Snoring Isn't Sexy

Awake In America Replaces Equipment To Treat Sleep Apnea Lost In Hurricane Ike

2008-09-15T11:09:00.002-04:00

There is an urgent need to help victims of Hurricane Ike replace lost and damaged CPAP units as a result of Hurricane Ike. The entire story can be found at Medical News Today. Please consider a donation.

Dr. Barsh
Snoring Isn't Sexy

Snoring Separately and ED

2008-09-13T08:41:00.004-04:00

According to CNN - 23% of married couple sleep apart and requests for two master bedrooms in new homes are growing. Snoring, in addition to being causally related to stroke, destroys relationships. Many psychologists warn that sleeping apart can spell trouble in a relationship.

Snoring also can be a sign of sleep apnea. With many sleep apnea sufferers, erectile dysfunction (ED) can be a problem. Recent research indicates that ED can result from periods of oxygen deprivation associated with sleep apnea. Although the research was conducted on animals, there is a strong possibility that this relationship exists in humans as well.

It is, therefore, quite possible that ED is a sign of sleep apnea which has been linked to high blood pressure, cardiac problems, stroke, diabetes and depression. If you snore heavily, have been observed to stop breathing during sleep, have high blood pressure and feel sleepy during the day even after a night's rest, before you pop the little blue pill think about having a sleep study.

You could not only be saving your marriage but also saving your life.

Dr. Barsh
SnoringIsntSexy.com

Snoring, Diabetes and Physicians

2008-09-05T13:05:00.002-04:00

DiabetesHealth.com released a statement today that said

Despite the fact that 94 percent of doctors are aware of the association between sleep apnea and diabetes, only 47 percent of them screen for the condition in their patients with diabetes. As a result, about 85 percent of sleep apnea cases among diabetics go undiagnosed.

Dentists are probably worse than physicians in this regard. If you are a patient with diabetes, ask your dentist why such an important relationship of diseases goes unnoticed in his/her office. For the most part, dentists see their patients more frequently than physicians see theirs and it would be a simple matter for a dentist to ask a few simple questions about sleep-breathing problems especially where dentistry can play such an active role in the management of these problems. Again from DiabetesHealth.com:

Dental Device (a.k.a. oral appliance, intraoral device, or mouthpiece):
Breathe through your nose. Now move your lower jaw forward. Does the back of your throat feel a bit more open, making it a little easier to breathe? A dentist or orthodontist can custom make a device for you to wear at night that will keep your lower jaw and/or tongue forward.

Help us get the word out about the relationship of sleep apnea and diabetes, ask about screening at your dentist's office.

Dr. Barsh

Snoring Isn't Sexy

Still think snoring is a joke?

2008-09-01T19:04:00.004-04:00

Snoring has always been considered a joke. "Two snorers walk into a bar...." You can finish the rest of the story, I'm sure.

Television advertising promotes the ability to stop snoring by sticking things on the outside of your nose, sticking things in the inside of your nose, spraying stuff in your throat, and by taking a boil and bite mouth device to pull your jaw forward (by the way, it's illegal in the United States to sell these over the counter). And, in fact, most of these WILL stop the snoring but do you really want to?

Huh? you say - of course I want to stop the snoring, why shouldn't I? As it turns out there is a good reason not to do it yourself. A scientific article released in the Sept. 1 issue of the prestigious journal Sleep shows that snoring is indeed an independent risk factor for the development of hardening of the arteries in neck - known as carotid atherosclerosis - that can progress to a point where it is associated with a stroke.

We know that snoring can also be a warning sign of sleep apnea as well especially if one's bed partner notices cessation of breathing at intervals during sleep. Stopping the snoring eliminates the warning sign and creates what is know as a silent apneic. Sleep apnea is associated with heart disease, stroke, diabetes, high blood pressure, depression, excessive daytime sleepiness, erectile dysfunction and even death during sleep from factors related to apnea.

So for a couple of reasons, stopping the snoring without medical or dental intervention can be a bad idea. It's your decision of course but before you decide, stop and take a few moments to think of the possible consequences - the point is not to just stop the sound of snoring, the point is to eliminate the obstruction that causes the snoring and to increase oxygen flow through the partially obstructed airway.

Dr. Barsh
Snoring Isn't Sexy

Driving on Labor Day Weekend

2008-08-23T08:14:00.002-04:00

It's hard to believe but Labor Day is only one week away. Despite high gas prices, it's estimated that more than 30 million Americans will be driving this Labor Day weekend.

Most people are aware of the dangers of drinking and driving, but few are aware of the dangers of sleepiness and driving. The 2008 Sleep in America Poll found that

64 percent of drivers who work at least 30 hours per week report they have driven a
vehicle while feeling drowsy in the past year, and more than one-third, 36
percent, have actually fallen asleep at the wheel. Sleep-related crashes
are most common in young people, especially men, shift workers, commercial
drivers, and people with untreated sleep disorders. NHTSA conservatively
estimates that 100,000 police-reported crashes are the direct result of
driver fatigue each year. This results in an estimated 1,550 deaths, 71,000
injuries, and $12.5 billion in monetary losses each year.

Be sure to get adequate sleep before any road trip this coming weekend and if you have been told that you snore, have had your bed partnhttp://www.blogger.com/img/gl.link.gifer tell you that you stop breathing during sleep, know that you have high blood pressure and that you are tired despite sleeping 7 - 8 hours at night - get yourself checked out for sleep apnea. For more information, visit snoringisntsexy.com

Have a great weekend and drive safely.

Dr. Barsh

Want to Look Better and Live Longer? First, Stop Smoking

2008-08-16T08:49:00.003-04:00

In the August 14 issue of the New York Times in the style section (where we all get our medical news apparently), there was an article that plastic surgeons are refusing to do face lifts for men and women who smoke. Hmmm... approaching a life endangering habit from a cosmetic point of view. Very much the same way we at Snoring Isn't Sexy.com approach snoring and sleep apnea.

While we are on the subject of smoking, two recent scientific articles point to the dangers of smoking and sleep apnea.

In February, 2008 an article was published in the Proceedings of the American Thoracic Society:

...obstructive sleep apnea is also being recognized as an independent risk factor for several clinical consequences, including systemic hypertension, cardiovascular disease, stroke, and abnormal glucose metabolism.
Factors that increase vulnerability for the disorder include age,male sex, obesity, family history, menopause, craniofacial abnormalities, and certain health behaviors such as cigarette smoking and alcohol use.

And in March in Sleep Medicine, Dr. Peretz Lavie published an article that stated that smoking interacts with sleep apnea to increase risk of heart disese:

There is a synergistic effect between cigarette smoking and sleep apnea on some of the biochemical cardiovascular risk markers. Patients with severe sleep apnea who smoke are at a greater cardiovascular risk than smokers with mild-moderate sleep apnea and patients who do not smoke.

We recommend quitting smoking at any age for any reason but if you smoke and have sleep apnea, you are at risk.

Quiet Now!

Dr. Barsh

New Website You might be Interested In

2008-08-08T07:15:00.002-04:00

There's a new web site that features a video diary Dr. Jonathan Lown's experience of living with CPAP that may develop into a resource that you want to keep your eye on over the next few months. The site features the ability to use what they call a "Still Sleepy Tracker" that apparently you can download and develop your own diary of sleepiness. The site is at StillSleepy.com.

While the video diary is interesting, there are a couple of problems that I find with the site.

First, there is no way to contact the developer of the site. When you visit any medical site, it is imperative that you be able to contact the web developer. As I mentioned in an earlier blog, many sites that offer medical information where, in fact, developed with the sole purpose of attracting search engines and cashing in on the advertising in the side bar.

Second, the site is actually a commercial for a pharmaceutical called Provigel. While there is a cost associated with development and maintenance of a web site, there is a serious conflict of interest at the site.

Third, the "Still Sleepy Tracker" is nothing more than the Epworth Sleepiness scale without attribution. While being able to measure daytime sleepiness it is not diagnostic for sleep apnea. It measures only one factor - daytime sleepiness - which could be due to a variety of reasons.

Finally, the video diary contains a video of a Dr. Jonathan Lown but fails to provide any background information as to whether Dr. Lown is a physician or a PhD. When you visit a medical information site, you should always be able to be able to access information about the medical authority featured on the site.

Dr. Barsh
Snoring Isn't Sexy

Sleep Apnea and increased risk of death (continued)

2008-08-04T07:05:00.003-04:00

Several other points need to be made in relation to this study:

The increased risk of death that was associated with severe sleep apnea was reduced when patients were treated with CPAP
Milder forms of sleep apnea did not seem to increase the risk of death
CPAP improved the symptoms of sleep apnea and may reduce the risk in severe case

Dr. Terry Young talks about the study:

Two points become very clear as a result of this study:

First - if you snore heavily and have stopped breathing during sleep, get evaluated for sleep apnea. I know I've said this before but it's worth repeating!

Second, if you are a dentist, whether you choose to work with colleagues to manage patients with sleep apnea or not, it is your obligation to screen all patients that you treat for sleep apnea. You screen now, or if not should screen, for oral cancer and high blood pressure and you encourage smoking cessation - add one minute to your examination and ask 4 short questions:

Do you snore loudly?
Do you often feel tired, fatigued or sleepy during the daytime?
Has anyone observed you stop breathing during sleep?
Do you have or are you being treated for high blood pressure?

(The STOP Questionnaire, Frances Chung)

Dr. Barsh

People with Sleep Apnea have a high risk of death

2008-08-01T08:05:00.002-04:00

A study was released in the Journal Sleep that showed that people with severe sleep apnea have a much higher mortality risk than people without sleep apnea.

From eScience News:

A study in the August 1 issue of the journal Sleep shows that people with severe sleep apnea have a much higher mortality risk than people without sleep apnea, and this risk increases when sleep apnea is untreated. Results show that people who have severe sleep apnea, which involves frequent breathing pauses during sleep, have three times the risk of dying due to any cause compared with people who do not have sleep apnea. This risk is represented by an adjusted hazard ratio of 3.2 after controlling for age, sex and body mass index. When 126 participants who reported regular use of continuous positive airway pressure (CPAP) therapy were removed from the statistical analysis, the hazard ratio for all-cause mortality related to severe sleep apnea rose to 4.3.

"We found that both men and women with sleep apnea in the general population - not patients - mostly undiagnosed and untreated, had poorer survival compared with persons without sleep apnea, given equal BMI, age and sex," said principal investigator and lead author Terry Young, PhD, professor of epidemiology at the University of Wisconsin-Madison.

According to Young, most previous studies of sleep apnea and mortality have involved patients referred for a clinical sleep diagnostic evaluation; the mortality risk for sleep apnea in the general population has not been previously reported.

This is serious business folks.

If you snore, have been observed to stop breathing and then gasp and choke while asleep, have high blood pressure and feel tired during the day SEE YOUR PHYSICIAN OR SLEEP MEDICINE DENTIST for an evaluation.

No joke - let's go a little further with a recommendation, if you snore loudly and regularly see a sleep medicine dentist or a physician - it's your life.

Dr. Barsh

Sleep Apnea and Your Bottom Line

2008-07-28T06:36:00.004-04:00

Obstructive sleep apnea affects over 18 million people in the United States alone. These people can suffer from heart disease, high blood pressure, diabetes, stroke and depression. Additionally, when untreated, sleep apnea causes excessive daytime sleepiness leading to accidental injury and lost productivity.

It has been estimated that employees wth untreated sleep apnea can increase employer's healthcare costs by $2000 to $5000 annually in physician visits, medication costs and increased hospitalizations. Employees with sleep apnea are more likely to have an accident at work, perform less well than their non-drowsy counterparts and are absent more frequently than other employees.

Sleepiness has been implicated in such major disasters as Chernobyl, Exxon Valdez and Bhopal.

If your business employs drivers it has been calculated that drivers with sleep apnea have an up to 15 fold increase of motor vehicle accidents which can be reduced or eliminated with proper treatment.

What can you do? First, the dentists associated with Snoring Isn't Sexy(tm) are well versed in screening, and if appropriate as decided in joint consultation with the patient's physician, treating the problem with an oral appliance.

Second, many dentists associated with Snoring Isn't Sexy(tm) will be adding sleep apnea screeners to their new web sites in the fall of 2008. Although these screeners are not at the dentists' web sites as yet, you can have your employees screened free of charge at our sister site's screener at Quietsleep.com.

Finally, if there are no dentists in your area that provide screening and treatment of snoring and sleep apnea, please let us know and we will do everything we can to point them to the proper continuing education.

It's your employees' health and your bottom line. Please help us, help you!

Dr. Barsh

Sleep Apnea and Heart Attack Risk

2008-07-23T07:29:00.005-04:00

A new study from the Mayo Clinic and reported in the Journal of the American College of Cardiology suggests that heart attacks that occur between midnight and 6AM are associated with sleep apnea.

"If a patient has a heart attack that wakes him or her from sleep, then it may be important to look for sleep apnea in them," said Dr. Virend Somers, one of the investigators.

More information on this study can be found at medpage today.

If you have sleep apnea or have had a heart attack that has awakened you from sleep, it's critical that you review this information.

Dr. Barsh

Validity of Medical Content - Your Responsibility!

2008-07-20T07:21:00.007-04:00

Lately there are a plethora of blogs purporting to be information about snoring and sleep apnea but which are, in reality, articles from content farms or sales pitches for products couched in the form of what may or may not be valid content. The key is usually in the last paragraph "About the Author."

For example, a site called Find Diseases Directory has an article by Suzy Hughes with "Information on Central Sleep Apnea". In it Ms. Hughes recommends use of Ambien to treat central sleep apnea.

Another site, has an identical article by Suzy Hughes on Central Sleep Apnea. As does artipot.com.

The fact that the drug "Ambien" is misspelled in each of these articles as "Ambient" should lead readers to suspect that the content is not exactly valid.

The problem is not the content but rather exactly who "Suzy Hughes" is. When you search Google for Suzy Hughes and "unique content" you are taken to a site named Uber Articles. It turns out that Uber Articles is a site that provides content for blogs and web sites designed not to produce valid content but rather to produce content designed to attract search engines and with that search engine optimization the dollars from Google Advertising.

"Who else wants Totally Unique Content for their websites and newsletters - Absolutely FREE?"

The search engines are bored with seeing the same old articles again, and again, and again - So why not give them something unique?

They will love you for it - and as a result your search engine rankings - and your visitors - will soar. In fact, this is the single most effective way to get the top spots in the search engines. It costs nothing, so why not get started right now?

Using our powerful, secret, Unique Article Wizard™, we are able to deliver literally thousands of unique versions of selected articles - all you need do is cut and paste the article into your web page or ezine, knowing that, at most, there will be only one or maybe two identical versions anywhere on the internet. You are even free to use these articles offline (naturally all on- or off-line use is subject to our terms and conditions).

If you prefer, you can even sign up to receive unique articles direct to your inbox - formatted, for your convenience, in both fixed length (60 characters), and free-flow text. Again, no one else will receive an article identical to the one you receive.

The site is not interested in validating content but rather producing content on a grand scale in areas from dating to World of Warcraft.

My recommendation is that if you ever come across a blog or web site that has a link back to Uber Articles, you take the information offered with a grain of salt knowing it was created for the sole purpose of attracting search engines to a site and not to provide health information.

As ever, the web is a great source of information but it is unregulated. Anyone can post anything on the web - valid or invalid. Content is a commodity, search engine placement is a commodity. Medical information on the web is a valuable way to educate yourself about disease and treatment but it is your responsibility to validate the source of that content yourself and, before deciding on treatment, discuss that treatment with your physician or dentist.

Dr. Barsh

About.com, Snoring, Dentists

2008-07-16T11:00:00.004-04:00

I don't know how many of you read About.com but last month they published an article entitled "Is Snoring a Problem? See your Dentist." We at Snoring Isn't Sexy(tm) and Quietsleep(r) would like to applaud their efforts and thank them for mentioning dentistry as an option in the field of sleep medicine.

But at the same time we'd like to correct a few inaccuracies in the article.

First a pet peeve of mine personally. About.com refers to doctors and dentists. While this is in common usage, it's blatantly incorrect. Dentists ARE Doctors. We received our degrees after four years of intensive education and training, many of us went on to receive post-doctoral degrees and many had internships and residencies. We encourage the proper usage of physician and dentist. Please...

The article stated that

However, if the sleep study rules out obstructive sleep apnea, or if the apnea is still very mild, then you might consider a visit to your dentist. A dentist can supply you with a dental appliance that can help you control your snoring. A dental appliance is a small plastic device that fits in the mouth. You wear it at night and it prevents the collapse of throat tissues that cause the snoring. These devices are easy to use and inexpensive. They are fitted to the individual patient and require no surgery.

While this is partially true, oral appliances have been approved for snoring and sleep apnea and as an alternative to CPAP when patients cannot tolerate the CPAP device. The statement issued in a parameters report from the American Academy of Sleep Medicine states

Oral appliances (OAs) are indicated for use in patients with mild to moderate OSA who prefer them to continuous positive airway pressure (CPAP) therapy, or who do not respond to, are not appropriate candidates for, or who fail treatment attempts with CPAP. Until there is higher quality evidence to suggest efficacy, CPAP is indicated whenever possible for patients with severe OSA before considering OAs. Oral appliances should be fitted by qualified dental personnel who are trained and experienced in the over- all care of oral health, the temporomandibular joint, dental occlusion and associated oral structures.

Practice Parameters for the Treatment of Snoring and Obstructive
Sleep Apnea with Oral Appliances: An Update for 2005
SLEEP, Vol. 29, No. 2, 2006

Secondly, as far as appliances are concerned, the article in About.com mentions only two:

One such device is the Snore Guard. Snore Guard looks like an athletic mouthpiece. You wear it while you're sleeping and it prevents the jaw and tongue from dropping back to obstruct the air passages. It allows you to breathe easier, and keep breathing so you get a more restful sleep.

Another such appliance is called Silent Nite. These devices are flexible, small, thin, and quite comfortable to wear. Your dentist will determine from a questionnaire and from impressions of your upper and lower arch just what shape your Silent Nite should take. Snore prevention devices have proved successful in more than 85% of cases, while other treatment, such as surgery or drugs have a success rate of less than 50%.

While both appliances are still available to dentists, neither, in my opinion, is an adequate choice to treat a disease as serious as obstructive sleep apnea.

Better choices for treatment of snoring and sleep apnea are the TAP, Somnomed MAS, Adjustable PM Positioner, Klearway, and many others. Full description of many oral appliances are available at Quietsleep.com. Your dentist who is trained in dental sleep medicine will be able to guide you in which appliance is best for your problem and your mouth. But remember, it's really not about which appliance, treatment of both snoring and sleep apnea is about the therapy.

Dr. Barsh

Benign Snoring?

2008-07-15T07:29:00.002-04:00

In a post on his blog today, a dentist Dr. Paavanj, discussed snoring and sleep apnea and its relationship to dentistry. In it Dr. Paavanj stated:

Can snoring be a sign of medical problems? If so, is there a particular type of snoring that signals the need to seek help?

A. Primary snoring has been reported in a few studies to have some link to hypertension, stroke and coronary artery disease.

However, there is a significant amount of debate about the health consequences of just snoring. The general consensus is that snoring is a benign condition. The intensity or loudness of the snoring has nothing to do with any health consequences.

While current thought may lead to controversy over whether snoring itself is a benign condition, there really shouldn't be but it takes redefining what snoring really is.

Obstructive sleep apnea is complete blockage of the airway in the pharyngeal (throat) area, snoring is partial obstruction and can be defined as obstructive hypopnea. This means there is, in snoring, a decreased amount of oxygen inspired with each breath which, in turn, can precipitate many of the same problems as apnea.

Since snoring can be a warning sign of sleep apnea and especially snoring accompanied by observed cessation of brathing, it's best to not treat any snoring as benign but to consider it as a wake up call (sorry for the pun) to visit a sleep physician or trained sleep medicine dentist for evaluation.

Snoring benign? Well maybe as far as the insurance companies are concerned but not as far as your health is concerned

Dr. Barsh

PURE SLEEP and other do-it-yourself "cures"

2008-07-13T09:19:00.008-04:00

There is a mail-order device that is advertised heavily on TV that purports to be an FDA-cleared device appropriate for snoring. The device is called PURESLEEP and was invented by a dentist, Dr. Douglas Fenton.

According to the PURESLEEP web site:

" PureSleep is an FDA-cleared prescription dental device and uses a technique called 'mandibular repositioning' which has been clinically validated through years of research and testing. For the first time ever, it is available without a visit to the dentist or physician. That translates into savings of more than 80% off the price a dentist would charge!"

(If the manufacturer is reading this post, I would appreciate it if he would comment and post the FDA Clearance number and registration date because I could find no reference to the PureSleep Device at the FDA web site.I will happily retract the comments about FDA approval if the FDA reference material is provided)

Even so, the statement "prescription dental device" implies that a dentist must prescribe the appliance which clearly is refuted by the statement "available without a visit to the dentist or physician."

The web site goes on to state:

"PureSleep is an FDA-cleared prescription dental device, now available for the first time without visiting a physician or dentist. To determine if it is appropriate to prescribe PureSleep to you, it is necessary to answer a few simple questions on this website or by calling an automated voice response system, using the toll-free number below -- any time, day or night. In either case, your answers to these questions will be recorded, and if appropriate, PureSleep will be prescribed to you and your order will be shipped."

(THE FDA states: Intraoral devices to treat snoring and/or obstructive sleep apnea are prescription devices unless adequate directions for use (21 CFR 801.5) are developed and FDA clears a 510(k) specifically for over-the-counter (OTC) distribution.)

The questions, as posted on the web site:

"PureSleep is an FDA-cleared, prescription device. Because of this, you must be at least 18 years old to purchase or use PureSleep. Furthermore, before we can provide you with a PureSleep device, we will need to ask you some questions about your health. The Pure Sleep Company is not liable for any damages or injuries resulting from false or erroneous information provided by you.
Are you at least 18 years old?
Do you agree to the terms and conditions?

The questions continue:

Have you ever been diagnosed with central sleep apnea?

Do you have chronic asthma, emphysema, or any other severe respiratory disorder?

Do you have loose teeth, abscesses, or severe gum disease?

Do you have full dentures, or are you presently undergoing orthodontic treatment?

Have you had a dental implant within the last year? Note that crowns, caps, and bridges are not dental implants.

Have you been diagnosed with temporomandibular disorder -- sometimes called TMD or TMJ?

Does it hurt when you open your mouth wide or yawn?

Does it hurt when you chew, or use the jaws?

Does it hurt when you are not chewing or using the jaws?

Is your jaw pain worse on waking?

Do you have pain in front of the ears or ear aches?

Do you have jaw muscle (cheek) pain?

Do you have pain in the temples?

Do you have pain or soreness in the teeth?

Do your jaw joints make noise so that it bothers you or others?

Do you find it difficult to open your mouth wide?

Does your jaw ever lock closed so you cannot open it?

Does your jaw ever lock open so you cannot close it?

Do you have a problem with your bite being uncomfortable?

Having answered all questions in the negative, I was taken to the following screen:

Great! Your responses to the questionnaire indicate that it would be appropriate for you to use the PureSleep stop snoring solution.

You have the option of making two payments of $29.95 ($59.90 total) plus $7.95 for shipping and handling. However most of our customers prefer the ease and convenience of a single payment - and you can still take advantage of our risk-free 30-day Money Back Guarantee.

To purchase PureSleep, simply select a payment option below and then click the "Continue" button below. Your order will then be transfered to our secure shopping cart where you can complete your purchase.

I prefer the ease and convenience of a single payment.
I prefer to make two payments.

PLEASE NOTE: There is not one question that attempts to determine whether or not the purchaser may have obstructive sleep apnea. And yet the device is supposedly cleared just for snoring. Even if relevant questions were asked, every reputable scientific article states that history alone cannot make the diagnosis of sleep apnea and that it must be confirmed with a sleep study.

Let us realize that even if this device was approved for over-the-counter sale as an anti-snoring mouthpiece, people most likely to purchase it are loud snorers and are often likely to have overlying mild to severe sleep apnea.

Big problem!

Sleep apnea is a serious medical problem that can lead to heart disease, stroke, high blood pressure, diabetes, motor vehicle accidents due to drowsing off while driving and even erectile dysfunction. Even though the device may control the snoring, it may not adequately treat sleep apnea leaving you open, in extreme cases, for death while you sleep.

There are no easy answers in medicine or dentistry. If you have sleep apnea or even if you snore heavily with pauses in breathing at night (observed by your bed partner), have high blood pressure and if you are tired during the day you should be evaluated by a sleep physician or dentist trained in sleep medicine.

PLEASE DON't DO IT YOURSELF. It's not a joke. If you find that you need an oral appliance have it constructed by a dentist who has been trained in this therapy. Often your medical insurance will cover the charges.

As in all things caveat emptor - it's your health and your life.

Dr. Barsh

Drowsy Driving and Snoring

2008-07-11T13:10:00.002-04:00

The National Sleep Foundation estimates that “drowsy driving” claims 1,500 lives and accounts for at least 100,000 auto accidents each year. Drowsy driving is almost as much a road hazard as alcohol related accidents. Truck drivers are especially subject to this problem because they live a sedentary lifestyle and have a high incidence of sleep apnea.

Sleep breathing disorders, including snoring and obstructive sleep apnea, are associated with heart disease, high blood pressure, stroke, mood disorders, motor vehicle and job-related accidents. There are accounts of employees being accused of on-the-job drunkeness when, in actuality, the problem was treatable sleep apnea.

You owe it to yourself, especially in these trying times when jobs are scarce, to talk to your physician or dentist about excessive daytime sleepiness and/or drowsy driving. A CPAP machine or, alternatively, a mouth device may solve your problem, save your job and even save your life.

Dr. Barsh

All Dentists Should Screen Their Patients for Snoring and Sleep Apnea

2008-07-07T09:07:00.004-04:00

18 million people in the United States alone suffer from sleep apnea, untold millions more snore. As a country we are experiencing an epidemic of obesity which can be a precursor of sleep apnea. Both snoring and sleep apnea are related to heart disease, stroke, high blood pressure, depression, diabetes, erectile dysfunction and accidental injury or death due to drowsy driving.

Dentists are in an ideal position to ask a few simple questions (Do you snore loudly? Have you ever been told you stop breathing during sleep? Do you have high blood pressure? Do you tend to drowse off during the day?) and, if the patient answers in the affirmative, to either refer or initiate management for sleep apnea.

Easy, quick - maybe two minutes of time - to improve the health of their patients.

Ask your dentist to become involved.

Dr. Barsh

Wal-Mart: The New Determinant in Medical Care

2008-06-25T08:40:00.008-04:00

Ladies and Gentlemen - we have a problem. I don't care if you are a physician, a dentist or a patient you've got to read an article in today's New York Times entitled "High Medicare Costs, Courtesy of Congress."

The article discusses the fact that as of July 1, companies will have to submit bids to compete with one another if they want to continue selling products to Medicare. While on the surface this may seem to be an excellent cost-cutting idea, low bid medical care is a dangerous precedent for several reasons. First, because it equates the quality of all devices with a similar function. For example, one of the items on the list (Chart is not available online) is CPAP. Currently Medicare pays $105 a month for a CPAP, the proposed cut will bring the monthly cost down to $67 a month. There's no distinction, in this chart, between CPAP, BiPAP, DPAP, humidfied units etc. it's just called CPAP. Will you get the device you really need?

Dangerous precedent - second reason for worry: we are on the verge of a national health care system. When will a Wal-Mart model be advocated for ALL health care? When will your doctor be forced to bid for the right to treat you? When will ALL doctors be forced into fields of medicine and dentistry that are not covered by a national health system in order to earn a decent income?

A recent press release emphasizes the possibility that more doctors and more research dollars will be spent on non-covered services than on those that are within the realm of government coverage:

"Rejuvenating newly identified fat compartments in the facial cheeks can help reduce the hollowed look of the face as it ages, according to new research by plastic surgeons at UT Southwestern Medical Center...'This anatomic fat cheek compartment completely changes how we look at facial aging,' said Dr. Rod Rohrich, chairman of plastic surgery at UT Southwestern and lead author of the study. 'The process to correct facial aging is now dramatically changed as well. No longer do we remove fat without pre-op analysis or merely lift the cheek; we must now lift and fill the face to restore a natural youthful, unoperated appearance.'

The research is part of an ongoing project among UT Southwestern plastic surgeons to better map fat compartments in the face and body.

'Research to identify specific fat compartments for surgeons to target helps provide more predictable results in the ongoing fight against facial aging,' Dr. Pessa said."

The appearance of facial aging as opposed to the health of individuals covered by Medicare... hmmm... let's figure out where the best medical minds would be more appropriately applied. But then again, cosmetic surgery is not and will not be covered by any government health care agency.

Think I'm being paranoid?

Another article in today's New York Times is titled "House Votes to Block Cut in Doctor's Medicare Fees." Again on the surface, a noble effort. But blocking a cut would reduce federal payments to Medicare Advantage plans that many retirees depend on for health care.

Doctor's fees, under Medicare, are ridiculously low anyhow - the projected increase of 1.1 percent in fees is not going to keep any physician in the system. With or without further cuts in compensation, many of the country's docs are opting out of Medicare. Personally, my wife's gynecologist and my cardiologist have opted out of Medicare and I have no option even of paying more for insurance in order to be able to utilize their services. Our internist was unable to continue rent payments to her landlord which forced her to close her private office and seek employment elsewhere.

With the thrust by both political parties to provide a national health plan that covers everyone (again, a noble goal) how far away are we from a medical system in which no bright individual wants to enter the field of medicine? How many excellent physicians, surgeons, dentists (who will sooner or later be forced into the system as well) will opt for cosmetics rather than treating your apnea, your heart disease, your diabetes?

And while we're on the subject, oral appliances for the treatment of snoring and apnea are considered durable medical equipment as well and are billed for under medical insurance. Will you be able to continue with your doctor's choice of appliance, or will you, under the new Medicare and National Health insurance, be forced to use a simple, ineffective boil and bite appliance because Wal-Mart sells them cheaply?

I don't know the answers but I know that we, as patients, physicians and dentists, need to start asking tough questions of our elected officials on both a national and local level. We've got to regain control of what was once the best medical care anywhere in the world.

Wal-Mart cannot be the shining star of health care to which we, as a country, aspire.

Dr. Barsh

Breathe Right Strips

2008-06-17T06:35:00.004-04:00

An article in today's Miami Herald discussed the efficacy of Breathe Right Strips. As you know these strips "opens your nose to: reduce snoring, relieve nasal congestion."

"The FDA approved the strips in 1996 for temporary relief of breathing difficulties related to a deviated nasal septum. The Mayo Clinic recommends nasal strips to prevent or quiet snoring." according to the article.

The author went on to state "Evidence is mounting that these strips can help snorers. It's worth a try, especially because there are no adverse effects."

True, dilating the nose to allow freer air passage has no adverse health effects per se but snoring can be a sign of obstructive sleep apnea. Dr. Chung and her colleagues at the University of Toronto defined and validated 4 questions to ask patients about to undergo anesthesia for general surgery. The four questions: snoring, tiredness during the day, observed cessation of breathing during sleep and high blood pressure.

Stopping the snoring does not stop obstructive sleep apnea which occurs because of obstruction in the throat behind the tongue but may just silence and eliminate several of the warning signs of apnea - snoring and observed cessation of breathing.

The lesson to be learned from this - quieting snoring is a double edged sword in people who may have obstructive sleep apnea. If the snoring is heavy, constant and punctuated by periods of silence then the best advice is to consult a sleep physician or a specially trained dentist especially in a person who is overweight, has a large shirt collar size and has high blood pressure.

Dr. Barsh

60 Minutes Tackles Sleep

2008-06-16T07:26:00.003-04:00

Last evening, June 15 2008, CBS dedicated most of their program to the Science of Sleep. Leslie Stahl investigated the correlation of sleep and health.

For those of you who may have missed the show, Snoring Isn't Sexy has added the two segments of the show to the web site. You can access these clips at www.snoringisntsexy.com/scienceofsleep.cfm.

The segment on Drowsy Driving in Part 1 is well worth reviewing. Sleep deprivation occurs not only when people do not get enough hours of sleep at night but also during sleep apnea when patients awaken frequently to breathe.

Part 2 discusses the relationship between sleep deprivation and obesity, heart disease, stroke and diabetes.

Although this show does not specifically address the problems of sleep apnea, most of the mental and health problems with sleep deprivation are applicable to sleep apnea as well. Be sure to watch the segment on noise and delta waves. This is identical to what happens during sleep apnea.

It turns out that sleep deprivation affects sexuality and performance as well so we weren't kidding when we said "SNORING ISN'T SEXY."

Dr. Barsh

Sleep Apnea Increases Risk of Death

2008-06-13T06:42:00.002-04:00

Terry Young, PhD found, in an 18 year long study at the University of Wisconsin, that people with severe sleep apnea had a 3.2 fold increase in risk of death from any cause comared with people whose sleep breathing was normal. Another study found that sleep apnea also increases the risk for cardiovascular disease.

CPAP may reduce the risk of death in people with severe sleep apnea. Oral appliance therapy was not included in the study.

The message is clear, however: first, dentists and physicians must be more aware of the possibility of sleep apnea in their patients, and, second, you must take responsibility for your own health as well. If you have been told that you snore heavily, stop breathing at times during sleep, have high blood pressure and a shirt neck size of 17 inches or more for men, 16 inches or more for women - it is imperative that you tell your physician or dentist and ask to be referred for a sleep test.

Dr. Barsh

17th Annual American Academy of Dental Sleep Medicine

2008-06-09T15:27:00.002-04:00

Over 650 dentists attended the 17th Annual American Academy of Dental Sleep Medicine.

The Academy has been offering continuing education in the sleep medicine field for dentists in working with oral appliance therapy for patients who snore and suffer from obstructive sleep apnea.

The lecturers presented information on Cardiovascular Complications of Sleep Apnea, The Relationship Between Obstructive Sleep Apnea-Hypopnea and Obesity, Airway Imaging, Dynamic and Static Evaluation of the Upper Airway and Its Role in Obstructive Sleep Apnea Management, and Efficacy of Oral Appliance Therapy as an Adjunct to CPAP.

It is critical that when you choose a dentist to treat your obstructive sleep apnea that you ensure that your choice has received the proper education and training.

Dr. Barsh

Beddie Buys

2008-06-05T15:14:00.005-04:00

What good is your Hastens Sangar if you can't manage to fall asleep or stay asleep? For that matter, how much can a drowsy, cranky person enjoy any of life's luxuries?

SLEEP. It's not just a fashion statement, a trendy marketing topic or a hot media story. While all of the preceding are true; we can't discount the reality: it's essential for human survival, sanity and health.
In this economy, even people who can afford high-end items are judicious about how they allocate their money. If you go for the designer handbag, perhaps you'll cut back on the thrice-weekly blow-outs. Likewise, the same balancing act might go into the acquisition of nocturnal niceties.

SNORING. Most people do it; and the majority doesn't even know. It's insidious and robs you of the potential to function at the top of your game. It's a one-two punch of being symptomatic (and maybe indicative)of Sleep Apnea, as well as being a hazard unto itself.

So back to that European bed...the one in which you find yourself awakening repeatedly throughout the night. Put the buyer's remorse on the shelf for a moment - and consider the fact that you might have a health problem. Then, give yourself a pat on the back for coming across this post because chances are, a relatively small appliance made by your dentist (and quite possibly reimbursed by your insurance company) will curtail or even STOP the snoring. Check out http://www.snoringisntsexy.com/. Sweet dreams!

Snoring Doesn't Cut It in Relationships

2008-05-31T11:10:00.006-04:00

Snoring Isn't SEXy AND THE CITY

The new movie "Sex and the City," based in part on writer Candace Bushnell's book of the same name, is a romantic comedy about four female friends living in New York City featuring dialogue about romance and sexuality.

Imagine that Miranda's relationship with Steve has gone down the hopper because Steve snores loudly and has been sleeping in a different room. Samantha has moved to L.A. with Smith who has a successful television career but has packed on pounds , stops breathing frequently at night and is now taking Viagra. Carrie's wedding plans with Big are in doubt because Big just had a heart attack (he awoke at 4:30 AM with chest pains and was rushed to the hospital) and has been advised not to have sex for a couple of months. Meanwhile Charlotte, who thought everything was perfect, was driving to work, fell asleep, and is now recuperating from the accident.

Just a little different scenario for the movie would ensue if any of the girls or the men they sleep with snore or have sleep apnea.

Snoring and Obstructive sleep apnea can ruin both relationships and health. Think about it.

Dr. Barsh

Over the Counter snore Appliances

2008-05-28T16:14:00.001-04:00

A plethora of the so-called boil and bite appliances are available on the Internet. These devices claim to "cure" snoring and apnea. Most are not FDA approved and are illegal in the united States.

While some will no doubt stop snoring, this will not treat your apnea and may actually increase the problem causing the apneic incidents to become worse.

Please remember that sleep apnea has serious medical consequences including heart disease, high blood pressure, stroke and diabetes.

It's always best to visit a qualified dentist or sleep physician.

Dr. Barsh
Larry Barsh, DMD
Snoringisntsexy.com
Quietsleep.com