1. 1 Company LOGO Don H. Lowrance, MS, DDS, PA Fellow, Board Ready Las Vegas Institute of Cosmetic Dentistry Board Certified Clinical Nutritionist Treating TMJ and Sleep Apnea Sleep … 1 The Elusive Dream

2. 2 Sleep Apnea and SDB  Tongue and throat muscles relax while sleeping and stop up the throat (most common cause)  Causes abnormal halts in breathing  Last from a few seconds up to over 1 minute  It can happen 5-30 times or more per hour  SDB is a Continuum: Snoring (warning) leads to Hypopnea (shallow breathing) and then Apnea (without breathing)  Types:  Central: breathing interrupted by lack of respiratory effort.  Obstructive: physical blockage to airflow stopping respiratory effort.  Mixed: has both obstructive and central apnea events 2

3. 3 SDB Affects 80.4 Million  100,000 accidents are caused each year by drowsy drivers (1,500 fatalities, 71,000 injuries and $48 Billion in medical costs) NHTSA non-alcohol related  Excessive Daytime Sleepiness: cost $150 Billion annually in lost productivity  20-30 million Americans experience occasional sleep problems  Not normal to feel sleepy during the day, unable to fall asleep or wake up not feeling refreshed 3

4. 4 Effects of SDB  Cumulative effect, compounds over time: You will build up a Sleep Deficit  Constantly tired  Difficulty focusing, concentrating, staying on task  Weight gain ! Yikes!!  Irritability  Aggravate or lead to Chronic Diseases 4

5. 5 Diseases that exist along with SDB 5

6. 6 Diseases that exist with SDB  Lack of proper sleep over time affects every aspect of your health:  High blood pressure  Type II Diabetes: 80% also apneic  Heart attacks: 3x more likely  Stroke: 2x more likely 6

7. 7 Diseases that exist with SDB  Lack of proper sleep over time affects every aspect of your Health:  Congestive Heart Failure  Depression: neuro-transmitters  Sexual issues: EDS, Impotence  6x greater risk for auto accidents (this does not include airplane accidents or factory workers and shift workers) 7

8. 8 Diagnosis: Start to Finish  Bed Partner Survey (online at CC Snoring.com)  Epworth Sleep Survey (online at CCSnoring.com)  Keep a Sleep Diary: Please!!!!  Physician Consultation and referral  Can obtain a sleep study (polysomnogram) at a Certified Sleep Center (not all the same) * Sleep conditions can only be diagnosed by a medical doctor who is a sleep specialist. 8

9. 9 Sleep Survey Are you tired throughout the day? Are you told you look tired? Do you nap often? Do you take pills to help you sleep? Do you have trouble controlling your emotions, difficulty concentrating or react slowly? Do you fall asleep watching TV, reading, driving, sitting still? When you’re asleep:  Do you snore, does your partner say you do?  Do you stop breathing?  Abruptly awaken or awaken gasping for air? Do you drink caffeine or eat sugary foods to keep you going? In the morning, do you feel refreshed? 9

10. 10 Are Untreated Sleep Conditions Harmful? Sleep, nutrition and exercise all affect the homeostasis (balance) of the functions of your body. A homeostatic imbalance can lead to organ failure and even death. Sleep conditions can only be diagnosed by a medical doctor who is a sleep specialist. Nutrition and exercise programs should be reviewed & prescribed by your physician. 10

11. 11 3 Common Treatment Choices: CPAP: a mask that pushes air past the blockage  Gold Standard: used in Mild to Severe Apnea  50% failure rate (don’t use their CPAP)  Contra-indicated: claustrophobia, snoring  Don’t like them, find them obtrusive, noisy  Have to wash mask daily, hose & filter weekly 11

12. 12 3 Common Treatment Options: Oral Appliances:  moves the jaw and tongue forward out of the throat  Over 20 different types  Used in Mild to Moderate Sleep Apnea and Snoring  Can be used with CPAP in Severe Apnea to make the CPAP more comfortable and lower the pressure  Contra-indicated in Gaggers 12

13. 13 3 Common Treatment Options: Surgery:  Tonsil and Adenoids  Nasal Obstructions, turbinate reduction  Reduction Large Tongue  Bariatric Surgery for weight loss 13

14. 14 Proper Sleep Hygiene  Establish a routine and stick to it.  Avoid long naps (no more than 15 min)  Ban laptops, cell phones and TVs after 9 PM.  Don’t consume any caffeine after 6 PM (half life of 12 hours).  No exercising after 6 p.m.  Avoid alcohol in the evening.  Keep clocks out of your line of vision.  If you can’t fall asleep, leave your bedroom and do something quiet until you’re ready to sleep.  Ensure your room is dark, cool and quiet. 14

15. 15 Is Treatment Necessary ?  Without treatment you will have more health problems with Cardiovascular Disease, Type II Diabetes, obesity, etc  Without treatment, your snoring will cause problems with your family and your quality of life  Without treatment, you will stay fatigued  Without treatment, you will leave the planet earth sooner than necessary---5 to 10 years sooner.  It is your choice ---- 15

16. 16 Information  The slide presentation is on my websites at CCSmiles.com and CCSnoring.com  Bed Partner Survey and Epworth Sleepiness Scale are on CCSnoring.com  Information about Sleep Laboratories can be obtained from my office by calling 851-8274  Send Bed Partner Survey and Epworth to your doctor and ask for a referral for a PSG at the lab “you” request. 16

17. 17 Resources for Sleep Apnea Treatment CCSmiles.com CCSnoring.com Harvard Medical School

18. 18 Don H. Lowrance, MS, DDS, PA Fellow, Board Ready Las Vegas Institute Board Certified Clinical Nutritionist Check out my blog: www.CCSnoring.comwww.CCSnoring.com 4707 Everhart Rd, Suite 101 Corpus Christi, TX 78411 361.851.8274 Serving the Costal Bend and San Antonio 18