelpful: “Clearing a blocked airway of food, foreign objects, fluid and other obstructions. A top priority in emergency situations.” There is no way for a person to learn about oral appliance therapy from this text.
Why Oral Appliance Therapy Needs to Be There
With the millions (if not billions) of Google searches people do each day, this sidebar could very well be one of the most commonly seen explanations of sleep apnea. It’s important that it be accurate and complete. Here are three main reasons why Google is doing searchers a disservice by not putting oral appliances in the sidebar:
Oral appliances are a frontline treatment
Oral appliances work as well as CPAP
Many people don’t benefit from CPAP
In the past, oral appliances were seen only as a backup treatment for CPAP. However, these days we understand that oral appliances are effective treatments for many people. In these cases, especially for people with mild or moderate sleep apnea, it makes little sense to force people to try CPAP before getting an oral appliance.
We also know that many people have difficulty complying with CPAP treatment, especially high-risk groups like veterans with PTSD and heart patients. People who have trouble with CPAP need to know there is an alternative.
Get the Truth about Sleep Apnea Treatment
This inaccuracy is another reminder that we shouldn’t trust Google for our medical information. If you’re looking for more accurate information about sleep apnea and its treatment in Omaha, please call (402) 493-4175 today for an appointment with a sleep dentist at the Advanced Dental Sleep Treatment Center.
We love hearing from our patients about the impact that sleep apnea treatment has had on their lives. We talk a lot about the long-term consequences of sleep apnea,but often the most important benefits of sleep apnea treatment are just in the day-to-day routine. When you get your sleep apnea treated, every day is a better day.
A Marriage in Jeopardy
Love brings people together, but love isn’t always enough to keep people together, especially when facing some of the daily trials that can be caused by sleep apnea. Darla loved her husband Rob, but she hated the way sleep apnea was impacting their life together. He would come home from work so tired that he fell asleep by 7pm, and when he slept, he snored. It was so loud that it disrupted Darla’s sleep. And he was cranky and irritable all the time, which made it hard to talk about the problem.
Not only that, but he used to doze off at work, which put his job at risk.
They didn’t know how long they would be able to go on like this.
A Standard He Couldn’t Stand
Rob thought that if he got treatment for his sleep apnea, he was most likely looking at a CPAP machine. But he also didn’t know that he could stand it. His mother had used a CPAP machine. He tried to use it a few times, but found he didn’t like the feeling of air on his face.
It’s possible that with the right mask, he might have been able to adapt, but it may have taken months and months of trial-and-error. He needed a treatment that would work now. And his family needed it, too.
Like a New Man
That’s when Rob decided to get treatment from Dr. Roger Roubal. He was able to get his sleep apnea treated–without CPAP. Instead, he got a simple, comfortable oral appliance that he could put in every night and keep in all night.
All of a sudden, Rob was like a man renewed. He had the energy he thought he’d left behind in his youth. He didn’t fall asleep at work anymore. Instead of coming home and falling asleep in exhaustion, Rob found he had more time and energy to spend with the kids. He had so much energy that he was able to go back to school to get his Master’s degree, something that had been a long-time goal. He had all but given up on it, but with his treatment, he found he had the energy he needed to achieve it.
And now that he has his sleep apnea under control, his irritability has vanished. With Darla being able to sleep better at night, the two of them have found that their love is renewed and as strong as it ever was.
Don’t Let Sleep Apnea Keep You Down
We love revisiting the stories of patients we’ve helped. Not only does it inspire us to know that we’ve made such a difference in someone’s life, we hope that this story can inspire others. We know that in the dark days and nights when you’re suffering with sleep apnea, you might think that there’s nothing you can do. You might look at CPAP not as a solution, but as another burden, a shackle that binds you to the bed.
Let us free you from sleep apnea and from CPAP. Please call (402) 493-4175 today for an appointment with an Omaha sleep dentist to learn whether you’re a candidate for oral appliance therapy.
Even though Dr. Roubal and Dr. Brigden have advanced training and credentialing from the major Dental Sleep Medicine Boards, the American Dental Association does not recognize Dental Sleep Medicine as a specialty at this time.
One of the unpleasant effects of sleep apnea is nocturia, where a person needs to wake up at night to urinate. However, a new study shows that treating sleep apnea can reduce the need to urinate at night, allowing people to get more uninterrupted sleep.
Why Sleep Apnea Can Cause Nocturia
Sleep apnea isn’t just related to getting up to urinate, it can be related to bedwetting in adults. It’s hard to see the connection between the breathing disorder sleep apnea and a need to urinate at night. However, there are many possible connections between these two types of sleep disturbance.
The simplest link is that sleep apnea awakens you at night. You may not know why you awoke, but now that you’re awake, you become aware of needing to urinate.
But it’s likely more than that. The body uses the hormone vasopressin to suppress its production of urine at night. However, sleep apnea interferes with the body’s production of vasopressin and other hormones. This may make it harder for the body to suppress urine production at night.
Treating Sleep Apnea Decreases Nocturia
So how common is nocturia among sleep apnea patients? Very, according to this study presented at the European Association of Urology’s convention in London in 2017.
All patients were prescribed sleep apnea treatment with CPAP. Researchers then found that 65% of those with nocturia experienced a significant improvement in their ability to stay asleep and not wake up to urinate. For example, about half of those who had needed to wake up twice a night with nocturia were able to sleep all night after getting their sleep apnea treated.
Limitations of the Study
Although these results are promising, there are some reasons why we have to be cautious about them. First, study results are only preliminary. They’ve been presented at a scientific conference, not published in a scientific journal, which means that they haven’t been fully evaluated yet.
And researchers opted to use just CPAP as their sleep apnea treatment of choice. CPAP has notorious problems with compliance–many people just don’t use their CPAP machines. This means that many of the individuals treated with sleep apnea weren’t actually getting sleep apnea treatment. These patients may benefit from oral appliance therapy, which is much simpler and more comfortable to use. But researchers didn’t address the issue of compliance in their press release.
The mode of treatment really doesn’t matter if the patient is in fact compliant. If your patients mention they wake up often to urinate during the night, and test positive for sleep apnea, treatment could help them tremendously in their daily lives! We will take great care of your patients who refuse to try a CPAP or have found themselves intolerant. Submit a referral online or via fax at 1-877-811-8129 at the Advanced Dental Sleep Treatment Center.
We know that although CPAP is a more effective sleep apnea treatment, oral appliances are just as successful at helping people improve their symptoms. Now a new meta-analysis has reinforced this conclusion. Although CPAP is better in some ways for sleep apnea, the poor compliance means that when it comes to practical measures, the two treatments aren’t statistically different.
A Good Review
For this study, researchers looked for randomized, placebo-controlled clinical trials of CPAP and oral appliances. These studies are considered the best form of evidence in determining which treatments really work. They initially identified 240 unique papers, but they narrowed this down to 12 studies that actually met their detailed inclusion criteria. These rigorous inclusion criteria ensured that researchers had a good, apples-to-apples comparison between the two treatments.
Where CPAP Was Better
The studies didn’t conclude that the two treatments were exactly equivalent. There were significant differences between the two treatments. CPAP was definitely better at reducing the apnea-hypopnea index (AHI). CPAP was also better at reducing people’s level on the Epworth Sleepiness Scale (ESS), although at the end of the studies, there was no significant difference between ESS of those using both treatments.
Where Oral Appliances Were Better
Although oral appliances weren’t as effective at reducing AHI, compliance was significantly better in the oral appliance group. On average, people used their oral appliances 1.1 hours more every night. That average represents a 25% increase over the minimum time considered compliant for CPAP.
Functional Outcomes Equivalent
The net effect of these differences is that the two treatments led to the same treatment results. Patients who used both treatments had similar improvements in the Functional Outcomes of Sleep Questionnaire. Nor were they any different in terms of cognitive website so Dr. Roger Roubal and his team at the Advanced Dental Sleep Treatment Center can help.performance.
Based on this information, researchers recommend that patients given CPAP be closely monitored for compliance. If they’re not compliant, they should be shifted to oral appliance therapy.
Don’t Stick with a Failing Treatment
If you’ve prescribed CPAP, you want to make sure your patient is giving it a fair try. However, if they can’t adapt to CPAP, there’s no reason to stick with that failing treatment. We will take great care of your patients who refuse to try a CPAP or have found themselves intolerant. Submit a referral online or via fax at 1-877-811-8129 at the Advanced Dental Sleep Treatment Center.
This study looked at patients recruited in a parent study over the course of three years. The patients were seen after they had been diagnosed with sleep apnea and prescribed CPAP, but before they actually started CPAP treatment. At this point, researchers collected baseline data from all patients. Then researchers saw patients again one year later to collect final data. They compared this data against the usage data from CPAP machines.
The initial pool in the parent trial was 242 patients, but researchers confined their analysis to those patients that used CPAP for the recommended time each night (4 hours or more) and those who essentially didn’t use it at all (0.5 hours a night or less). This left them with a group of 182 patients, 72 who used CPAP and 110 who didn’t. Most patients in both groups were men.
On average, patients reported mild sexual dysfunction at baseline (a rating of 1 on a 5-point scale). After 12 months of treatment, CPAP users saw a 0.7-point improvement in their sexual dysfunction, but nonusers saw a 0.1-point improvement, essentially no improvement at all.
What surprised researchers most is that this difference was being driven by the women in the study population. Although men only saw an average improvement of 0.14 points, women saw an improvement of 1.24 points, about nine times as large!
The Patients CPAP Leaves behind
Overall, this study isn’t particularly remarkable. The population didn’t have a high degree of sexual dysfunction, and the improvements measured weren’t that great. What is most noteworthy about this study is how many patients just don’t benefit from CPAP treatment. Of the initial 242 patients, only 72 (30%) used their CPAP for an average of 4 hours or more, the recommended treatment level.
This means that 70% of the patients prescribed CPAP essentially still had untreated sleep apnea. This is unacceptable. People with sleep apnea need to be treated. Therefore, we need to work harder to ensure that people are prescribed a sleep apnea treatment they will actually use.
If you‘ve been prescribed CPAP and can’t adapt or don’t want to try it, please call (402) 493-4175 today for an appointment with an Omaha sleep dentist at the Advanced Dental Sleep Treatment Center. We can assess your sleep apnea to determine whether oral appliance therapy is appropriate for you.
We know that most people with sleep apnea don’t know they have it. Overall, estimates of undiagnosed sleep apnea show that perhaps 80-90% of people with the condition don’t know they have it. Now a new study suggests that the rate of undiagnosed sleep apnea for seniors could be even higher!
A Large Population-Based Study
For this study, researchers used the data from the National Health and Aging Trends Study (NHATS). In the NHATS, Americans age 65 and older were given a questionnaire. This questionnaire contained several questions that were similar to the STOP-BANG screening tool commonly used for assessing sleep apnea risk. They looked at the responses seniors gave to these STOP-BANG-like questions to determine their risk of sleep apnea. Then they checked to see how many people had actually been tested for sleep apnea.
They found out that most of the 1052 respondents (56%) were at high risk for sleep apnea. They also found that very few of them had actually been tested for sleep apnea. In fact, only 8% had been tested for sleep apnea. But of those that were tested, 94% were diagnosed with sleep apnea. If the same rate of diagnosis held for the ones that hadn’t been tested, it would mean that about 86% of seniors with sleep apnea remained undiagnosed. This is truly unacceptable. We understand the serious risks of sleep apnea, and we know that it can and should be tested.
All Older Americans Should Be Evaluated for Sleep Apnea
Researchers in this study concluded that we are not doing enough to test older Americans for sleep apnea risk, and we also don’t do enough to follow up on that risk with an actual diagnostic test. Therefore, they recommend that every older American should be screened for sleep apnea, and, when that screening test suggested they might have the condition, it should be tested for using a sleep test that is appropriate. In many cases, this means a home sleep test, although sometimes a sleep lab test is recommended.
Should You Be Tested for Sleep Apnea?
If you are an older American who hasn’t been tested for sleep apnea, it’s time to consider whether such a test might be right for you.
We offer a simple prescreening tool that can help you decide whether you should get a test for sleep apnea. It’s free, and we can look at the results and give you recommendations for how to proceed to protect your health. After all, sleep apnea is associated with elevated risks of all the leading causes of premature death among seniors.
To learn most about your sleep apnea risk and how to treat it, please call (402) 493-4175 Kun today for an appointment with an Omaha sleep dentist at the Advanced Dental Sleep Treatment Center.
Cruises are supposed to be the most relaxing type of vacation possible. You essentially check into a hotel that already includes all your drinks and food. The hotel then travels from destination to destination, allowing you to travel without having to worry about making arrangements. Any excursions you take can be arranged and handled through the cruise ship, so they are stress-free. Your biggest decision is whether you want to see a comedian or stage show.
But when things go wrong on a cruise ship, they can go very wrong. And because of the confined nature of the ship, once things start going wrong, they can spiral out of control. That’s what happened recently for cruise passengers on the Carnival Dream, when a freak chain of events led to a passenger’s CPAP machine catching on fire when displaced passengers were bunking down together on the floor of the spa.
From Dangerous Floods to Fires
Ironically, the story of the fire begins with the fire suppression system. The system experienced a problem, causing it to leak profusely. The water poured down, accumulating ankle-deep in several cabins and corridors. Footage of the event has since been suppressed, so it’s hard for you to get a sense of it unless you had already seen it, but some likened it to a scene from Titanic.
Carnival spokespeople said that the “crew and guests were amazing during this voyage,” as the crew cleaned up the water, tore out and replaced carpet, and dried out the rest of the affected carpet. In all 50 staterooms were affected. Carnival says that the restoration of these staterooms took up to six hours, so some passengers opted to sleep in the spa rather than return to their staterooms.
Among these guests was a man who relied on a CPAP machine to sleep properly. When he turned it on to try to sleep, the machine “caught fire,” according to another guest. CPAP fires are very rare (but not unheard of). The suspected cause is water that got in the machine, which they say was at least partly submerged in the incident. No one was hurt, and we don’t know the extent of the fire, but it certainly seems an indignity heaped on people who had already suffered.
CPAP Machines Are One More Nuisance When You Travel
If you love to travel, you try to balance the comforts from home with the experience of the destination. You don’t want to transport anything that’s more of a nuisance than it’s worth.
Unfortunately, a CPAP machine might just be that. Although you’re rarely going to be in a flooding situation like this, there are many potential conditions where a CPAP machine is going to cause trouble. There are many travel situations where the machine would be exposed to the dampness. They can be hard to carry, hard to clean, and you may have difficulty with power.
That’s why you should consider an oral appliance for travel, even if you like your CPAP at home. An oral appliance is easy to transport, easy to clean, doesn’t need power, and will never start a fire.
We know that most people who have sleep apnea haven’t been diagnosed by a doctor. However, we have partly counted on people being able to identify sleep apnea symptoms to help them seek diagnosis and treatment. But now a new study suggests that many people with sleep apnea may not experience the key symptom of daytime sleepiness, even though they have serious sleep apnea. However, they may still have increased risk of car crashes, and other people around them may see the problem. This means that people and their doctors have to be on the lookout for other telltale sleep apnea symptoms as well.
Perception Plateau for Sleepiness
For this study, researchers wanted to explore the link between sleep deprivation and car accident risk. They focused on the two most common sleep disturbances: sleep apnea and short sleep duration. They used data from the Sleep Heart Health Study, which gave data on health and sleep from 1745 men and 1456 women age 40-89.
Although recommendations recognize that not everyone needs the same amount of sleep, researchers wanted to focus on short sleep because it’s so common, affecting up to 30% of American adults. For the purposes of this study, short sleep was defined as sleeping 6 or fewer hours a night.
Short sleep resulted in significantly higher risks of car accidents–about 33% higher risk. Sleep apnea could be much worse. Mild to moderate sleep apnea caused a slightly elevated risk of car accidents–13%–but severe sleep apnea more than doubled the risk of car accidents, a 123% higher car accident risk.
But, they found, people’s car accident risk wasn’t related to their sense of daytime sleepiness. People didn’t feel sleepy, even though sleep disturbance clearly impacted their performance.
One explanation for this is that people who are chronically sleep deprived just aren’t aware of how tired they really are. Instead, their awareness of being sleepy plateaus, and they begin to perceive their sleepiness as relatively normal, even though their performance is clearly compromised.
You should also keep a watch out for signs that you’re dozing off or zoning out in the car during your daily commute.
If you have symptoms of sleep apnea, you should talk to a doctor, even without daytime sleepiness. A sleep test is the only definitive diagnosis for sleep apnea.
Comfortable Treatment Option
To learn more about the benefits of comfortable, convenient sleep apnea treatment with an oral appliance in Omaha, please call (402) 493-4175 today for an appointment with a sleep dentist at the Advanced Dental Sleep Treatment Center.
Warmer weather seems it may be getting closer. You, I, and your patients are a little extra health conscious right now as we prepare for the summer by maybe going on a diet, losing weight, or living healthier. For people with sleep apnea, this is more than just self improvement. It may be self-preservation. Sleep apnea is a life-threatening condition, and lifestyle changes can literally mean the difference between life and death.
But how do you choose the right diet for reducing sleep apnea? One diet has scientific proof that it can help with sleep apnea, but that doesn’t mean it’s the best choice for your patients.
The Mediterranean Diet Has Scientific Backing
When Cardiologists are asked to rate the healthiest diet, they consistently recommend the Mediterranean diet. It has a lot of benefits: it’s popular, easy to implement, and doesn’t require the patient to buy books or special meals, so it’s relatively inexpensive. It’s also effective for weight loss and heart health. And it’s the only diet that’s been specifically shown to help with sleep apnea control.
In the supporting study, sleep apnea sufferers were divided into two groups. Both groups were told to exercise, were prescribed CPAP, and were told to follow a diet. One diet was a generic “prudent diet,” which is high in fruits, vegetables, legumes, and poultry. The other group was told to follow the Mediterranean diet. People who were on the Mediterranean diet saw more improvement in their sleep apnea–as well as greater reductions in their waist circumference.
Although just one study, it’s the only evidence we have that one diet might be better for sleep apnea than others.
The True Best Diet for You
Although the Mediterranean diet comes highly recommended and has this one study in support of it, that’s not a guarantee that it’s the best diet for your patient (or their sleep apnea). There are many factors to consider. First, although most people find the diet easy to follow, not everyone does. And second, it’s important to be cautious about the alcohol (wine) that’s considered a normal part of the diet. One or at most two glasses of wine with dinner is reasonable, but more than that can interfere with sleep and actually worsen sleep apnea.
But the best diet for your patient is the one that they’ll actually stick to. Finding that diet may take a few iterations, and it might require the use of external support, either in the form of a professional group or just informal support from family and friends.
Sometimes Sleep Apnea Treatment Must Come First
However, if your patient has sleep apnea, you have to remember that they u have the cards stacked against them for dieting, exercise, and weight loss. Poor sleep can make it hard to stick to a diet, and can make it even harder to lose weight. With poor sleep, you’re more likely to crave sweets, snack unconsciously, rely on caffeinated drinks, and more likely to store calories as fat. This can make it hard to be successful with any diet or weight loss.
But treating sleep apnea first can give your patient a significant boost to their efforts. With better sleep, they’ll be able to control their temptations and will be less likely to rely on caffeine drinks in the afternoon.
It’s important to note that the couple was not exactly in a healthy relationship when this fracas started. In fact, they were in the process of separating, but they hadn’t yet moved out. (As if we needed any more evidence that the premise of Splitting up Together is a bad idea.) We don’t know how much snoring contributed to the breakup, but this situation does remind us that most people don’t have the option of just sleeping apart to escape snoring. Many married couples don’t have an extra bedroom–many don’t even have the resources to move out right away when they’re breaking up.
Reportedly, before the couple went to bed on the night of January 22, the husband said, “If you snore tonight, I won’t be responsible for my actions.” Of course, she’s not exactly responsible for her snoring, and, as the court made clear, he was responsible for his actions.
When her snoring woke him during the night, he literally kicked her out of bed and then attacked her. She managed to get away, but he attacked her again. By this point, neighbors arrived and pulled the couple apart. The husband grabbed a guitar and struck her in the head with it several times, giving her an inch-long cut. The woman was then able to escape and contact the police.
The court initially considered imprisonment for the man, but they considered that he had no previous record and had not previously attacked his wife. So the court allowed him to have electronically monitored probation instead. He has to be in his home from 7pm to 7am every night for the next 10 weeks.
Protect Your Marriage, Your Liberty, and Your Person
Snoring is a serious issue in any relationship. People need sleep, and not everyone is lucky enough to have a partner who sleeps through your snoring. If one person can’t sleep because the other is snoring, it creates tensions that can be very hard to resolve. Leaving your snoring untreated sends negative signals to your partner, and it can lead to a separation or divorce. Worse, it can lead to violence as the entire messy breakup can cycle out of control. If you’re the victim of violence, you can suffer serious injuries. And if you’re the one who acts violently, you can face very serious charges, charges that can put you in jail and impact your ability to see your children after the divorce.
Don’t let snoring cause serious problems in your marriage. Even if you don’t see yourself with your partner in the future, snoring can cause problems now (not to mention with any potential future partner), so it’s best to get your snoring treated.
To learn more about effective snoring treatment options in Omaha that can make living together that much easier, please call (402) 493-4175 today for an appointment with a sleep dentist at the Advanced Dental Sleep Treatment Center.