These are two Zyppah devices invented by Dr. Jonathan Greenburg, an expert in sleep apnea. The devices treat the source of apnea (and snoring: the tongue. (Walt Mancini/Staff Photographer) (Walt Mancini)
Sleeping is one of the most peaceful, rejuvenating things we do.But for some people, catching some Z's can be life-threatening.
Up to 18 million Americans suffer from sleep apnea and the majority of them don't even know it, according to the American Association for Respiratory Care. Sleep apnea causes people to stop breathing at various times while asleep, with each pause in breath ranging from 10 seconds to 120 seconds or more depending on the severity of the condition.
Bob Muro, a 68-year-old Woodland Hills resident, would stop breathing for 45 to 50 seconds at a time throughout the night.
"My wife would wake me up and say, 'You're not breathing.' I would say, 'What do you mean I'm not breathing?' And she said, 'You take air in and that's it for like 45 to 50 seconds,"' Muro explains.
His wife finally convinced him to see his cardiologist who ordered him to take part in a sleep study, through which he was diagnosed with severe sleep apnea.
Muro's brain was waking up 52 times a night due to a lack of oxygen, but he would have never known if it wasn't for his wife.
Dr. Alon Avidan, director of the UCLA Sleep Disorders Center, says sleep apnea can lead to high blood pressure and an increased risk of heart disease and stroke. It can also lead to sudden cardiac death during sleep if it is not being treated.
Avidan describes the condition as a silent killer because many people don't know they have it, since the symptoms occur while they sleep. But red flags, he says, include loud snoring, gasping for air during sleep, fragmented sleep and waking up feeling tired.
According to various studies, untreated sleep apnea also can increase risk of dementia, cancer and type-2 diabetes.
There are three types of sleep apnea -- obstructive, central and mixed -- all of which result in a person's breathing being interrupted. The most common type is obstructive.
"Sleep apnea is a sleep disorder in which the airways in the back of the throat collapse," Avidan says. "Sleep apnea is more likely to occur during REM (rapid eye movement) sleep because the muscles relax."
In adults, the most common obstruction is the tongue which collapses into the back of the throat, blocking the airways.
There can be other issues such as nasal congestion, polyps, a small jaw, and alcohol use, some of which only temporarily cause sleep apnea, says Avidan.
Dentist Jonathan Greenburg gave up practicing dentistry about five years ago to focus on snoring and sleep apnea treatments.
He's founded five Snore No More Centers across Southern California with facilities in Beverly Hills, Encino, Newport Beach, Pasadena and Valencia.
Greenburg
Dr. Jonathan Greenburg demonstrates the Zyppah device he invented to eliminate snoring and sleep apnea. Greenburg is an expert in sleep apnea and is the founder of five Snore No More centers in Southern California. (Walt Mancini/Staff Photographer) (Walt Mancini)
says snoring and sleep apnea are completely caused by the tongue."Snoring and sleep apnea are related to the tongue falling back and blocking the airway," Greenburg says. "Snoring is a partial blockage of the airway and sleep apnea is a complete blockage of the airway."
He says he often has patients come in saying their snoring and/or sleep apnea is caused by their nose, but he asks why they don't snore when they're awake then.
"Because your nose doesn't change position. Only at nighttime does your tongue relax and fall back," Greenburg says. "So if it was about your nose, then you would snore while you're awake because nothing else changes."
As you age, your chances of developing sleep apnea increase because the muscles in your mouth, including your tongue, lose tone and start to sag, says Greenburg.
Treatment options have included surgery, using a CPAP (continuous positive airway pressure) machine, or using dental appliances such as a mandibular advancement device.
In theory, the dental appliances bring the jaw forward which brings the tongue along with it making it less likely to fall back into the throat.
There are more than 100 types of these dental appliances available, but generally they work only for mild sleep apnea. Out to change this, Greenburg has invented an elastic feature that is added to the appliance that essentially holds the tongue in place.
The feature has been added to a new line of dental appliances called Zyppah that include over-the-counter, temporary and professional devices. Greenburg says this allows him to treat patients with moderate to severe sleep apnea.
"Zyppah is the elastic piece," Greenburg says. "It's the magic sauce that makes us able to treat moderate to severe sleep apnea -- without that we couldn't."
After receiving his diagnosis of sleep apnea, Muro was referred to Greenburg. He is currently using Greenburg's device called the Dorsal Hybrid and says it has worked to treat his severe sleep apnea.
Muro has undergone a sleep study using the device and says he no longer wakes up during the night and the oxygen levels in his blood have increased, but he is waiting to do a final sleep study to ensure the sleep apnea has been completely cured.
"Well of course it works but psychologically I can't sleep unless I have it in," Muro says.
"I know that sounds crazy but it's the truth. I put it in and I know I'm going to get a restful sleep so it gives me confidence. It slips in, it slips out. This process has taken me probably a year and a half, fine tuning it to fit the contour of my mouth."
But according to Avidan, patients with mild sleep apnea do well with various types of these dental appliances, and he doesn't believe any one appliance is better or worse than any other on the market.
Depending on the severity, he says the gold standard of therapy is the CPAP machine, which incorporates an air pump, a hose and a mask.
"CPAP has the most data in improving sleep apnea and effects of sleep apnea, but compliance is not the best," Avidan says.
Depending on the particular study, the percentage of patients who will actually use the CPAP machine ranges between 30 percent and 60 percent, Avidan explains.
While it may be complicated because one treatment doesn't fit all, and experts vary in which therapies they recommend using, the underlying message they all share is that people who think they may suffer from sleep apnea should seek treatment.
"Usually snoring is the best indicator, although you can be a silent apneic and not snore. If you're sleeping by yourself, you can get a tape recorder, a voice-activated tape recorder, and check with that," Greenburg says.
"If you're finding you're gaining weight and can't lose weight, you suddenly have high blood pressure, type-2 diabetes, any of those things, it's a good indicator you need to get checked out."
Find out more
* To learn more about dentist Jonathon Greenburg's Snore No More Centers, where his Zyppah line of devices for treatment of snoring and sleep apnea is available, call 818-205-1122 or go to www.zyppah.com.* To contact Dr. Alon Avidan at the UCLA Sleep Disorders Center, call 310-267-5337 or go to www.sleepcenter.ucla.edu.
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Source: http://www.dailynews.com/ci_21376822/not-so-silent-killer-sleep-apnea-and-how?source=rss_viewed
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