Sleep and Health Journal

By Ira Shapira, DDS

Is it time to consider oral appliances for traveling? On August 4, 2007 the new government rules for TSA screening took effect. These new standards can be found at http://www.tsa.gov/travelers/sop/index.shtm. The rules now state that large electronic items such as DVD players, video cameras that take cassettes and CPAP machines must be taken out of the hand luggage and placed in bins in the same manner as laptop computers. This is a major inconvenience for the business traveler who also takes a laptop and travels without checked luggage.

By Jeffrey P. Pancer DDS, D, ABDSM

According to the AASM (The American Academy of Sleep Medicine), Oral Appliances are indicated for treatment of mild and moderate apnea and for those patients with severe apnea who are unable to tolerate CPAP therapy. The AASM describes patients with an index of 5 to 15 events per hour as having mild apnea. Those who stop breathing 15 to 30 times per hour are considered to have moderate apnea, and those with more than 30 events per hour are considered to have severe apnea. However, many sleep physicians suggest these levels are too restrictive and believe a looser definition is more appropriate. Many feel that mild should be from 10 to 30, moderate from 30 to 50 and severe over 50. This discussion is confused by the fact that many patients (at all levels) show no symptoms other than snoring, and snoring is usually a problem that offends only the bedpartner, not the one who snores.

Obesity, hypertension, dyslipidemia, and hyperglycemia are prevalent in obstructive sleep apnea syndrome (OSAS). Metabolic syndrome, however, is defined by visceral fat obesity plus at least two of these factors. However, whether OSAS contributes to the development of metabolic syndrome has not been defined. The authors investigated whether the components of metabolic syndrome were associated with OSAS in nonobese patients. They investigated the occurrence of hypertension, dyslipidemia, and hyperglycemia in 42 men with OSAS and 52 men without OSAS matched for age, body mass index (BMI), and visceral fat accumulation.

By Simeon Margolis, M.D., Ph.D.

Some estimates suggest that half of adult men and a third of adult women in the U.S. are snorers. Snoring is commonly only a minor social problem that disturbs a sleeping partner or causes embarrassment to the snorer.

But sleep deprivation in the snorer's partner can lead to discord, and homicides have been described because of snoring. I have been embarrassed when my children have told me that my snoring has kept them awake in an adjacent room.

This is a real story of Nick Sabatino. Nick was a 16 year old when his 18-year-old friend lost control of his car and the car sped down a hill and struck a cement bridge. The vehicle was sent flying over the creek for 43 feet and burst into flames. The driver was killed, but Nick was rescued with more then 90% of his body burned. Not many people survive such burn, and if they do, people became severely disable, angry and depressed.

Sleep Apnea & CPAP Devices

What is sleep apnea?

In some people, the windpipe that brings air into the body is blocked during sleep. This keeps the lungs from getting enough air. This is called obstructive sleep apnea. People who have sleep apnea stop breathing for 10 to 30 seconds at a time while they are sleeping. These stops can happen up to 400 times every night. The consequences of these disturbances can be serious and sometimes life-threatening.

A cardiologist in Boston reportedly became curious as to why patients who had been given pacemakers were suddenly snoring less. What he discovered could potentially revolutionize the treatment of sleep-related breathing disorders such as sleep apnea.

Neil S. Freedman, M.D.
Obstructive sleep apnea is an extremely common, and often underdiagnosed, medical problem affecting up to 4% of the middle aged American population. It is characterized by episodic partial and total obstructions of the upper airway, resulting in a reduction or inability of air to get from the nose and mouth to the lungs during sleep. Disrupted sleep resulting in daytime sleepiness is often the consequence, as the body attempts to normalize its nighttime breathing pattern. Until recently, it was thought that daytime sleepiness with its associated problems of impaired memory and inability to concentrate were the only important symptoms associated with this disease. Several recent studies have demonstrated that obstructive sleep apnea is associated with an increased risk for cardiovascular disease, poorer quality of life, and higher incidence of depression.

Dr. Sushil Sharma, M.D.

When we sleep many parts of our body are resting, but not our heart. Cardiologists and Sleep Medicine specialists discovered unusually intensive heart activity heart in REM sleep and during dreams. While the body is lying quietly, the heart rate speeds up as if the person is running or fighting. Researchers have been surprised to find that the relationships between the heart and other organs in sleep were different from those during an awakened state. For example, if you start to breathe fast your heart rate will also speed up. In sleep however, (especially in REM sleep) if your breathing increases the heart rate might not follow, moreover, it might decrease. In addition, if the heart rate slows down for a few minutes oxygen saturation in the blood will decrease to a dangerous level.