I saw Dr. Stern several years ago after trying CPAP for my sleep apnea. The CPAP was very effective, but only when I used it. As a physician, I’m aware how important it is to comply fully with treatment, and I truly intended and wished to keep the CPAP on every night. During sleep, however, this was not under my control, and I’d often wake up in the morning with the device on the bed beside me. I also travel a lot for work, and had the unhappy experience of carrying a burdensome CPAP along with me at a conference in Italy. Dr. Stern determined that I would be a good candidate for the dental appliance, and it has been a great success. My sleep study results were comparable to that achieved with CPAP. I never recognized sleep trouble before the CPAP or dental appliance, but was often very tired, falling asleep in the late afternoon or early evening. Now, I’m able to attain better quality sleep, in stages 3 and 4, and am much better rested with better energy throughout the day. Dr. Stern and his staff are consistently helpful, knowledgable, and friendly, and it’s certainly worth the drive from Toronto!! Thanks again.
Dr. Mark R.
Just wanted to thank Dr. Stern for his help and expertise. He is extremely knowledgeable when it comes to sleep appliances and prevention of snoring.
With Dr. Stern’s expertise, my wife sleeps well and I can go on golf trips with my buddies without listening to their complaints about my snoring every morning.
His staff are very friendly
Dr. A.Covens MD, FRCSC
New Information Connects Obstructive Sleep Apnea with Depression
Snorting, gasping, or stopping breathing while asleep was associated with nearly all depression symptoms, including feeling hopeless and feeling like a failure, according to results from what authors say is the first nationally representative sampling to examine this relationship. They note that additional research may be needed to determine whether regular screening for these conditions by mental health professionals and sleep specialists should be recommended.
The data come from survey results using the PHQ-9, the nine item depression scale of the Patient Health Questionnaire, in a national sample of 9,714 American adults. In men, sleep apnea was associated with probable major depression, but snoring was not associated with depression symptoms in men or women. Snorting/stopping breathing 5 nights a week or more was strongly associated with probable major depression in both genders, as compared to those who never experienced these issues.
The likelihood of depression increased with the reported frequency of snorting and/or instances when breathing stopped in the study, according to lead author Anne G. Wheaton, PhD. She suggested screening for both disorders could help address the high prevalence and under-diagnosis of sleep apnea and depression, especially if sleepiness is a chief complaint.
Sleep Apnea Linked to Silent Strokes
People with severe sleep apnea may have an increased risk of silent strokes and small lesions in the brain, according to a small study presented at the American Stroke Association’s International Stroke Conference 2012.
“We found a surprisingly high frequency of sleep apnea in patients with stroke that underlines its clinical relevance as a stroke risk factor,” said Jessica Kepplinger, MD, the study’s lead researcher and stroke fellow in Dresden University Stroke Center’s Department of Neurology at the University of Technology in Dresden, Germany.
“Sleep apnea is widely unrecognized and still neglected. Patients who had severe sleep apnea were more likely to have silent strokes, and the severity of sleep apnea increased the risk of being disabled at hospital discharge.”
The researchers found:
– 91% (51 of 56) of the patients who had a stroke had sleep apnea and were more likely to have silent strokes and white matter lesions that increased risk of disability at hospital discharge.
– Having more than five sleep apnea episodes per night was associated with silent strokes.
– More than one-third of patients with white matter lesions had severe sleep apnea and more than 50% of silent stroke patients had sleep apnea.
– Even though men were more likely to have silent infarcts, correlations between sleep apnea and silent infarcts remained the same after adjustment for such gender differences.
Women with Sleep Apnea Have a Higher Degree of Brain Damage than Men
Women suffering from sleep apnea have a higher degree of brain damage than men with the disorder, according to a study conducted by researchers at the UCLA School of Nursing.
The multi-year study, titled “Sex Differences in White Matter Alterations Accompanying Obstructive Sleep Apnea,” looks at patients diagnosed with obstructive sleep apnea. Researchers compared the nerve fibers in these patients’ brains to fibers of individuals without sleep problems and focused on unearthing the difference in brain damage between men and women with sleep apnea.
“This study revealed that, in fact, women are more affected by sleep apnea than are men and that women with obstructive sleep apnea have more severe brain damage than men suffering from a similar condition,” said chief investigator Paul Macey, assistant professor and associate dean of information technology and innovations at the UCLA School of Nursing.
In particular, the study found that women were impacted in the cingulum bundle and the anterior cingulate cortex, areas in the front of the brain involved in decision-making and mood regulation. The women with sleep apnea also showed higher levels of depression and anxiety symptoms.
“What we don’t yet know,” said Macey, “is, did sleep apnea cause the brain damage, did the brain damage lead to the sleep disorders, or did the common comorbidities, such as depression, dementia, or cardiovascular issues, cause the brain damage, which in turn leads to sleep apnea.”
The findings are reported in the December issue of SLEEP
Sleep Apnea Spikes Death Risk
Sleep apnea is associated with an increased risk of death, according to new results from the Wisconsin Sleep Cohort, an 18-year observational study supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health.
Researchers found that adults (ages 30 to 60) with sleep-disordered breathing at the start of the study were two to three times more likely to die from any cause compared to those who did not have sleep-disordered breathing. The risk of death was linked to the severity of sleep-disordered breathing and was not attributable to age, gender, body mass index (an indicator of overweight or obesity), or cardiovascular health status.
The 1,522 study participants included a mix of generally healthy men and women who were between the ages of 30 and 60 years when the research began. Each person was given an overnight sleep test at the beginning of the study, and then each was followed for an average of 13.8 years.
This study is the most comprehensive assessment of mortality risks associated with sleep apnea to date. The researchers note that these findings suggest that treatment of severe sleep-disordered breathing may help protect sufferers from an increased risk of death.
“Sleep-Disordered Breathing and Mortality: Eighteen-Year Follow-Up of the Wisconsin Sleep Cohort,” was published August 1 in the journal Sleep.
Less Sleep Ups Risk of Diabetes and Obesity
A study by researchers at Brigham and Women’s Hospital (BWH) reinforces the finding that too little sleep or sleep patterns that are inconsistent with our body’s “internal biological clock” may lead to increased risk of diabetes and obesity. This finding has been seen in short-term lab studies and when observing human subjects via epidemiological studies. However, unlike epidemiological studies, this new study provides support by examining humans in a controlled lab environment over a prolonged period, and altering the timing of sleep, mimicking shift work or recurrent jet lag.
Researchers hosted 21 healthy participants in a completely controlled environment for nearly 6 weeks. The researchers controlled how many hours of sleep participants got, as well as when they slept, and other factors such as activities and diet. Participants started with getting optimal sleep (approximately 10 hours per night). This was followed by 3 weeks of 5.6 hours of sleep per 24-hour period and with sleep occurring at all times of day and night, thereby simulating the schedule of rotating shift workers. Thus, during this period, there were many days when participants were trying to sleep at unusual times within their internal circadian cycle. The study closed with the participants having 9 nights of recovery sleep at the usual time.
The researchers saw that prolonged sleep restriction with simultaneous circadian disruption decreased the participants’ resting metabolic rate. Moreover, during this period, glucose concentrations in the blood increased after meals, because of poor insulin secretion by the pancreas.
According to the researchers, a decreased resting metabolic rate could translate into a yearly weight gain of over 10 pounds if diet and activity are unchanged. Increased glucose concentration and poor insulin secretion could lead to an increased risk for diabetes.
“We think these results support the findings from studies showing that, in people with a pre-diabetic condition, shift workers who stay awake at night are much more likely to progress to full-on diabetes than day workers,” said Orfeu M. Buxton, PhD, BWH neuroscientist and lead study author. “Since night workers often have a hard time sleeping during the day, they can face both circadian disruption working at night and insufficient sleep during the day. The evidence is clear that getting enough sleep is important for health, and that sleep should be at night for best effect.”
The study was electronically published on April 11, 2012 in Science Translational Medicine.
The oral appliance has changed my life. It allows me to get a restful sleep and has stopped my snoring. It is a lot easier to use than a CPAP.
Dr. P. P. T., MD
When I was diagnosed with severe Sleep Apnea and I was told that I had to wear a CPAP for the rest of my life every time I have to sleep. I was very upset and scared. I started using the CPAP machine but felt uncomfortable all night.
Then, I found Dr. Stern on the internet and decided to see him. He introduced me to this really cool oral appliance that is practically transparent. I was not sure if it would work, however, decided to go for it. I finally returned my CPAP machine!
I have to tell you it is the best thing that has ever happened to me. I sleep much better. Wake up fresh every day. I can toss and turn and walk around with it, if I need to. It fits perfectly over my teeth and is very easy to remove.
I am very thankful to Dr. Stern for changing my life. I will recommend using this oral appliance to anyone who has Sleep Apnea. It will change your life forever!
Thank you Dr. Stern, you are the BEST!
I am extremely satisfied with my sleep apnea appliance. My quality of life has improved tenfold. Thank you for everything.
Yes, I would like to say that the appliance has helped me. I do feel like I have more energy at work. It takes some getting used to. I have turned it up numerous times.
I have had the flu in the last little while and due to coughing did not wear my appliance and I did feel different at work on those days.
Just to mention, my wife says I do not snore when I use the appliance.
Before using an appliance, nearly 3 years ago, I snored loudly. Since I started wearing the appliance nightly, my snoring is negligible.
Finally, a quiet sleep – for my wife! Thanks Dr. Stern.
I have been using my Oral Sleep Appliance for approximately 2 years and I cannot believe the difference it has made to my life.
I am more awake in the morning, meaning not tired, grumpy, and just plain feeling better to face the day.
I make sure that I use my appliance every night because I know the benefit to me and everyone around me. More importantly, I feel so much better each and every day and am so happy that I was able to find this PERFECT solution to help me!!!!!
Thanks to the appliance that I am wearing, I no longer feel tired during the day and sleep better at night.
The appliance has been once of the best decisions I’ve made. I never knew what it was like to wake up feeling rested until now. I perform better at work, my focus is better and I’m more productive in everything I do. I actually enjoy waking up now. Life is better.
I feel better after I have used my Somnodent. My snoring has gone down from a scale of 10 to 3. My wife is happy and I am happy too. My Sleep Apnea is almost gone.
I am pleased to report that my sleep apnea has been significantly reduced by the dental appliance provided by Dr. Stern. I had unsuccessfully used a c-pap device with little improvement and much discomfort.
I can attest to improved sleep, increased energy, and virtual elimination of annoying snoring. Dr. Stern’s dental device is comfortable, effective and very easy to maintain.
I would recommend anyone with sleep apnea issues to visit Dr. Stern for a consultation. He is very knowledgeable, professional and is willing to spend time with patients to answer any questions and explain the device. The staff are also efficient and a pleasure to interact with.
President of Medstar First Aid Services Inc
Several years ago I attended a Sleep Clinic due to my excessive snoring and sluggishness during the day.
As a result I was diagnosed with moderate Sleep Apnea and was referred to Dr. Stern, a
Specialist in Oral Appliances.
I was fitted for an Oral Appliance and during this meticulous process was always kept informed by Dr. Stern and his staff of the steps involved in the fitting of such an Appliance.
After a few weeks I returned to the Dental clinic to receive the finished product at
which time I was briefed on the proper usage of the Oral Appliance.
Since I have had it. I sleep much better, I feel refreshed in the morning and have a lot
more energy during the day.
I highly recommend an Oral Appliance to those of you who are heavy snorers and feel
tired after a full nights sleep.
(Retired Toronto Police, Emergency Task Force)
I have found that the oral appliance has changed my life for the positive. I feel my air passages opening the second I put in my appliance. It has significantly decreased my snoring, but more importantly, I get a great night sleep. Something I haven’t had in many years.
Thanks to Dr. Stern and his great staff.
The oral appliance has improved my life dramatically, I am sleeping much better. I am waking up feeling refreshed. I am not falling asleep in the morning when I am driving to work. I feel endorphins when I exercise. I have proof of increase oxygen intake when I am sleeping (with a second sleep study). I am very grateful that the oral appliance is working. I would highly recommend this for anyone who is suffering from Sleep Apnea.