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Oral Appliance Therapy – Overview

November 6th, 2012

The American Academy of Sleep Medicine has developed a website devoted to sleep education, appropriately named Included are their recommendations on Oral Appliance Therapy for CPAP intolerant patients and those with Mild or Moderate obstructive sleep apnea.  Be sure to take advantage of this resource when you, your friends or family have questions.

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Half of Women May Have Sleep Apnea

September 24th, 2012

Women have finally achieved equality with men….at least when it comes to obstructive sleep apnea. In a recent study, among women aged 20-44, 25% had sleep apnea, compared to 56 % of women aged 45-54 and 75 % of women aged 55-70.  Among women with hypertension or who were obese – two risk factors for sleep apnea – the numbers were even higher, reaching 80 to 84 % of women.  Obstructive sleep apnea appears to be an equal opportunity employer!

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Fat and Getting Fatter

September 24th, 2012

U.S. obesity rates to soar by 2030. Historians will also look back on the 21st century as the “Golden Age” of Obstructive Sleep Apnea! FAT is the OBSTRUCTIVE part of sleep apnea and is it’s number one cause! I guess you don’t necessarily need water to drown. FAT is slower, but it will get the job done.

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Can Losing Weight Be This Easy?

September 24th, 2012

WOW! Can weight loss really be this easy? According to Dr. David Ludwig, director of the New Balance Foundation Obesity Prevention Center at Boston Children’s Hospital, “I know of no other category of food whose elimination can produce weight loss in such a short period of time” Obstructive Sleep Apnea #1 cause is obesity, meaning a body mass index (BMI) greater than 30. Go online and check your BMI, I think you’ll be surprised!

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Major Win in the Battle for Oral Appliance Legitimacy

January 20th, 2012

U.S Army researchers recently cast a spotlight on adjustable oral appliances, with results of their study published in the Journal CHEST, titled “Efficacy of an Adjustable Oral Appliance and Comparison to Continuous Positive Airway Pressure for the Treatment of Obstructive Sleep Apnea Syndrome,” where they evaluated and compared results of overnight sleep studies in which patients used adjustable oral appliances or CPAP devices. Results were measured by the apnea-hypopnea index (AHI) score, used to assess the severity of sleep apnea based on the total number of complete cessations (apnea) and partial obstructions (hypoapnea) of breathing that last for at least 10 seconds per hour of sleep. The researchers found that a significantly higher percentage of patients using an adjustable oral appliance experienced successful reduction of their AHI score to below five apneic events per hour in this study compared to past reports (62.3 percent versus 54 percent)

Oral appliance therapy was recommended by The American Academy of Sleep Medicine in February of 2006 for the treatment of mild to moderate obstructive sleep apnea and for CPAP intolerant patients.  And here we are some 6 years later with the medical community still questioning the efficacy of oral appliance therapy,  supporting their “concern” based on the lack of scientific studies to support it’s efficacy.  Well, here’s yet another study, and rather large at that!

If oral appliance therapy isn’t efficacious….why does every major medical insurance carrier provide benefits for the therapy?

More information and education is FREELY available at


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New Study: Sleep Disorders, Health, and Safety in Police Officers

January 4th, 2012

new study of Police Officers in the U.S and Canada found 40% of police officers had symptoms of a sleep disorder, the most common being obstructive sleep apnea.  The officers were more likely to be burned out, depressed or have an anxiety disorder. They committed more administrative errors and safety violations and were more prone to falling asleep at the wheel than sound sleepers.  They were also 40% to 60% more likely to report making serious administrative errors, falling asleep while driving or committing a fatigue-related error or safety violation during work. Poor sleepers reported more citizen complaints and more often showed uncontrolled anger toward a suspect or citizen….. all while carrying a GUN!

“You have people who are sleep deprived, which means that their ability to make good decisions, to respond effectively, to drive emergency vehicles well … all of those things are impaired,” said Bryan Vila, a criminal justice professor who studies sleep and performance in cops at Washington State University in Spokane but wasn’t involved in the study.”

And the culture that surrounds police work perpetuates the problem.

“In general we have this cultural attitude of, sleep is for the weak,” said Dr. Michael Grandner, from the Center for Sleep and Circadian Neurobiology at the University of Pennsylvania in Philadelphia.  “When you’re in an environment where signs of weakness are particularly discouraged, there may be a social pressure to not address sleep problems or to shrug them off.”

After many years of treating obstructive sleep apnea and listening to patients concerns and complaints, I think there is more at work here than the macho statement “sleep is for the weak”!

The reason most do not seek care is because of the treatment that is most commonly recommended for the disorder…CPAP! Almost everyone knows somebody that either wears a CPAP or has tried and just can’t do it and haven’t been given any alternative treatment.  They come to my office and say “what do you have, because I’m not going to wear that mask when I sleep”! When I inform them that there is another recommended treatment for obstructive sleep apnea that is covered by most all medical insurance carriers they commonly say, “Why didn’t my doctor tell me about this!”  When they discover they can manage their condition without CPAP and oral appliance therapy is a covered benefit of their specific medical plan, their next statement is usually, “can we get started today?”

Don’t let the threat of CPAP keep you from getting the sleep you crave.

As Albert Einstein said,

“Doing the same thing over and over, expecting a different result, is insanity”.

Don’t go insane! Visit The Center for Sleep & TMJ Disorders to find solutions for a happier, longer, safer life!



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The CPAP Alternative for Sleep Apnea

November 17th, 2011

Problems with breathing during sleep usually start many years, if not decades before the patient is motivated to seek answers to the question:  ”What’s really going on here”!?

The most common 1st sign of a sleep apnea is snoring. Snoring is most always ignored by the patient for years until many of the other medical conditions associated with untreated sleep apnea start affecting the quality of the patients daily life or their regular sleep partner does more than just complain.

Snoring is the first sign that the airway is being compromised and oxygen is not getting into the lungs and therefore the brain.  Untreated snoring, over the course of time, leads to sleep apnea.

Please read below how a young mother of three describes her life with undiagnosed sleep apnea. Though she had been snoring ” for as long as I can remember”, it wasn’t until being diagnosed with high blood pressure, placed on medication and experiencing daily fatigue, which affected her family life, that she was motivated to get answers. Finally getting that answer, she goes on to describe how she struggled to comply with the recommended treatment: continuous positive airway pressure, commonly referred to as CPAP.

Now she had yet another problem…CPAP, and had to go looking for answers again! Please read the letter she sent to our office after completing oral appliance therapy.

I just want to tell you how much oral appliance therapy has made a difference in my life.

For as long as I can remember, I had a difficult time going to sleep and staying asleep. As I would start to doze off, my snoring and stifled breathing would jolt me awake.  Once asleep, I would often wake in the middle of the night from the same thing….snoring and NOT BREATHING!

About two years ago, I was diagnosed with high blood pressure and put on medication.  At one of my check-ups, I complained to my doctor about being tired all the time.  She ordered a sleep study for me because she suspected sleep apnea as a probable cause for my fatigue and hypertension.  The sleep study proved that I did in fact have sleep apnea.  Then I was given a bulky CPAP mask and machine to use for sleeping.  The mask was awful! I had to sleep on my back to keep it from shifting on my face, the hose would squeak when I moved, and I had to set my alarm clock to go off early so I could take it off before my husband woke up (there was no way I was going to let him see me in that thing – talk about a romance killer!) Worst of all, it didn’t help. I could never get comfortable enough with it to get a good night’s rest and would often give up and take it off in the middle of the night.

On the day of my first appointment with you, I woke up tired with a horrible headache.  Still groggy, I wandered to the kitchen and ate a high fat/high carbohydrate breakfast as I typically did and had my morning “cocktail” of a 64 ounce Diet Coke and two Tylenol.  When my two older kids left for school, I laid on the couch wishing I could go back to sleep while my four year-old watched cartoons.

My husband drove me to your office because driving the busy freeways made me panic.  Then, while filling out forms in your waiting room, I ate two pieces of lemon pound cake that had been set out for your patients – even though I wasn’t hungry. All in all, it was shaping- up to be a typical day for me.

When I met you and we discussed all the negative ways in which sleep apnea and sleep deprivation can affect a person’s life, I was amazed at how many of those things described me.  I was always tired, was plagued by insomnia, ate junk food all day and couldn’t manage my weight. I panicked when driving, and I was often irritable with my family.  I desperately wanted to get help so that I could improve the quality of my life.

About a month later, I brought my oral appliance home and tried it for the first time.  When I went to bed, it took me about 15 minutes to fall asleep.  When I woke in the morning, I felt refreshed. I asked my husband if I had snored that night (although I was always aware of my loud snoring and would often wake myself up from the noise) and he said I was quiet all night.  After about five days of wearing the appliance I was completely used to it.

Now, I put it on just before bed and fall asleep within minutes. These days I wake up ready to start each day with plenty of energy, I am aware and alert enough to care about what I eat when I am hungry.  My morning Diet Coke and Tylenol is a thing of the past.  I have lost 16 pounds.

At my last check-up, my blood pressure was normal and if it is normal at my next check-up, my doctor is taking me off my medication. I can drive anywhere without having major panic attacks.  Best of all, I am more patient with my family and my four year old now spends his days with me instead of SpongeBob SquarePants!

When I think back to how I felt on that morning of our first visit (and for so many mornings for years before that) compared to how I feel now, I cannot believe it! I am healthy and vibrant and rested.  I have all the energy I need for my busy life and my family and I happily greet each day.  Thank you, Dr. Fritzsche and your wonderful staff, for helping me to have a better life.~ Talley H.

Most patients that suffer with sleep apnea don’t realize all the ways it has been robbing the quality of their lives until they are successfully treated.  They have forgotten what a good nights sleep feels like and attribute their problems with aging, stress, overwork and diet.

At The Center for Sleep & TMJ Disorders,  we provide the answers to the many questions our patients have and provide the solutions that they can actually use, regularly & comfortably.

Please read and listen to what other patients have had to say about their journey in finding the answers to their unique situations, by clicking on Patient Stories.

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Sleep Apnea a Risk Factor for PTSD?

October 28th, 2011

That was an observation made by one of the researchers after reviewing the results of a recent study conducted at Walter Reed Army Medical Center in Washington, DC.

PTSD stands for Post Traumatic Stress Disorder.

Though the study was not designed to gather that type of data and cannot support that conclusion, the question remains.  Why would 78% of the patients without traumatic brain injuries test positive for sleep apnea?  Are soldiers being deployed with undiagnosed sleep apnea?

One would not be surprised at an increase of sleep disorders, especially insomnia, in head-injury victims… but sleep apnea?  Maybe in a older, obese and out of shape population, but not in a presumably young, healthy and relatively fit population (similar to the soldiers).

The rate of sleep apnea in a healthy/fit population is accepted to be approximately 4% to 5%. Could sleep apnea more prevalent in our society than is commonly recognized?

As these heroes return from the battle fields and rejoin our society, it is incumbent upon physicians and sleep medicine specialists to screen them for undiagnosed sleep apnea.  We can see many of the physical scars with which they return. It’s what we cannot see, obstructive sleep apnea, that will prevent them from the physical and mental healing necessary to be successful in starting their new lives at home.

Sleep apnea is the unseen destroyer of marriages, families, careers and the overall quality of life. Left untreated, it’s co-morbid medical conditions eventually take your life!

The internal combustion engine we call our body is no different than the one in your car. Without a sufficient supply of oxygen, neither well run well and will eventually stop running.  Just put a dirty air filter in your car and see what happens!

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How Much Does Sleep Apnea Cost?

October 27th, 2011




You know the feeling. “Time to get up already?” You don’t want to get out of bed.  Heck, you don’t feel much better than when you went to bed!   Groggy, sluggish and irritable… you can’t make the coffee strong enough or quick enough.  “How am I going to make it through the day?”  But there is more to sleep apnea than just feeling like #&*%!  It costs you physically, financially and relationally as well.  In fact, the National Commission on Sleep Disorders has estimated that sleep deprivation costs the nation $150 billion every year. You will find you’re paying a high price for sleep apnea when you combine this fact with the health risks and damaged relationships that accompany sleepiness caused by sleep apnea. Listed below are five ways in which sleep apnea is costing you real money.

More Out of Pocket Expense

The chosen beverage of sleep-deprived people is caffeine. Energy drinks like Red Bull or Monster; Diet Coke or Mountain Dew; black coffee or tea; all the morning, afternoon and evening trips to Starbucks, these indulgences can quickly add up. For instance, if you buy a Starbucks Latte every day, you can end up spending close to $1,800 per year. You could save money by picking less expensive caffeinated drinks, but most of us don’t.  The cost of convenience is another cost that sleep-deprived people often pay.  You’re too tired to make dinner so you order a pizza, stop for fast food or take-out instead. The same is true for washing your car, cleaning your house or mowing the lawn. All things you “could do” but more than likely you hire others to do……and these services add up quickly.

More Medical Issues

People who don’t get enough sleep due to sleep apnea develop life threatening health issues, according to published research studies. Sleep apnea increases your risk of stroke and heart disease. In fact, you are 15 % more likely to have a stroke and 48 % more likely to develop heart disease. Additionally, sleep apnea affects appetite hormones. Studies show people who sleep four hours or less each night have a 75% higher chance of being obese, which just makes the sleep apnea worse.  Obesity is the #1 sign of probable sleep apnea and snoring is #2.  A connection between lack of sleep and an increased risk for colon cancer, breast cancer, heart disease and diabetes was found by a Harvard-run Nurses’ Health Study.  And finally, sleep apnea reduces your immunity to disease and viral infections because immune cells stop functioning properly.

More Accidents

Without enough sleep, you are going to be clumsier than normal, which leads to an increase in accidents at home or at the office. Additionally, driving when you are sleepy is as dangerous as driving drunk. Anywhere from 16% to 60% of car accidents involve a sleepy driver and 30 to 40% of all heavy truck accidents are caused by sleep deprivation and fatigue. In fact, sleepy driving causes Americans to spend roughly $48 billion per year to cover accidents.

More Bad Decisions

Your ability to concentrate, short-term memory, ability to handle complex tasks, critical thinking, decision-making skills, your vocabulary and communication skills are all impacted by the lack of sleep caused by sleep apnea. On the job, these can result in  poor evaluations, fewer raises and promotions. Sleepy employees cost employers $3,225 more than employees who get enough sleep. Sleepy students don’t score well on tests costing them the colleges they aspired to attend and career paths they select. The overall GPA of a sleep-deprived student compared to a student with adequate rest is 2.84 as compared to 3.18. When you’re tired, you are more likely to make bad decisions, throwing “caution to the wind”! This means that lack of sleep can alter the way you make financial decisions, causing you to take more risk with your finances.

More Relational Difficulties

Sleep apnea can be costing you in the relationship department as well. Grumpy people are typically sleepy people.  But sleep apnea also contributes to mood changes including depression, increased irritability and the loss of a sense of humor. Lack of sleep results in a “quick fuse” reducing your threshold for anger management and you can quickly lose friends, make spouses angry, upset negotiations and even get into fights or run someone “off the road”! Who wants to be around you?  Meanwhile your stress, anxiety, worry, frustration, and nervousness all increase. You grind your teeth, your neck is killing you and you wonder “what’s wrong with the world?”  You may even experience overwhelming feelings of not being able to cope with simple problems and moderate workloads. Finally, the lack of sleep caused by sleep apnea can leave you wanting to avoid group participation or interactions with others. You sit at home too tired to go anywhere and may eventually disengage from the outside world altogether.  You call this a life?


Remember sleep is not a luxury but a necessity. Not getting enough sleep is detrimental to your health, relationships and your budget. So when it comes to getting sleep, remember less sleep caused by sleep apnea results in many more problems than just feeling like  #&*%!

Click on “Video Library” on this website and watch “The Science of Sleep”.  You can thank me later!


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What Does Sleep & Sex Have in Common?

October 26th, 2011

Less Sleep means Less Sex!

Getting a good night’s sleep is a thing of the past for most adults which leads to poorer health, lower productivity on the job, more danger on the roads and — a less vibrant sex life, an eye-opening new survey shows.

75% of the respondents to the National Sleep Foundation poll report symptoms of sleep problems, such as difficulty falling asleep, waking during the night, experiencing fatigue during waking hours, or snoring.

Roughly 25% of respondents who have partners report that their sexual relationship has been damaged because they have been too sleepy. They had less sex, less often or lost interest in having sex because they were too tired.

People don’t understand the importance of sleep and “survive” on a daily basis, walking around in a “fog” like zombies, which effects how they are perceived in their work and social environments and how they feel & function.

Most people ignore such problems, and few think they actually have one, the survey shows.

People who are sleep deprived don’t recognize how much they need sleep and how poorly they are performing; they think they get away with it!   When we’re sleep deprived, we are not the same. We function much better if we had a full night’s sleep.

The human body has the capacity to function even though we’re sleep deprived, but it’s like gaining an extra 50 pounds. You can still climb the stairs and jog, just not as easily as before and it puts “wear & tear” on the system.

50% of those polled were able to say they slept well on most nights. 25% of adults say sleep problems have some impact on their daily lives.

Richard Gelula, the sleep foundation’s CEO, says there’s a link between sleep and quality of life.

“People who sleep well, in general, are happier and healthier,” he says. “But when sleep is poor or inadequate, people feel tired or fatigued, their social and intimate relationships suffer, work productivity is negatively affected, and they make our roads more dangerous by driving while sleepy and less alert.”

Symptoms of a sleep problem include insomnia, going to the bathroom many times during the night, waking up feeling unrefreshed, snoring, restless legs, or pauses in breathing.

But most importantly, it’s the quality not the quantity that matters most, the report says.

A lot of the nation’s sleep habits can be attributed to an always-on-the-go, always “connected” cell phone society.  Our society allows us to work, shop, tweet, post, watch TV and surf the internet 24 hours a day.  Many see sleep as a waste of free time until the alarm goes off.  Then it’s….”wish I would have gone to bed sooner”.

What can be done?
Educating people about the self-deception that they are getting away with less sleep.   It takes a toll on you and everybody around you….so get your butt in bed!

Among the study’s findings:

More than 26% are at risk for sleep apnea, a serious sleep disorder associated with hypertension and stroke.Sleep apnea is most often the result of untreated snoring. Snoring is your first sign that your nighttime airway is being compromised and your not getting the oxygen your body needs to rest. Snoring happens when you sleep because muscles relax during sleep and when they relax too much they can block the air flow completely. Then you hear pauses in the snoring and snorts. When somebody does that, suspect sleep apnea.Night after night, that takes a toll on quality of sleep. But also, because you’re not moving air properly, it takes a toll on the heart and lungs – blood pressure, increased incidence of heart attacks and strokes.

The American Academy of Sleep Medicine recommends only two (2) therapies for the treatment of obstructive sleep apnea (OSA).  Continuous positive airway pressure (CPAP) therapy or oral appliance therapy.  CPAP is recommended for severe cases while oral appliance therapy is recommended for mild to moderate cases and for patients that can not tolerate CPAP.  Surgery is not recommended, but is an option.

  • Snoring, a symptom of sleep apnea, is disruptive to bed partners: More than half of those who snore (57 %) report disrupting others, and almost 20% of snorers report snoring at levels louder than talking and that they can be heard in the next room.
  • Americans often compensate for lack of sleep by drinking caffeine — 25 % of Americans drink 4 or more caffeinated beverages daily — or napping, with more than 50% of respondents saying they nap at least once a week, and 33% reporting napping two or more times a week.
  • 60% of adult motorists say they have driven while drowsy in the past year; 4% report that they have had an accident or near-accident because they were too tired or actually fell asleep while driving.
  • 75% say their partner has a sleep problem, and the most common is snoring.  Actually they both have a sleep problem.  The “snorer” keeps their partner awake!
  • 70% of people say their doctor has never asked them about their sleep.The foundation and many sleep experts recommend avoiding alcohol and caffeine close to bedtime. The group also recommends that adults pay attention to how much sleep they get and the quality of that sleep, and seek help if needed.The National Sleep Foundation is a nonprofit organization that lobbies Congress and state governments on public health and safety issues surrounding sleep disorders and deprivation, including drowsy driving and school start times. It receives its funding from the sleep products industry, pharmaceutical companies, other corporate sponsors, physicians, clinics and sleep centers.The poll, conducted by WB&A Market Research, used a random sample of 1,506 adults who were interviewed over the phone between Sept. 20 and Nov. 7, 2004. The margin of sampling error is plus or minus 2.5 percentage points.
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