SNORING KILLS! HEAVY SNORING INCREASES RISK OF STROKE AND CAROTID ATHEROSCLEROSIS. RISK IS INDEPENDENT OF OTHER RISK FACTORS. PUBLIC HEALTH IMPLICATIONS ARE ENORMOUS ACCORDING TO ARTICLE IN SLEEP, SEPTEMBER 1, 2008. SLEEP APNEA DENTISTS MAY PLAY MAJOR ROLE ALLEVIATING IN THIS HEALTH CONCERN

    /24-7PressRelease/ - GURNEE, IL, September 14, 2008 - Heavy snoring is often a sign a sleep apnea a life threatening condition. A new study published in Sleep shows that heavy snoring in the absence of sleep apnea also seriously increases risks for carotid atherosclerosis and stroke. 110 volunteers were divided into three groups. Mild snorers who snored less than 25 % of the night, Moderate snorers who snored 25-50% of the night and Heavy snorers who snored more than 50% of the night. The prevalence of carotid atherosclerosis increased with severity of snoring. Prevelance rates for carotid atherosclerosis were 20% for mild snoring, 32% for moderate snoring and 64% for heavy snoring. It has previously been reported in JAMA that snores have a 300% increase in motor vehicle accidents. The risks in this study were definitive even after adjusting for age, sex, smoking history and hypertension. Snoring can no longer be considered humorous but must be considered a warning sign of a serious health problem. Sleep Apnea Dentist who are trained in Dental Sleep Medicine and treatment of TMJ disorders are taking a major role in the treatment of sleep apnea and snoring. Patients generally prefer oral appliances to CPAP treatment. Additional information on Sleep apnea and oral appliances are available at www.ihatecpap.com . It is a premiere site for locating a sleep apnea dentist.

It is estimated that that between 15-54% of middle aged adults snore. Snoring is a major warning sign for sleep apnea a much more serious life-threatening disorder that affects 4% of middle aged men and 2% of middle aged women. Snoring in children has been associated with poor school performance and ADHD. Epidemiologic studies associate Obstructive sleep apnea with cerebrovascular disease. The gold standard of treatment for sleep apnea is CPAP or continuous positive air pressure where the patient is fitted with a mask connected to a compressor by a hose. While almost 100% effective compliance is often poor with only 23-45% of patients using CPAP. Patients average only 4-5 hours a night with CPAP leaving them untreated for much of the night. Dental Sleep Medicine provides a lifesaving alternative for patients who do not tolerate CPAP or CPAP masks. The American Academy of Sleep Medicine recognizes oral appliance therapy as an effective first line treatment for mild to moderate apnea and an alternative treatment for severe sleep apnea when patients do not tolerate CPAP. The American Academy of Dental Sleep Medicine endorses this position. An excellent resource for patients wishing to learn more about dental sleep medicine and using oral appliances as a CPAP Alternative is www.ihatecpap.com . Dr Ira L Shapira, a Gurnee, Illinois Dentist is a Diplomate of the American Board of Dental Sleep Medicine and founded the site to increase knowledge and understanding of sleep apnea dangers and inform the public about the availability of treatment with comfortable oral appliances as an alternative to CPAP. CPAP is still considered the gold standard of treatment but most patients are not compliant and many go without treatment

The carotid artery and the carotid bifurcation is in close proximity to the pharyngeal walls where snoring vibrations originate and are therefore exposed to these vibrations that may cause damage to endothelial cells in the carotid artery walls. A recent study was done in rabbits that confirmed that vibrations from snoring are transmitted to the walls and lumen of the carotid arteries. Regardless of the direct effects of snoring on carotid arteries and risks for arthrosclerosis the most important aspect of snoring is as a warning sign of sleep apnea. There is a six-fold increase in heart attacks and strokes in patients with untreated sleep apnea. One study showed a 38% decrease in eight-year survival in patients with untreated sleep apnea compared to treated patients. Sleep apnea has also been implicated in short-term memory loss, Alzheimer's and dementia. Data from the Sleep Heart Health Study showed an increased prevalence in carotid atherosclerosis in OSA patients that mirrored increased risks of strokes.

Both snoring and apnea are associated with increases in daytime sleepiness and reduced mental abilities in adults and children. Sleep apnea has been shown to delay and/or permanently affect brain development in children, an article in Sleep showed structural changes in the brains of patients with OSA (obstructive sleep apnea). It is well known that emotional, hormonal, cognitive and autonomic nervous system changes occur in patients with OSA and the study in July sleep investigate 41 patients with untreated sleep apnea and 69 control subjects. The study showed that many of the problems remained despite treatment of sleep apnea including cognitive and mood changes a sustained elevated sympathetic activity. Functional Magnetic resonance imaging (fMRI) found changes that are probably related to injuries of the brain from OSA that arte not well understood. The white matter of the brain in OSA patients has shown extensive affects including changes to axons in the Limbic system that regulates emotions as well as changes in the pons, frontal, temporal and parietal cortices. It also affected projections into and out of the cerebellum. These changes may explain why many patients do not feel complete improvement after treatment.

Another article in the July issue of Sleep is vitally important because it discusses treatment of sleep apnea in prepubertal children. We know that OSA negatively affects the developing brain as well as the adult brain. It is therefore imperative to address snoring and sleep apnea starting in the pediatric population. If we can identify, treat and correct the problems early we can positively affect the quality of patient's lives. The article calls for Orthodontic expansion and Adenotonsillectomy to treat OSA. This is logical because work of researchers like Harvold has shown changes in the craniofacial development with restricted nasal pharyngeal breathing. These changes are the same structural abnormalities found in adult sleep apnea patients.

A recent study in the Journal of Clinical Sleep Medicine (Vol 4, No 4, 2008) showed persistence of Obstructive Sleep Apnea in patients after Surgical Weight loss. The weight loss reduces The AHI (apnea-hypopnea index) but does not eliminate the apnea. This is consistent with metabolic syndrome where patients gain weight due to disrupted sleep from apnea. The weight loss improves the apnea but does not correct the underlying problem. Dental Sleep Medicine can prevent the problem with early orthodontic expansion and all children who snore, have suspected sleep apnea, ADD or ADHD should be evaluated for orthodontic expansion and removal of obstructive tonsils and adenoids at as young an age as possible.

The National Heart Lung and Blood institute has declared that sleep apnea is a TMJ disorder. Their 2001 report is mandatory reading for all dentists and physicians treating patients with sleep and emotional problems or chronic pain. CARDIOVASCULAR AND SLEEP-RELATED CONSEQUENCES OF TEMPOROMANDIBULAR DISORDERS can be found at http://www.nhlbi.nih.gov/meetings/workshops/tmj_wksp.pdf

Information on Sleep Apnea treatment with oral appliances is available at www.ihatecpap.com

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 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 Schools 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.

# # #