La Crosse, Wisconsin: 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
LA CROSSE, WI, February 11, 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."
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.
Lacrosse Sleep Apnea Dentist Dr Kevin Ladesic is bringing comfortable alternatives to CPAP to patients with obstructive sleep apnea in the Tri-state area. Dr. Ladesic originally became involved in treating sleep apnea after learning of the serious problems that are often a direct result of untreated apnea and has joined the national I Hate CPAP campaign and launched http://www.Lacrosse.IHateCPAP.com to introduce oral appliance and CPAP alternative options to sleep apnea sufferers who can't tolerate CPAP or have stopped using it. The recent research (below) on strokes was just one more reason for him to offer this lifesaving treatment alternative to his patients.
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 Ladesic was a former associate and trained with Chicago dentist Dr Ira Shapira 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. Drs Ladesic and Shapira are clear in stating that they does not HATE CPAP which is still the gold standard for treatment. Dr Shapira 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 "i hate CPAP" provacative it resonates strongly 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 that 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)
Dr Ladesic has trained not only in Dental Sleep Medicine but also in the treatment of Temporo-mandibular disorders. He is well acquainted with the intracacies of neuromuscular dentistry and takes enormous pleasure in relieving patients of migraines, chronic daily headaches, TMJ pain, sinus pain and other chronic disorders. He believes in using neuromuscular dentistry as a tool in healing patients while doing dental restorative and cosmetic proceedures.Dr Ladesic recommends that 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 Treatment of sleep disorders and TMJ disorders are actually two very different faces of identical problems. TMJ disorders are often referred to as "The Great Imposter" because symptoms are so varied and many patients go thru numerous treatments before a proper diagnosis is arrived at.
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.