SleepDent

Please understand that untreated obstructive sleep apnea puts a substantial strain on your heart and cardiovascular system. In fact, many heart problems can be caused or exacerbated by obstructive sleep apnea. Maybe your physicians are trying to improve your situation by removing that strain from your heart. You need to have a discussion with your doctors to see if this is where they are going with their strategy. Arthur B. Luisi, Jr., D.M.D.

I think that it is important to reiterate that feeling less tired is just one of the MANY, MANY benefits of effective treatment of obstructive sleep apnea. Some of them could be: a potentially longer life, less chance of having a nocturnal stroke or heart attack, less chance of having dementia, better cognitive ability, less obesity, less difficulty losing weight, better sex drive, and the list goes on and on. So don't feel that it has failed you just because you still feel more tired than you would like. You are still benefiting in many important ways. Arthur B. Luisi, Jr., D.M.D., The Naples Center for Dental Sleep Medicine. Practice partner, dental sleep medicine, The NCH Healthcare System. Practice partner, dental sleep medicine, The Millenium Physicians Group.

Thank you for the support. Appreciated. Dr. Luisi

I think that you have made a really important point here. At this point we really DON'T know why people can have effective treatment on CPAP according to the objective numbers and yet still don't feel as rested and as well as they would hope to and expect to. This is a really important research topic that should be resolved. On a personal level, I can report something from my practice that might be a sliver of a clue. There have been patients in my practice who have approached me for oral appliance therapy after continuing to feel lousy after long-term successful CPAP treatment. In those cases where the oral appliance controls the OSA well, the patient usually does eventually start to feel well. My personal theory is that, in these cases, the whole CPAP experience was just too intense and draining for those particular patients. I can't give you the particulars of why and how this would happen. I can only tell you that, for the right patients, the oral appliance experience is much gentler and seems to make them feel better. Arthur B. Luisi, jr. D.M.D.

Well, maybe the key to it might be your statement that your first bout with OSA was 20 years ago. It would be helpful to know your present age. The quality of sleep normally degrades somewhat with increasing age. On average, elderly people have worse sleep and more daytime sleepiness than younger people. If you are in the much older age group now, it might be unrealistic to expect the same sizzling results from your younger days. Never-the-less, it would not be good to use this as an excuse either, maybe it might make sense to consult with your family doctor to see if you have any other medical problems making you feel draggy. There are also other sleep problems besides OSA and further exploration with the sleep doctor could also be in order. Arthur B. Luisi, Jr, D.M.D.

Well, in spite of your obviously poor experience with your health care providers, there is good news here. If you have gone from a diagnosed severe sleep apnea with an AHI of 56 to a treatment AHI of 1 to 4, you would now be considered functionally normal as long as you stay on your treatment every day. That means you can rest easy during your sleep with no chance to have a stroke or heart attack according to our best current knowledge. So be happy, be relaxed. You did it. Now just keep up the good work. Arthur B. Luisi, Jr., D.M.D.

I am a dentist working in dental sleep medicine. I will address questions number one and two: 1. As to how long it will take for your body to overcome the sleep deprivation. It depends. Everyone is different. On average, after all your problems are resolved, you might feel A LITTLE BIT better after two weeks. You might feel better still after a month and pretty good after two months. On the other hand, you could continue to feel rotten for one, two, three, four, five, even six months as your body repairs. You never know. Just hang in there. 2. Being only 35, I would expect your cognitive function to improve. I doubt if you are irreversible at this point. Again, the time from will vary from person to person. Arthur B. Luisi, Jr., D.M.D. The Naples Center for Dental Sleep Medicine. Practice partner, dental sleep medicine, NCH Healthcare System. Practice partner, dental sleep medicine, The Millenium Physician Group.

No question about it. You were handled very poorly at the sleep center. It is a wonder that you are as positive as you are after that experience. In the area where I work, such treatment of a patient would be pretty unthinkable.(Well, not exactly. There was one clinic in my area that could have treated patients in that shoddy manner, but it has since closed down.) Painful to read it. Arthur B. Luisi, Jr., D.M.D.

Actually, I don't think that making the choice is that hard. There is an established medical specialty of being board certified in sleep medicine by the AASM. At this point, even for some insurance coverage it is becoming mandatory to have a board certified specialist on board. So start with a certified sleep specialist for your initial diagnosis and testing and THEN consult with ENTs, sleep dentists, D.M.E.s, physical therapists, etc. as the need arises. Very organized, very effective. Arthur B. Luisi, Jr., D.M.D.

Excellent observation. Dr. Luisi