Tag Archives: sleep apnea

Heat-Cured Hard Acrylic VS Dual Laminate Appliances

Weekend courses teaching oral appliance therapy are conducted all over the country and with over 100 commercially available oral appliances it can be really difficult to navigate the appliance selection process. Considering the mechanical functioning of the appliance is essential when determining which one to choose for treatment, but often times the material used to construct the appliance is equally as important and overlooked. Two of the most generally known materials are heat-cured hard acrylic and dual laminates. Studies have shown that while there are advantages and disadvantages to each material, most doctors favor heat-cured hard acrylic appliances because they have a compelling superiority over the latter when it comes to fitting, repairs, longevity and patient comfort.

Some of the most pressing issues in doctors’ offices are fitting the appliance correctly in the patient’s mouth. Obstructive sleep apnea is a serious medical condition that can sometimes be so severe that doctors don’t have time to send back an appliance to be remade if it doesn’t fit. National statistics show a lower percentage of remakes in hard acrylic formed appliances. The reason for this can partly be credited to ease of modification chairside due to minor cosmetic dental changes. If anything changes in the patient’s mouth for example, the addition of a crown, a completely new appliance must be created as realignment can’t be done in laminate appliances. On a hard acrylic appliance, the appliance can sometimes be ground to re-fit. Furthermore, the addition of clasps in hard acrylic appliances provide further retention whereas a laminate appliance does not allow for it to contain clasps.

Repairs are inevitable when it comes to oral appliances. Fortunately when repairs are necessary, the ramifications can be minimized simply by the choice of appliance design. Doctors can take a more basic approach to repairing hard acrylic appliances including, but not limited to, effortlessly bonding new acrylic to cracks or chips in their own. Mending a laminate appliance can become more complicated when considering the soft liner located on the inside. Many times that same soft layer has been shown to absorb moisture and start to yellow with bacteria. Unfortunately this is not a matter of repair, rather a matter of replacement.

Gergen’s Orthodontic Lab, which is the largest manufacturer of the Sleep Herbst in the country, has seen hard acrylic appliances last over to 20 years. Regrettably, the soft layer in laminate appliances always eventually loses the bond to the hard layer- meaning it will always peel apart over time, leading to the doctor sending it back to the manufacturing lab to be rebuilt.

Typically patient comfort is one of the cornerstones of the decision making process in choosing treatments. While each of the designs have equal amounts of pros and cons to patient satisfaction, time and time again there have been proven patterns and methods that demonstrate it is easier to overcome the cons associated with treatment via hard acrylic appliances. This is contrary to general belief being that dual laminates are more comfortable. Moreover, tongue space is greatly reduced in dual laminate appliances due to the extra layer being present.

All things considered, both hard acrylic and dual laminate appliances grant favorable benefits in many cases. Clearly though when taking into account the comparison of both designs regarding fitting, repairs, longevity and patient comfort the preferred choice when selecting one of the two is the hard acrylic design more often than not.

Alan Hickey

Alan Hickey

Publisher of Sleep Diagnosis and Therapy Journal the Official publication of the American Sleep and Breathing Academy, the Journal is a clinical and technical publication for dental and medical professionals.

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Special Committee In Washington To Look At Oral Appliance Therapy As Benchmark Therapy For OSA, Thanks To The ASBA And Our Team

More great news coming from The American Sleep and Breathing Academy! It is no secret that the ASBA has been working tirelessly for the advancement of dental sleep medicine and, in September, the culmination of all of that hard work will come to fruition. Key members of the American Sleep and Breathing Academy, along with NFL icons such as Roy Green, and Congressman Marty Russo will be in front of a special congressional committee speaking about treatment of Obstructive Sleep Apnea (OSA) with oral appliance therapy.

Spearheaded by Congresswoman Anna G. Eshoo, this special committee was assigned a health and science aid to gather information on the effectiveness of oral appliance therapy in treating OSA. Congresswoman Eshoo’s main goals with forming this committee is to make oral appliances a benchmark therapy. The hope is that the information gathered within this committee, along with insight from these key ASBA members, will help to educate patients on all treatment options; an education that is not typically presented at the time of treatment. “In a world where CPAP is over prescribed and patient outcomes are less than ideal, this meeting of ASBA elites and political powerhouses will change the landscape of dental sleep medicine”, says David Gergen, Executive Director of the American Sleep and Breathing Academy.

The ASBA is the only Academy that is fighting for dentists in the space that we call sleep. There is strength in numbers and the ASBA currently has 770 members. It is the fastest growing academy in the World. Now is your opportunity to be a part of an organization that is paving the road for oral appliance therapy to be the benchmark in OSA treatment. Visit americansleepandbreathingacademy.com to join the movement.

Alan Hickey

Alan Hickey

Publisher of Sleep Diagnosis and Therapy Journal the Official publication of the American Sleep and Breathing Academy, the Journal is a clinical and technical publication for dental and medical professionals.

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Future Reimbursement In Dental Sleep Medicine To Be Based On Diplomacy And Patient Outcomes

 

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The American Sleep and Breathing Academy (ASBA) is an organization dedicated to enriching our members’ knowledge and skill in the treatment of sleep disordered breathing. Our goal is to provide current evidence based information to our members and enable them to provide optimal treatment for their patients. The ASBA offers Certification to its members as a confirmation of their knowledge, skill and experience. While there are multiple levels of Certification within our organization, the primary goal is to show the industry that our diplomates are able to achieve better patient outcomes and a more successful business overall.

It is very important that a dentist needs certification from an accredited academy because dental sleep medicine must be consistent based on outcomes and the literature. If we look into the future of healthcare in the not so distant future, reimbursement will be factored on credentialing and patient outcomes. The ASBA is a unique organization that emphasizes research and outcome monitoring in combination will contribute to the success of our diplomate members.

The ASBA diplomate will show the medical world that they are a master of dental sleep medicine. Insurance carriers require quantifiable information to show patients and referring physicians that their doctors have higher treatment outcomes; in addition if you are already a diplomate in another academy and become a diplomate of the ASBA you are more likely to receive referrals from local physicians as a double diplomate. This includes but is not limited to compliance monitoring and objective outcomes monitoring which will confirm that an ASBA diplomate provides a certified higher standard of care.

As an ASBA member, you have an opportunity to attend the ASBA review course for diplomacy September 23rd and sit for the exam September 24th in Phoenix, AZ. Register here or call 602-478-9713 for more information.

Certification guidelines include:

  • 40 hours of continuing education in Dental Sleep Medicine, in the last 2 years. This year’s Board Review and Annual Meeting can count towards the 40 hours. Proof must be emailed to psv101@icloud.com before sitting for the certification exam.
  • Submit 10 cases that you personally treated successfully with Oral Appliance Therapy.
  • (Each case submission must be submitted and numbered as cases 1-10, with no names. Names must be whited out!)
  • Three must be severe, that were reduced by at least 50%. Three must be moderate that were reduced by at least 50% and have a treated AHI of less than 10. Four can be mild to moderate with a treated AHI of less than 5.
  • The diagnostic and follow up studies must be administered by a 3rd party diagnostic facility using either HST or PSG., and must be emailed to psv101@icloud.com, by January 15, 2017.
  • Pass the 100 question, certification exam, given on September 24, 2016. Categories for the exam:
  • Basic Sleep Medicine, Oral Appliance Therapy, Polysomnography, Portable Monitors, Surgery, Pediatrics, Complications, CPAP, Imaging
Alan Hickey

Alan Hickey

Publisher of Sleep Diagnosis and Therapy Journal the Official publication of the American Sleep and Breathing Academy, the Journal is a clinical and technical publication for dental and medical professionals.

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Final Public Listening Session Today! Let Our Voices Be Heard!

truckaccident-300x240                                                                                                                                                    Today at 1:30PM- 3:30PM PST the third and final public listening session will be held at the Westin Bonaventure Hotel and Suites, 404 S. Figueroa St. in Los Angeles. On March 10, 2016 The Federal Motor Carrier Safety Administration and Federal Railroad Administration announced a notice of proposed rule making to receive feedback about any potential sleep apnea regulations. Information on the prevalence of moderate-to-severe obstructive sleep apnea (OSA) among individuals occupying safety sensitive positions in highway and rail transportation, and of its potential consequences for the safety of rail and highway transportation can be solicited at this hearing as well as be submitted online in the form of comments. The 90-day comment period will be ending June 8, 2016.

Through the listening session, interested parties will have one last opportunity to share their views and any data or analysis regarding sleep apnea with representatives of the FMCSA and FRA. As a contributor, you are asked to identify whether you are in the transportation industry or medical profession, but you can choose to remain anonymous. The Agencies will transcribe all comments and place the transcripts in the dockets FMCSA-2015-0419 and FRA-2015-0111.

Previous listening sessions took place May 12 in Washington, D.C., and May 17 in Chicago. Highly prioritized concerns during the sessions have included the cost of sleep studies for drivers and locomotive engineers, the failure of most safety-sensitive transportation employees with apnea to use their CPAP machines and ensuring that any apnea mandates consider safety benefits over costs and driver health.

As ASBA members, we need to provide input on how it is important to driver and public safety to be treated for OSA. For those who are unable to attend in person, the entire proceedings of today’s listening session will be available on the through a live webcast, which can be found here.

Alan Hickey

Alan Hickey

Publisher of Sleep Diagnosis and Therapy Journal the Official publication of the American Sleep and Breathing Academy, the Journal is a clinical and technical publication for dental and medical professionals.

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ASBA Is The Only Academy Fighting For Dental Rights In The Sleep Apnea Arena-ASBA Receives Support From Congresswoman Anna G. Eshoo Written By David Gergen

Congresswoman Anna G. Eshoo and Dr. Alpher
Congresswoman Anna G. Eshoo and Dr. Alpher

The Georgia’s new legislation now says, “Depending on the diagnosis of the type and severity, one possible treatment option for obstructive apnea is the use of oral appliances.  The design, fitting, and use of oral appliances and the maintenance of oral health related to the appliances falls within the scope of the practice of dentistry.  The continuing evaluation of a person’s sleep apnea, the effect of the oral appliance on the apnea , and the need for, and type of, alternative treatment do not fall within the scope of dentistry.  Therefore, the prescribing of sleep apnea appliances does not fall within the scope of the practice of dentistry.  It is the position of the Board that a dentist may not order a sleep study. Home sleep studies should only be ordered and interpreted by a licensed physician.  Therefore, only under the orders of a physician should a dentist fabricate a sleep apnea appliance for the designated patient and conduct only those tasks permitted under OCGA title 43, chapter 11. (Adopted 4/1/2016)”

This is very disappointing for dentists in Georgia. Let’s look at the interpretation of this new law. Does it mean a dentist will no longer be able to titrate their appliance by using a home sleep test? It surely means a dentist cannot refer out to a sleep testing company such as Complete Sleep, Snap or Easy Sleep or hand out an HST to one of their patients and have a Board Certified physician do the read and diagnosis. To the ASBA this is horrible news and we will be fighting it with all of our resources. You will be pleased to know that just yesterday, ASBA Board Member and Diplomate Dr. Elliott Alpher was in Washington D.C. alongside Congresswoman Anna G. Eshoo discussing this very topic and transportation.

David Gergen, Dr. Alpher, Marty Russo, Roy Green, Lieutenant Holmes, Mark Walczak, asba
David Gergen, Dr. Alpher, Marty Russo, Roy Green, Lieutenant Holmes, Mark Walczak

Dr. Elliott J. Alpher, Diplomate to and representing the American Sleep and Breathing Academy and Congresswoman Anna G. Eshoo (DCalif.), Ranking Member of the Energy and Commerce Committee’s Subcommittee on Communications and Technology for the 114th Congress met today to ask her support on proposed rulemaking for screening, diagnosing, treating and tracking compliance of Obstructive Sleep Apnea (OSA) in individuals occupying sensitive positions in highway and rail transportation.

The Federal Motor Carrier Safety Administration (FMCSA) and Federal Railroad Administration (FRA) have requested data and information concerning the prevalence of moderate-to-severe obstructive sleep apnea (OSA) among individuals occupying safety sensitive positions in highway and rail transportation, and on its potential consequences for the safety of rail and highway transportation.

Many mental functions are reduced when an individual experiences fatigue and sleepiness. It is estimated that 20% of accidents are caused by drivers’ inattention and sleepiness, and the occurrence of drowsiness when driving is a major risk factor for dangerous accidents. Chronic excessive sleepiness and sleep-disordered breathing are common in commercial vehicles drivers.

Dr. Alpher Washington D.C.
Dr. Alpher Washington D.C.

“OSA is a prevalent disorder among workers, which increases the risk of occupational accidents and has a significant impact on public safety. Fortunately, many of these accidents could be prevented by screening and treating sleep-disordered breathing with the resources and technology available…we are grateful to have Congresswoman Eshoo’s support on this matter,” says Dr. Alpher.

Dr. Alpher, one of the District’s most experienced specialists for sleep and jaw disorders, on staff at George Washington University Hospital and Georgetown University Hospital, has been known as a leader in the treatment of sleep disorders and jaw pain for 25 years. Dr. Alpher has pioneered a conservative, non-invasive approach utilizing computerized and verifiable diagnostic methods to treat TMD, snoring and sleep apnea. This method of treatment has proven to be greatly successful and is highly regarded as the first method of choice by physicians and patients.

Dr. Alpher was also responsible for heading a delegation to the Medical Advisory Board (MAB) to introduce the new technology of compliance chips in oral appliances to treat and monitor sleep apnea and snoring of truckers and other transportation personnel. In addition, he earned the status of Diplomate of the American Board of Craniofacial Pain & Dental Sleep Medicine in October 2013 and serves as a board member. Dr. Alpher is a Diplomate of the American Academy of Pain Management, Life Member of both the American Dental Association and the District of Columbia Dental Society. Dr. Elliott Alpher says, “The ASBA is the only academy fighting for the dentists’ rights in the sleep apnea arena and the efforts will become stronger as the American Sleep and Breathing Academy grows. The more members we have the more firepower we’ll have. I am so pleased that I have joined this academy because this is the only academy making a huge difference in my humble opinion. We are so blessed to have former Congressman Marty Russo as our ally.” Dr. Elliott Alpher was elected to the ASBA Hall of Fame for his lifetime achievements in the field of dental sleep medicine. If you are a concerned dentist about your rights, join the American Sleep and Breathing Academy at americansleepandbreathingacademy.com.

Alan Hickey

Alan Hickey

Publisher of Sleep Diagnosis and Therapy Journal the Official publication of the American Sleep and Breathing Academy, the Journal is a clinical and technical publication for dental and medical professionals.

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Medicare and Private Insurers Raise Rates for Sleep Apnea Dentistry

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Sleep therapy continues to receive scrutiny by regulators and payors. Centers for Medicare and Medicaid have been monitoring patient outcomes and clinical yield for patients. There has been no formal announcement as to their findings however CPAP reimbursement continues to be cut while Oral Appliance Therapy reimbursement has officially been increased by Medicare. Revenue from code E0486 has doubled in recent months according to reports by ASBA members, Industry leaders predict that private insurance will follow Medicare reimbursement guidelines.
 Supporting this trend is the recent announcement by Cigna the first private insurer to develop a national policy for Oral Appliance Therapy, settling on $2500 as a bundled fee. In other regions fees have increased by 25 to 100%. Jurisdiction “D” reimbursement rates has remained unchanged.
 Insurers are expected to work with industry to monitor outcomes data to balance revenue and patient care expectations. It is also very significant and important to note that evidence of post graduate training and Diplomacy has become a method that some insurers use to deny insurance claims (this is new and bears watching).
 The American Sleep And Breathing Academy continues to monitor insurance reimbursement, and policies through its relationships with Washington DC insiders like Congressman Marty Russo and others.
 “In June of 2015 the ASBA was the first organization to warn Dentists of the risk to using the “S” code for billing TMJ Splints. Advance notice of this change saved ASBA members thousands of dollars in hard costs associated with billing errors and uncollected revenue.” – David Gergen CDT
 The latest opportunity identified by the American Sleep And Breathing Academy team of lobbyists is a new government protocol for chronic care management. CCM has the potential to contribute a strong revenue stream for sleep apnea dentists in 2016. The physician who developed the Chronic Care Program spoke at the Sleep and Wellness conference in Scottsdale AZ April 15 and 16. 
 
CMS Bets on Oral Appliance Therapy a blog post Gergensortho.com
A running discussion for the last 6 years here at Gergens Orthodontic Lab has been the CPAP as Gold standard of sleep therapy vs Oral Appliance therapy debate. These discussions usually go for hours and have gone on for years. The strongest debate has been between David Gergen President of Gergens Orthodontic Lab and Executive Director of American Sleep and Breathing Academy (ASBA) and Randy Clare who supports CPAP. Gergen knows CPAP has its place and time in the sleep world, but strongly feels that the oral appliance will surpass CPAP as the go-to treatment within 10 years. Clare would debate if that’s the case, respiratory techs will be managing the oral appliance patients not the dentists. Back and forth compliance vs treatment efficacy. David Gergen has been back and forth to Washington working with congressman Marty Russo trying to get some traction within the federal government on this issue.
The key point of distinction of course is what drives medical care in the United States is reimbursement. The story for CPAP in the reimbursment arena since competitive bidding became an issue has slowly restricted access to care and fed a consolidation of providers. Fewer providers to provide care and the care they can afford to provide is less personal which results in lower compliance rates which results in lower reimbursement. January 1 2016 CMS cut CPAP reimbursement by 25%. Will this affect a diagnosed OSA patients ability to get great care of course it will.
On the other side of the ledger Oral Appliance therapy has not been a focus for CMS. The OAT program has been way underfunded. This has made access to oral devices for sleep apnea difficult for medicare patients. Dentists were not finding it easy to provide care for these patients because reimbursement was so low. January 1 2016 CMS raised reimbursement for OAT to $3700 in jurisdiction B (see attached EOB) If you don’t know your jurisdiction for medicare I have also added a map for your use.
I expect that this will increase access to care significantly. I feel it indicates a trend and perhaps insurers are ready to consider higher compliance rates and better return on sleep therapy dollars. After all the dental team sees the patient at minimum every six months which is a much better way to manage a lifelong condition with severe health implications.
Alan Hickey

Alan Hickey

Publisher of Sleep Diagnosis and Therapy Journal the Official publication of the American Sleep and Breathing Academy, the Journal is a clinical and technical publication for dental and medical professionals.

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Arizona Cardinals Join ASBA, Phoenix Police, and Pro Player Health Alliance For The Worlds Largest Sleep Apnea Awareness Event

20160126_chadiwck_19.33.50                                                                                                                                                                                                                                                                                                                    Pro Player Health Alliance is an organization dedicated to helping treat former NFL players who suffer from obstructive sleep apnea (OSA). As a result these superstar athletes then become more than just patients, but every day people who publicly support and spread the awareness of OSA at events across the nation. With a combined effort of former NFL greats, local establishments and public figures, the community as a whole can unite to direct potential patients toward dental/medical professionals who can help.

 

The next Pro Player Health Alliance event, aimed at improving awareness and undersDavid Gergen Larry Fitzgerald Roy Green Alan Hickey Randy Claretanding of sleep related disorders in the general public, is also a fundraiser to benefit the Phoenix Police Foundation. In addition, it will be the first official celebration to kick off the new season for the Arizona Cardinals. Shining a light on life threatening health complications that can be caused by allowing OSA to go untreated has become a primary objective for the Arizona Cardinals since partnering with Pro Player Health Alliance. Location and time of the public awareness event and fundraiser will be Tuesday September 6, 2016 at 6:30 p.m. to close at Padre Murphy’s 4338 West Bell Road, Phoenix AZ 85308. It is expected that this event will draw over 5,000 thousand attendees.

Roy Green, NFL legend and former Cardinals WR/DB has said, “If I had met David Gergen years ago, I may not have had to experience having a heart attack, let alone three heart attacks and two strokes. I am extremely grateful for what he’s done for me and my former teammates and I’m glad to be a part of spreading awareness on sleep apnea so others don’t have to go through what I did.”

Pro Player Health Alliance President David Gergen, owner of Gergen’s Sleep Appliance Lab and Executive Director of the American Sleep and Breathing Academy is an icon throughout the dental sleep community and will be the MC for the event. David will be on hand to help the public meet their favorite player and to share his extensive knowledge of sleep disorders including the dental treatment of sleep apnea.

David Gergen on stage

 

 

 

 

 

 

 

“Over the years more and more retired NFL greats have contacted me regarding their sleep apnea. I am happy to refer them to a dentist or medical doctor who can help them. It became very obvious that the general population was having the same issue. Roy Green and I decided to help the retired players and improve awareness of sleep disorders by promoting large public events.” – David Gergen

Sleep Apnea Therapy: Its all about the TEAM!

Sleep Disorders have dominated the health and wellness blogs and news sites for the last several years. It is time for patients and caregivers to wake up to the issues that come from sleep apnea.

More than 40% of adults in the U.S. have a disorder such as snoring, insomnia, restless leg syndrome or sleep apnea, according to recent studies. Dr. Patricio Reyes head of Neurology Veteran’s affairs hospital Phoenix AZ says in his recent experience it’s now clear that a lack of sleep “not only increases the risk of errors and accidents, it also has adverse effects on the body and brain,”. Neurological impact of sleep according to shows a clear implication in Dementia, Parkinson’s disease and Alzheimer’s disease. Yet most sleep disorders go untreated.

Derek Kennard often relates the story that until he began treatment with a sleep Herbst oral appliance he had not slept for more than 2 hours at a stretch

 Derek Kennard a former NFL center and Dallas Cowboys Super Bowl champion who was tough enough to play a championship game Derek Kennardagainst the Pittsburgh Steelers with a separated shoulder was almost brought down by sleep apnea. He just didn’t sleep well at night. Only grabbing sleep in 2 hour increments.  Kennard says his wife reported his breathing would stop, she would need to nudge him to get him breathing again. His passion for publicizing sleep diagnostics and therapy comes not only from his obvious success but from the fact that his brother a diagnosed sleep apnea patient passed away in his sleep from a heart attack. Heart problems are a recognized complication of sleep apnea. Reggie White also passed in his sleep of a heart attack.

Kennard is very aware of the large segment of the population that have sleep apnea. In his role as a school councilor, he has seen the signs and symptoms of obstructive sleep apnea in his coworkers. So this condition is not only a condition related to the bigger guys on the team.

Sleep Apnea is often associated with obesity which can create a false impression of a patient’s potential risk. Kennard’s brother was 6’4” and skinny as a rail.

Derek Kennard as Darth Vader
Derek Kennard as Darth Vader

Once his condition was identified Kennard went to a sleep Dr for a few tests. The most important test was an overnight sleep study. As part of the study he was put on CPAP. CPAP is a device that blows air up your nose and holds your airway open. This device is considered the gold standard or best in class therapy for obstructive sleep apnea. Kennard found that this was not a treatment he could tolerate.

The greatest impact Kennard’s condition had on his life was the sleepiness that came from waking every 2 hours. This sleepiness caused mood swings, concentration issues and of course drowsy driving. He reported falling asleep while driving often stopping on the way home from work for a short nap to improve his concentration.

Many Studies have been done in the sleep lab at Arrowhead Hospital “A patient who is young who is young, healthy and fit can be put them in a pre-diabetic state just by putting them on an irregular sleep schedule,” Reyes, says.

It is also shown in recent research that there is also a strong connection between sleep and the immune system, Reyes says. “People who do not sleep well have a 200 to 300 percent increased risk of actually catching a cold,”.

Dr. Rudi Ferrate a sleep Dr. from Arrowhead Hospital says i“My whole clinic is full of patients who are brought in by their spouses,”  When a patient is being initially diagnosed assessed Dr. Ferrate uses a simple questionnaire call the Epworth sleepiness scale. This is a list of 8 simple questions which have been validated to give a very accurate prediction of sleepiness.

Dr. Ferrate is a board certified sleep physician who is focused on all of the more than 94 sleep disorders from bed wetting and nightmares to sleep apnea. Sleep Apnea affects 1 in 3 adult males in the United States. Dr. Ferrate requires an objective measure of sleep quality using an at home or in hospital sleep study in order to form a diagnosis of sleep apnea.

Sleep Apnea is a term that refers to the absence of airflow either due to airway obstruction or due to neurological component in which the brain does not ask for a breath. The treatment for Sleep Apnea is continuous positive airway pressure (CPAP) device or, more recently an oral appliance like a sleep Herbst.

Derek Kennard’s wife couldn’t stand his snoring, but she didn’t love listening to his CPAP machine either. Kennard was concerned that “Darth Vader machine took the sexy out of the bedroom. Kennard said to me I can’t wear thing that thing, I feel like I am drowning.

Herbst
Sleep Herbst By Gergen’s Orthodontic Lab

“Some players have such severe sleep apnea that they must use both a CPAP machine and a Herbst device to get restful sleep, but Kennard is glad that the device is adequate for his treatment.

Sleep diagnosis at home or in the sleep lab is a very important part of getting treated. This will provide an objective diagnosis for the sleep physician to evaluate your condition and suggest a treatment. There are a wide range of options for treatment. CPAP for severe cases mild to moderate cases with the sleep Herbst and in some cases positional therapies with a slumberbump body position device.

David Gergen CDT

David Gergen CDT

David Gergen, CDT and President of Pro Player Health Alliance, has been a nationally respected dental lab technician for over 25 years. He received the award for “The Finest Orthodontic Technician in the Country” given by Columbus Dental in 1986. He also has been appointed Executive Director of the American Sleep and Breathing Academy Dental Division, a national interdisciplinary academy dedicated to sleep training and education with over 60,000 members. David rolled out of bed on December 4, 1982 and had his career “ah ha” moment. He knew he was going to be an orthodontic technician and he knew he was going to help people all over the country to help treat their sleep disorders in partnership with their dentists. He has worked for some of the pioneers in the orthodontic and sleep dentistry fields. He was the personal technician for the likes of Dr. Robert Ricketts, Dr. Ronald Roth, Dr. A. Paul Serrano, Dr. Clark Jones, Dr. Harold Gelb, Dr. Joseph R. Cohen, Dr. Rodney Willey, Dr. Allan Bernstein, and Dr. Thien Pham. One of his proudest achievements is receiving The National Leadership award for Arizona Small Businessman of the Year in 2004.

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AAA Drowsy Driving Numbers Signal Large Problem

 

The AAA Foundation for Public Safety’s long-awaited report on the effects of drowsy driving concluded that as much as 21% of crashes (from 2009-2013) in which a person was killed, likely involved a drowsy driver.

 

“If these proportions are applied to all reported crashes nationwide, results suggest that an average of 328,000 crashes annually, including 109,000 crashes that result in injuries and 6,400 fatal crashes, involve a drowsy driver,” wrote AAA analysts in a report released this week.

 

According to the National Highway Traffic Safety Administration (NHTSA), approximately 1.4% of all motor vehicle crashes in the United States, 2.2% of those that resulted in injuries, and 2.5% of all fatal crashes in years 2005-2009, involved a drowsy driver, and those crashes resulted in a total of 5,021 deaths over those years.

 

“However, the official government statistics are widely regarded as a substantial underestimates of the true magnitude of the problem,” writes AAA. “This study estimates that as many as 6% of all crashes in which a passenger vehicle is towed from the scene, 7% of crashes that result in any injuries, 13% of crashes that result in sever injuries requiring hospitalization, and 21% of fatal crashes involve a drowsy driver.”

 

Full report:

https://www.aaafoundation.org/sites/default/files/AAAFoundation-DrowsyDriving-Nov2014.pdf

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Wikipedia is No Substitute for Doctors

 

The “Mail online” recently trumpeted what physicians have been lamenting since the beginning of the Internet age: the web is not necessarily reliable for medical information. Call it a validation of sorts, courtesy of Dr. Robert Hasty of Campbell University in North Carolina colleagues.

 

The team concluded that many entries in Wikipedia, especially medical entries, contain false information. The message? Don’t use Wikipedia in place of your doctor.

 

The team published its study titled “Wikipedia vs Peer-Reviewed Medical Literature for Information About the 10 Most Costly Medical Conditions” in the Journal of the American Osteopathic Association, calling the information published in 20,000-plus medical related Wikipedia entries into question.

Click Here to read study

According to the report, researchers identified the “10 costliest conditions in terms of public and private expenditure”—which included diabetes, back pain, lung cancer and major depressive disorder—and compared the content of Wikipedia articles about those conditions to peer-reviewed medical literature. Two randomly assigned investigators found that 90% of the articles contained false information, which could affect the diagnosis and treatment of diseases.

 

Also from the Post, “Pew research suggests that 72 percent of Internet users have looked up health information online in the last year. False information on Wikipedia accounts — like a edited information about the side effects of a medication or false information about the benefits of one course of treatment over another — could encourage some patients to push their doctors toward prescribing a certain drug or treatment.”

 

Source: Mail Online

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