22.03.2014
Heart attack or heart failure: having sleep apnea exposes you to four times the risk of a heart attack. On top of all this sleep apnea is being seen as a leading cause of motor vehicle accidents. Obstructive Sleep Apnea (OSA) suffers may experience hundreds of apnea episodes a night and, if they live alone or sleep alone are unlikely to remember the episodes.
Usually, a patient with Sleep Apnea is often at first provided a Continuous Positive Airway Pressure (CPAP) machine as the first step in treatment. The SomnoDent® MAS is much more effective comfortable than existing MAS devices: for the treatment of Sleep Apnea the SomnoDent® MAS is worn throughout sleep to uphold the patency of the upper airway by increasing its dimensions and reducing collapsibility.
Worn in the mouth like any other orthodontic appliance during sleep, oral appliances prevent the soft tissue from collapsing and interrupting normal breathing patterns.
For more information on SomnoDent® MAS, or to book an appointment at our conveniently located dental practice in Sacramento, please do not hesitate to contact us. Check back regularly for helpful tips and topics about caring for the health and appearance of your smile, along with updates about the latest dental treatments available at our dental practice located in Sacramento. Sleep Review's webinar "Insourcing Versus Outsourcing Home Sleep Testing" is now available for on-demand viewing. How it works: Oral appliance therapy (OAT) helps prevent the collapse of the tongue and soft tissues in the back of the throat by supporting the jaw in a forward position, keeping the airway open during sleep. Bennett: It is important for sleep physicians to collaborate with a dentist who can conduct a thorough intraoral examination to assess candidacy for an oral appliance. How it works: Worn on the back of the neck, Night Shift (by Advanced Brain Monitoring) begins to vibrate when users begin to sleep on their back and slowly increases in intensity until a position change occurs. New developments in 2014: Advanced Brain Monitoring received FDA clearance for Night Shift in June 2014.
Concern: I can advise the patient to sleep on two tennis balls in a sock to stay off his back for a much cheaper price.
Concern: Night Shift will wake my patient up due to the vibration, thereby still interrupting his sleep. How it works: Winx (by ApniCure) generates negative pressure in the oral cavity, which draws the soft palate and uvula forward, and stabilizes the tongue position, thus enlarging the upper airway.
White: A single night sleep study either in the lab or in the home can easily determine if the Winx device will work in a given patient. New developments in 2014: The FDA approved a lower resistance version of EPAP, Theravent, which is an over-the-counter product indicated only for primary snoring.


Williams: The Provent Nasal Cannula is a diagnostic tool to be used with the Provent Sleep Apnea Therapy device during sleep studies, enabling practitioners to confirm product efficacy. How it works: The most common type of oropharyngeal surgery for OSA, UPPP, enlarges the retropalatal upper airway by excising a portion of the posterior soft palate and uvula with trimming and reorientation of the tonsillar pillars. Patients who should NOT try it: Some argue that patients with a BMI of 40 and above should opt for bariatric surgery over oropharyngeal surgery. New developments in 2014: More and more surgeons are opting to perform a drug-induced sleep endoscopy (DISE) prior to oropharyngeal surgery in order to find out exactly where the blockage is and help determine the responders versus the nonresponders.
How it works: Gastric banding, sleeve gastrectomy, and gastric bypass surgery lead to significant weight loss, including lessening the buildup of fat tissue in the upper thorax and neck.
Patients who should NOT try it: Patients with severe pulmonary hypertension need a more extensive plan to be prepared for surgery.
How it works: Inspire therapy is an implanted system that senses breathing patterns and delivers mild stimulation to key airway muscles, which keeps the airway open during sleep. Sleep apnea is similar to snoring, but whereas snoring is only a partial closure of the back of your throat, sleep apnea is the complete closure of the back of your throat, causing a lack of oxygen that results in the brain kick-starting the breathing process. In fact, for those who sleep alone, they may not know they suffer from OSA even after many years.
We profile the spectrum of FDA-approved therapies, including when to try them, considerations for each, and new developments. For severe OSA patients, only after initial trial of CPAP, oral appliances have been shown to be 50% effective. For patients with an elevated supine apnea index, overall snoring may increase with positional therapy because supine apneas are replaced with snoring. In our study, the number of arousals due to sleep disorder breathing exceeded the number of supine attempts resulting in positional feedback by a factor of 15.
Assessment of a neck-based treatment and monitoring device for positional obstructive sleep apnea.
However, insurance coverage will increase over time and many patients are willing to pay for Winx out of pocket as they will get a full refund of the console only over the first 30 days of use if Winx is ineffective or not well tolerated. A multicenter evaluation of oral pressure therapy for the treatment of obstructive sleep apnea. A novel nasal expiratory positive airway pressure (EPAP) device for the treatment of obstructive sleep apnea: a randomized controlled trial.
For these reasons, the Pillar Procedure may be indicated in any patient with a significant palatal component.


But the soft palate is a significant contributing factor in most patients with OSA, and by combining the Pillar Procedure with other minimally invasive treatments, many patients can achieve significant improvement, without the pain, risk, and inconvenience of surgical intervention.
Efficacy of the Pillar implant in the treatment of snoring and mild-to-moderate obstructive sleep apnea: a meta-analysis. Favorable anatomy for UPPP includes large tonsils and favorable tongue placement (small base of tongue).
Additionally, bariatric surgery and subsequent weight loss provide better treatment options for patients if they are in need of further treatment. Obstructive sleep apnea and pulmonary function in patients with severe obesity before and after bariatric surgery: a randomized clinical trial. A second study showing the capabilities of Night Shift as a screening device accepted for publication. Use of Night Shift resulted in significant reductions in stage N1 and increased in N2, while REM and sleep efficiency increase and arousals and awakenings were significantly reduced. Because OSA typically does not result solely from palatal flutter, results are optimized when the Pillar Procedure is combined with other anatomically appropriate treatments.
Objective measurement of compliance during oral appliance therapy for sleep-disordered breathing.
Remotely controlled mandibular protrusion during sleep predicts therapeutic success with oral appliances in patients with obstructive sleep apnea.
Health outcomes of continuous positive airway pressure versus oral appliance treatment for obstructive sleep apnea: a randomized controlled trial. This kind of stop-start breathing can be detrimental to your health because with prolonged apnea (not breathing) the amount of oxygen in vital organs such as the brain, lungs and kidney can drop so low that cellular damage can occur. It is important to tailor the treatment to the individual needs of each patient to promote long-term therapeutic success. And a third option is maxillary mandibular advancement (MMA), in which the upper and lower jaws are surgically moved forward. Night Shift is listed on FSS fee schedule so VA Centers can purchase it at a discount for their patients.
Pillar has been on the market in the United States for over 12 years, and has been shown to be a remarkably safe procedure.



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