You have every reason in the world to hate CPAP

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CPAP is life saving technology for people with obstructive sleep apnea.  Unfortunately, the majority of patients do not tolerate CPAP and often go untreated.  Dental Sleep Medicine offers a comfortable, safe and effective alternative to CPAP.  Dr Shapira is a pioneer in the use of oral appliances to treat CPAP with over 30 years experience.

Ira Shapira has been utilizing physiologic dentistry for over 30 years to treat TMJ disorders, headaches, migraines and sinus pain. Dr. Shapira is a dentist whose philosophy of care leads to more than just a pretty smile. Cosmetic dentistry is one of his specialties, but more and more his practice has come to focus on the tremendous health benefits that can come from a smile that blends form and function. The founder of, a nationwide network of dentists dedicated to educating patients about the dangers of sleep apnea and the treatment options available, he says, “I often joke that I was a quack for 25 years when I was one of the few dentists in the world treating sleep apnea and I woke one day to find I was the expert.

His interest in sleep apnea treatment began with his son’s treatment for the condition.  “I was told my 5 year old son had ADHD could not start kindergarten and needed to be on Ritalin for life.  I said I don’t think so.  He had a sleep study and had severe apnea which was treated with tonsilectomy and orthodontic.  Turns out his drug of choice was OXYGEN not Ritalin.  He graduated magna cum Laude  double major, double minr.  All he needed was good sleep!”   Following this experience he became a visiting Asst Profesor at Rush Medical School’s Sleep Disorder Center where he did research on jaw position and sleep apnea in the 1980’s long before most ohysicians or dentists even knew what sleep apnea was.  He felt that people needed to learn about sleep apnea, and he decided there should be more treatment options available. This intensely personal origin to his interest in sleep apnea is responsible for his treatment attitude: “I like to think of my patients as though they were members of my family. I want them to have the quality of care they can appreciate and that I would expect for myself or my family.”

The same spirit has inspired him to found, a website that can help people get in touch with local physiologic  dentists who can resolve the most common form of headaches: tension headaches.  These headaches are related to TMJ disorders and to Myofascial Pain and Dysfunction (MPD)…

Sleep Apnea Treatment

Dr. Shapira Sleep Apnea Treatment 0 Comments

Suffering from sleep problems like snoring and trouble breathing?

sleep-apnea-treatmentAre you having problems sleeping and keep waking up at night suddenly, as well as snoring loudly? You could have something called sleep apnea. Sleep apnea is surprisingly common right across America. It can occur at any age and to either gender, but it is more common amongst older males.  Many patients have sleep apnea, sometimes severe but do not fit the typical pattern.

It is quite simply the narrowing or blockage of the airway while you are asleep. This means at times there is a restriction in the amount of oxygen you take into the lungs. The outcome of this could be trouble breathing and snoring.  Patients who have sleep apnea usually have a smaller airway when awake as well and are predisposed to apnea when their muscles are relaxed.  Patients with forward head posture or recessive chins are at greater risk for sleep apnea.

These are some typical symptoms of sleep apnea:

  • Loud and persistent snoring
  • Persistent sleepiness during the day
  • Elevated blood pressure
  • Depression
  • Erectile dysfunction
  • Decrease in work efficiency
  • Morning headaches
  • Morning dry mouth
  • Needing to hit the snooze button on your alarm
  • difficult to control diabetes
  • Weight Gain or altered metabolism

What’s causing that sleep apnea?

Quite a lot of research has gone into finding out what causes sleep apnea. Some of the causes are listed below:

  • Alcohol consumption
  • Smoking
  • Obesity
  • Thick necks
  • Acid reflux
  • Large tongues relative to the size of the mouth.
  • Sleeping on your back (supine)

What these tend to do is relax the muscles in your airway so much that it might become difficult for you to breathe. A dental solution may be available, in the form of some oral appliances which can help to let you get more sleep, but you may need to tackle lifestyle changes too.

A treatment that fits in the palm of your hand

An oral appliance can help with sleep apnea treatment, but does not cure the problem. It can help to relieve the symptoms and there are many available for you to choose from.

Thornton Adjustable Positioner (TAP)

This is a comfortable, adjustable mouthpiece, which helps to make sure your airway is kept open so that you can maintain correct breathing. The device pushes your lower jaw forward into such a position that the airway remains open.  Better breathing takes place with less snoring so you and your partner can get a decent night’s sleep.

The MAS – Dorsal Fin Device, made by SomnoMed

This is a custom-made oral appliance, which is made up of upper and lower dental plates with a specially designed fin-coupling piece allowing the mouth to open and close normally. This device helps to adjust your jaw level. This improves the comfort level and effectiveness of your treatment, as the jaw is only moved as far as is necessary to reduce sleep apnea and alleviate snoring so that you can sleep better.

Herbst Telescopic Appliance

This appliance may be effective if you are a chronic snorer and also have moderate to mild obstructive sleep apnea. This adjustable appliance should allow you to move your jaw both laterally and vertically, eliminating the necessity to disengage it. It is fitted onto your teeth with clasps, but friction helps to hold it in place too. If it is first positioned in the wrong place it can be removed and repositioned using shims to ensure a sufficient supply of oxygen reaches your lungs.

In some cases, we may recommend dental treatments such as orthodontics or a mouth reconstruction (with veneers, implants, and other treatments) to help treat your sleep problems

Could one of these work for you?

If after reading this you think there is a solution to relieve your sleep apnea symptoms, then you may need to have a thorough examination to determine what is the root cause of your sleep disorder. We may be able to help you breathe better and help reduce sleep disorder symptoms by fitting a suitable orthotic device.

What is Sleep Apnea? Does Your Loved One Snore, Stop Breathing and Gasp for Breath?

Dr. Shapira Trouble breathing while asleep 0 Comments

Trouble breathing while asleep? It could be sleep apnea

what-is-sleep-apneaSnoring is the most common warning sign of sleep apnea.

Do you find it difficult to breathe when you sleep or find yourself snoring far too often? You could be suffering from something called sleep apnea.  Many patients are

Many patients are unaware of their sleep apnea, even when it is very severe or life-threatening and concerned family or friends inform them of the problems.  If you have loud disruptive snoring there is an excellent chance it is a warning sign.  Listen to the warning before it’s too late!

Sleep apnea is a sleep disorder which occurs when breathing stops and starts repeatedly. You could have sleep apnea if you know you snore loudly and you still feel tired right through the day even if you thought you had enough sleep. Sleep apnea can happen when your throat muscles relax at the wrong time or when your brain fails to send the correct signals to the muscles that are responsible for controlling breathing.

These are some of the common sleep apnea symptoms:

  • Sleepy all day
  • Loud snoring
  • Short lapses in breathing while asleep
  • Sleep a lot but still tired
  • Suddenly waking up accompanied by a shortness of breath or heart palpitations
  • High Blood Pressure or Hypertension
  • Waking up with a dry mouth or a sore throat
  • Headache, especially morning headache
  • Insomnia, waking during the night and not being able to return to sleep.
  • Concentration problems
  • Motor Vehicle Accidents or near misses
  • Marital Discord

What  are some of the most common sleep apnea causes?

Apnea comes from the Greek meaning “want of breath”

The most common type of sleep apnea is called obstructive sleep apnea (OSA). This is when the muscles in the back of your throat relax and block your air flow.  This is actually an active process, when we breathe in we create a vacuum that sucks our airway shut, usually at the base of the tongue.When this happens, not enough oxygen gets into your blood. Your body reacts very quickly and you normally find yourself waking up suddenly with a choking or snorting noise. It tends to happen time and again through the night, so you just can’t get enough sleep.

Sleep Apnea is the most severe form of sleep disordered breathing and is a total blockage of the airway.  Hypopnea is an incomplete blockage of the airway that still causes oxygen to drop significantly but may just have snoring with total stoppage of breathing.  Upper airway resistance syndrome (UARS), also called Respiratory Related Arousals (RERA) is a partial blockage of the airway and is usually found in younger healthier and thinner individuals, especially women.  It can cause all the same symptoms as Sleep Apnea and is one of the major cause of  Fibromyalgia.

People with certain characteristics are more likely to experience sleep apnea. For instance, if you are overweight, a male or a smoker you are more likely to get sleep apnea. There are other physical reasons for sleep apnea, too. You might be more likely to get sleep apnea if you have a thick neck, a receding chin or enlarged adenoids or tonsils. Some allergies can cause sleep apnea too.  Many of the patients do not fit this clinical picture but still experience sleep apnea.  This is due to the configuration of their upper and lower jaws and tongue.

The problem could be dental related

The National Heart, Lung and Blood Institute of the NIH published a report on “The cardiovascular and sleep related consequences of Temporomandibular Disorders”. They have recognized that the same underlying mechanisms are involved in snoring, sleep apnea and TMJ disorders.

There are ways to relieve sleep apnea and it may be surprising to learn that dental solutions could help. You don’t have to suffer needlessly as these days there are devices available which have been shown to be very beneficial for sleep apnea sufferers.

Some of the most commonly used devices used by dentists look a bit like a sports mouth guard. They gently and comfortably move the lower jaw forwards and downwards and help to keep your airways open.  These are called Mandibular Advancement Devices (MAD) and there are over 100 types available.

One of these devices is the TAP 1 appliance that is one  the most effective devices available.  It consists of an upper and lower appliance connected with a hook and a bar.  There is a handle that is turned to advance the lower jaw.  This handle acts as a volume control for your bed partner.  who can turn off your snoring and increase your airway. The Somnodent appliance by Somnomed is one of the most comfortable appliances available.

A second device that may be used is a tongue retainer. This is a splint which holds the tongue in the right position and works to ensure the airway is kept open. Overall, dental solutions not only improve oral and dental health for sleep apnea sufferers, but improve sleep patterns and reduce snoring, too.

Could your medical solution be a Dental Appliance right for you?  Start living a better life now.

If you think you suffer from sleep apnea and have tried ways of relieving it without much success, then it may be time to consider a dental solution to this dangerous medical problem.

We will need to examine your mouth and throat properly and may be able to give useful recommendations about what can be done to help you relieve your symptoms.  Oral appliances are a first line treatment for mild to moderate sleep apnea.  CPAP is still considered the first choice for severe sleep apnea but oral appliances are considered an alternative to CPAP for patients desiring a more comfortable treatment or for patients who cannot tolerate CPAP.

Sleep disorders are often associated with other TMJ and orofacial pain disorders. Differential diagnosis of sleep and orofacial pain disorders is essential to health.…