New Jersey Dentists Are Saving Lives and Improving Marriages By Eliminating Snoring And Sleep Apnea Without CPAP. Patients Appreciate Freedom From Hoses, Masks and CPAP Machines.

    GURNEE, IL, June 10, 2009 /24-7PressRelease/ -- Dr DePaola thinks the science behind Dental Sleep Medicine is important. His patients are mainly concerned with the improvements in the quality of their lives.

Dr Frank R DePaola cites a study from the Oxford Centre for Respiratory Medicine showed that people with even minimally symptomatic obstructive sleep apnea (OSA) are at increased risk for cardiovascular disease because of impaired endothelial function and increased arterial stiffness. He is concerned for the health and wellness of fellow Texans, their families as well as the safety of our highways. Patients with mild sleep apnea have a 600% increase in motor vehicle accidents and a 300% increase in MVA with serious bodily injury. This is true even when there are no signs of daytime sleepiness. He has joined www.ihatecpap.com to promote diagnosis and treatment snoring and obstructive sleep apnea. Numerous studies have shown the negative effects of snoring and sleep apnea on marital contentment.

According to Dr DePaola obstructive sleep apnea is known to cause 6-7 fold increases in heart attacks and strokes. He sites this new study which showed that patients who exhibit even minimally symptomatic obstructive sleep apnea (OSA) might be at increased risk for cardiovascular disease because of impaired endothelial function and increased arterial stiffness. "Snoring is the number one symptom identifying sleep apnea. It is the annoying snoring that brings patients in for vital medical treatment" according to Dr Depaola.

"It was previously known that people with OSA severe enough to affect their daytime alertness and manifest in other ways are at increased risk of cardiovascular disease, but this finding suggests that many more people - some of whom may be completely unaware that they even have OSA - are at risk than previously thought," said lead author of the study, Malcolm Kohler, M.D.

The study was published in the first issue for November of the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine. At the American Thoracic Society meeting last year data was presented showed a 300% increase in motor vehicle accidents with severe injuries to one ore more people in mild apnea with no symptoms of daytime sleepiness. Mild Apnea is also known to cause permanent brain damage in adults and developing children.

"Only one out of approximately five subjects with [clinically defined OSA] complains of excessive daytime sleepiness in population studies," according to Geraldo Lorenzi-Filho, M.D., Ph.D. in his editorial in the same issue of the Journal. "It is now recognized that OSA triggers a cascade of biological reactions, including increased sympathetic activity, systemic inflammation, oxidative stress, and metabolic alterations that are potentially harmful to the cardiovascular system."

Dr. Kohler and colleagues performed a controlled, cross-sectional study to assess differences in endothelial function. The study compared 64 patients who had proven OSA to matched control subjects without OSA. These findings prove that minimally symptomatic OSA is a severe cardiovascular risk factor that was previously underestimated.

"In our study, the augmentation index, a measure of central arterial stiffness that independently predicts cardiovascular events in high-risk populations, was significantly higher in patients with minimally symptomatic OSA compared to matched controls," said Dr. Kohler. "We also found impaired endothelial function as indicated by decreased vascular reactivity of their arteries compared to control subjects without OSA." The American Academy of Dental Sleep Medicine 18th annual meeting was held June 5-7, 2009 and additional data was presented showing that Oral Appliances have similar outcomes to CPAP. Patients are more compliant with oral appliances according to Dr DePaola who adds that spouses and significant others of sleep apnea patients appreciate the improvements they see in their partners.

The difference in arterial stiffness between OSA patients and control subjects, Dr. Kohler said was "comparable in size to the effect seen after four weeks' continuous positive airway pressure (CPAP) therapy in patients with moderate to severe symptomatic OSA." This means that even patients with mild apnea will benefit from CPAP therapy. The problem with CPAP is that most patients do not continue to use it on a regular basis. Studies have shown that only 23-45 % of patients actually use CPAP and even users average only 4-5 hours a day. It is recommended that CPAP be worn 7 1/2-8 hours nightly.

Dr.Kohler and colleagues from the Oxford Centre for Respiratory Medicine are currently investigating the effects of 6 month CPAP therapy on arterial stiffness and endothelial function as part of an international randomized controlled trial (Multicentre Obstructive Sleep Apnoea Interventional Cardiovascular Trial; MOSAIC) which will show the impact of CPAP therapy on cardiovascular risk in patients with minimally symptomatic OSA. The problem with compliance with is still a problem but it has been shown that oral appliances are as effective as CPAP for mild to moderate sleep apnea ant that oral appliances have much higher compliance. Information on oral appliance therapy can be found at www.ihatecpap.com

Due to the fact that permanent damage to the brain and cardiovascular system results from untreated apnea this lack of treatment compliance has led an intense effort to improve compliance by improving the design of the machines and the masks. This effort has been only minimally effective. The field of Dental Sleep Medicine has emerged as the best hope for patients who do not tolerate CPAP treatment. The American Academy of Sleep Medicine has endorsed oral appliances as a first line treatment along with CPAP for mild to moderate sleep apnea and as an alternative treatment for severe sleep apnea. This position is also endorsed by the National Sleep Foundation, The American Sleep Apnea Association (AWAKE) and the American Academy of Dental Sleep Medicine. Dr Kent Smith a founding member of DOSA and a nationally known lecturer on Dental Sleep Medicine says that an excellent site for information on Dental Sleep Medicine http://www.ihatecpap.com was developed by Dr Ira L Shapira a Chicago dentist who is a Diplomate of the American Board of Dental Sleep Medicine and a pioneer in the field of dental sleep medicine. Dr Shapira was a charter member of the Sleep Disorder Dental Society, which evolved into the American Academy of Dental Sleep Medicine and is a founding member of DOSA,The Dental Organization for Sleep Apnea. Dr Kent Smith, of Dallas Texas was instrumental in the creation of DOSA. The website, www.ihatecpap.com has a find a dentist area to help patients connect with Sleep Apnea Dentists.

DR SHAPIRA, DR DEPAOLA AND DR KENT SMITH ALL EMPHASIZE THAT THEY DO NOT HATE CPAP AND THAT CPAP IS AN EXCELLENT TREATMENT FOR PATIENTS WHO TOLERATE IT AND USE IT THE RECOMMENDED 7-8 HOURS NIGHTLY. THEY BELIEVE THAT DENTAL SLEEP MEDICINE PROVIDES COMFORTABLE CPAP ALTERNATIVES FOR PATIENTS WHO DO NOT TOLERATE CPAP. NUMEROUS STUDIES HAVE SHOWN THAT MOST PATIENTS PREFER ORAL APPLIANCES TO CPAP WHEN THEY ARE GIVEN A CHOICE.

To learn more about the dangers of Sleep Apnea and the treatment alternatives you can use the following resources:

http://www.sleepapnea.org/awake/index.html
http://www.sleepfoundation.org/site/c.huIXKjM0IxF/b.2417141/k.27D9/Home_of_the_Sleep_in_America_Poll.htm
http://www.sleepandhealth.com
http://www.ihatecpap.com/sleep_apnea_dangers.html

http://www.24-7pressrelease.com/view_press_release.php?rID=68378

http://www.24-7pressrelease.com/view_press_release.php?rID=71702

http://www.24-7pressrelease.com/view_press_release.php?rID=64910

Courses at the AADSM meeting included lectures on pediatric sleep apnea by David Gozal MD who was just appointed chair of pediatrics at The University of Chicago. His research is currently supported by several NIH grants and he is the Deputy Editor of SLEEP.

Dr Geraldo Lorenzi-Filho MD gave a lecture on Sleep Apnea, Hypertension, Atherosclerosis and Cardiovascular Disease. He presented information on the connections between OSA (obstructive Sleep Apnea) and Atherosclerosis. OSA has profound effects on the Cardiovacular (CV) System he also detaile Mechanisms linking OSA to Hypertension. He sited the Wisconsin COHORT study showing that the higher the Apnea Hypopnea Index (AHI) was directly related to increased risks of Hypertension. Information he gave originally reported by Marin in the Lancet in 2005 showed that OSA was responsible for Cardiovascular death and implicated in increasing arterial stiffness and narrowing of the carotid artery.

Congressman Gus Bilirakis (R-Fla.) introduced House Resolution 384, "Sleep Apnea Awareness," which resolves that the House will support raising public awareness of sleep apnea and encourage all Americans to educate themselves and others about the consequences of sleep apnea and its potential treatments. Dr Ira L Shapira a Diplomate of the American Board of Dental Sleep Medicine applauds the Congressman and urges everyone to contact their representatives and senators to support passage of important legislation that will make the nations roads safer and lower health care costs. Dr Shapira is the founder of http://www.ihatecpap.com that promotes diagnosis and treatment of sleep apnea. CPAP is the gold standard of treatment for sleep apnea but the majority of patients do not tolerate the treatment. Dr Shapira does not hate CPAP but ofers information on oral appliances that treat sleep apnea and that have been shown to be better tolerated than CPAP. Information on oral appliance treatment of sleep apnea can be found at http://www.ihatecpap.com/oral_appliance.html

Below is text of the full resolution:
HRES 384 Recognizing the importance of increased awareness of sleep apnea, and for other purposes.
Whereas sleep apnea is a common condition that affects more than 12,000,000 Americans, according to the National Heart, Lung, and Blood Institute at the National Institutes of Health;
Whereas there are several types of sleep apnea that cause people with this condition to repeatedly stop breathing throughout the night, often many times;
Whereas sleep apnea is a chronic condition that disrupts sleep three or more nights each week, leading to excessive daytime sleepiness;
Whereas sleep apnea becomes more common with age, and 1 in 10 people over the age of 65 suffers from it;
Whereas sleep apnea is more common in men than women, and more than half of the people with sleep apnea are overweight;
Whereas sleep apnea can strike anyone, at any age, at any time, including children;
Whereas untreated sleep apnea can lead to high blood pressure, heart attack, stroke, obesity, and diabetes;
Whereas untreated sleep apnea can also increase the chance of having work-related or driving accidents and adversely impact the quality of life of those suffering from this condition in other ways;
Whereas lifestyle changes, mouthpieces, surgery, and/or breathing devices can successfully treat sleep apnea in many people; and
Whereas the lack of public awareness of this serious condition leads to many undiagnosed and untreated cases: Now, therefore, be it
Resolved, That the House of Representatives--
(1) supports raising public awareness of sleep apnea; and
(2) encourages all Americans to educate themselves and others about the consequences of sleep apnea and its potential treatments.

I HATE CPAP LLC is a major organization that has worked diligently to increase public awareness of the dangers of sleep apnea. http://www.ihatecpap.com/sleep_apnea_dangers.html

SEE THE FOLLOWING CONTACT INFORMATION FOR NEW JERSEY DENTISTS DR BIXBY AND DR DEPAOLA FOR PATIENTS WANTING COMFORTABLE ALERNATIVE TO CPAP.

Dr Frank R DePaola
Center for Dental Sleep Medicine
at The Maxwell Place
1209 Hudson St.
Hoboken, NJ 07030
http://www.NorthNJ.IHateCPAP.com/

Dr Ira L Shapira is an author and section editor of Sleep and Health Journal, 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 is a Regent of ICCMO and its representative to the TMD Alliance, He was a founding and certified member of the Sleep Disorder Dental Society which became the American Academy of Dental Sleep Medicine, A founding member of DOSA the Dental Organization for Sleep Apnea. He is a Diplomate of the American Board of Dental Sleep Medicine, A Diplomat of the American Academy of Pain Management, a graduate of LVI. He is a former assistant professor at Rush Medical School's Sleep Service where he worked with Dr Rosalind Cartwright who is a founder of Sleep Medicine and Dental Sleep Medicine. Dr Shapira is a consultant to numerous sleep centers and teaches courses in Dental Sleep Medicine in his office to doctors from around the U.S. He is the Founder of I HATE CPAP LLC and http://www.ihatecpap.com Dr Shapira also holds several patents on methods and devices for the prophylactic minimally invasive early removal of wisdom teeth and collection of bone marrow and stem cells. Dr Shapira is a licensed general dentist in Illinois and Wisconsin.

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