All Press Releases for July 15, 2010

Rockford, Illinois Sleep Apnea Treatment: I Hate CPAP! Offers Comfortable Alternatives to CPAP. Dental Sleep Medicine and Oral Appliances can Improve Your Sleep and Improve Your Life!

Sleep Apnea is a serious medical condition that can lead to heart attacks, strokes, endocrine problems and worsen diabetes. CPAP, the standard treatment is abandoned by 60% of all patients. I HATE CPAP! offers a more comfortable alternative.

    ROCKFORD, IL, July 15, 2010 /24-7PressRelease/ -- Waking up feeling well rested and ready and excited to meet a new day is a wonderful feeling. Unfortunately, patients with snoring, sleep apnea, upper airway resistance, insomnia and numerous other sleep disorders rarely experience this.

Loud snoring not only is a major sign of sleep apnea but also disrupts the sleep of your partner. Do not foolishly ignore loud or disruptive snoring - it may be a warning sign of this serious and dangerous disorder that can cost you your health or even your life!

Learn more about the dangers of sleep apnea at

Sleep apnea is defined by repetitive episodes where breathing stops causes an arousal from sleep and then the cycle starts again. It is common for patients with sleep apnea to deny they have a problem. This is often observed by the bed partner who sees pauses in breathing followed by gasping for breath.

CPAP, the standard medical treatment for sleep apnea, is one of the greatest success stories in medicine. It can be effective in treating almost every patient with obstructive sleep apnea, snoring, hypopnea and upper airway resistance.

CPAP is also one of the greatest failures in medicine not because it isn't effective but because it is not used. The failure to utilize an effective medical treatment is called non-compliance. Non-compliance is the typical result when CPAP is prescribed. Medicare has recently taken a serious look at the costs of CPAP to the taxpayers and realized that there was a poor return on investment. It is for this reason that Medicare will no longer pay for CPAP that is not used at least four days a week for four hours a night. This is an incredibly low standard for usage but the savings to Medicare will be enormous.

Medicare is dead wrong! The real savings for Medicare comes from decreased medical expenses for strokes, heart attacks, diabetes, Alzheimer's, dementia and numerous other disorders that are improved when apnea is well treated. Even poor treatment is better than no treatment. Of course, treatment that is used all night every night is ideal and only one in four CPAP users achieve that goal. Oral appliances ( are much better tolerated by patients who usually report using them all night long.

A recent study showed that 60% of patients abandon CPAP treatment completely. That means only 4 in 10 patients use their CPAP machines. Even patients who do use their CPAP machines average only 4-5 hours of nightly use, not the recommended 7 1/2 hours. One in four utilize it all night so the rest of patients have only minimal actual usage.

I believe that Medicare and patients with sleep apnea would be much better served if Medicare paid for CPAP based on the percentage of time it was actually used. 100% usage would be 7 hours a night, 7 days a week. The actual time CPAP was used in the first full year of treatment could then be used to determine Medicare payments - i.e. 50% usage would receive 50% payment.

The reason most patients give for not wearing their CPAP is that they "hate CPAP". They hate the CPAP mask, they hate the noise, they hate the hose. I HATE CPAP! LLC and the website took its name from the passion of these patients. Why is such a successful treatment such a phenomenal failure? CPAP is not a failure but it does fail the majority of patients. It is still a $4 1/2 billion a year industry. Approximately 25% of patients love CPAP from the first time they use it and they use it faithfully forever. I HATE CPAP! was founded by Dr Ira L Shapira, a Chicago dentist and a Diplomate of the American Board of Dental Sleep (D, ABDSM). He is a charter member of the Sleep Disorder Dental Society (SDDS), which evolved into the American Academy of Dental Sleep Medicine (AADSM). He is a founding member of DOSA, The Dental Organization of Sleep Medicine and a member of the Academy of Dental Sleep Medicine.

Patients who love CPAP from the start are the exception. Studies have also shown that patients who do embrace CPAP treatment early on rarely become successful CPAP users in the future.

Oral appliances are very well accepted by patients who love both the comfort and convenience but are most pleased to not have to deal with masks, hoses compressors, humidifiers, noise air leaks and other annoyances associated with CPAP. 95% of patients offered a choice between CPAP and Oral Appliance Therapy chose the oral appliances. In countries like Sweden where the national health insurance offers patients their choice of treatment, oral appliances are the primary treatment modality. Only a small percentage of patients chose CPAP when offered a choice.

Oral appliances and CPAP are both considered first line approaches for treating sleep apnea by the American Academy of Sleep Medicine and the American Academy of Dental Sleep Medicine. CPAP is still considered the only first line therapy for severe obstructive sleep apnea but studies have shown that Oral Appliances can also treat many cases severe sleep apnea very successfully. The American Academy of Sleep Medicine recognizes Oral Appliances as an alternative to CPAP for severe sleep apnea when patients do not tolerate CPAP.

The National Sleep Foundation has declared that "oral appliances are a therapy whose time has come".

CPAP will probably always be the primary first line treatment for the morbidly obese patients and with patients who have obesity-hypoventilation syndrome.

The reason is based on the different ways the CPAP and oral appliances use to treat sleep apnea. First you must understand what actually happens during snoring and sleep apnea. The easiest way to understand this condition is to use Dr Shapira's garden hose analogy. Normal breathing is like a garden hose where a lot of water passes with very little disruption. Simple snoring would be like placing your thumb over the hose to water your garden. There is now a lot of disruption to the flow but the total amount of water flowing is the same. When breathing this disruption would be loud snoring.

Obstructive apnea would be like kinking the hose so no air passes. Apnea could then be described as suffocation followed by awakening from sleep and then gasping for life-saving air. The apnea index is how many times you suffocate and then awaken to gasp for air per hour. This repetitive awakening and gasping for air is extremely stressful for the heart and creates an underlying stress disorder as it creates continual stimulation of a fight for your life scenario that creates stress hormone release.

Hypopnea is a partial apnea. It can be described as almost suffocation and there is at least a 4% drop in oxygen levels. It is more annoying to the bedmate as you can snore very loudly with hypopnea but it still leads to a gasp.

Upper Airway Resistance Syndrome (UARS) or Respiratory Effort Related Arousals are when it is hard to breathe and disturbs the patient's sleep but the event does not meet the criteria definition of apnea or hypopnea.

CPAP works by stenting the airway with air pressure much the way some "buildings" are held up by blowing air. Oral appliances work by bringing the airway forward which increases the size of the airway. In severe obesity the large amount of fatty tissue surrounding the airway may not be stented or opened by an oral appliance but CPAP can be turned up to a very high pressure to blow past the obstruction. The actual airway collapse is not merely passive but rather inspiration creates a negative pressure or vacumn that causes the airway to suck closed. While oral appliances alone may not be successful in treating the morbidly obese they will allow CPAP to be successful at much lower pressures.

The TAP appliance (Thorton Adjustable Positioner) is leading the field of Dental Sleep Medicine in creating combination therapy that improves compliance and efficacy of CPAP by combining CPAP and integrated Oral Appliances. The TAP 1 appliance is one probable the most successful appliance in treating severe sleep apnea due to the handle that allows advancement of the jaw after the appliance is in the mouth. The TAP 3 appliance can now be fitted with a similar handle. The TAP 3 is also ideally suited for combination therapy with a TAP-PAP combination.

If patients are comfortable utilizing full face masks than any dental oral appliance can be used in combination with CPAP. The Somnodent Appliance by Somnomed is one of the most comfortable appliances available. The SUAD Appliance by Strong Dental is one of the most robust appliances for patients with severe bruxism. The Myerson EMA appliance is a very comfortable and compact appliance.

Dr Ira L Shapira has been treating patients with sleep apnea with oral appliances for over 28 years and stresses how important it is that practitioners be familiar with a wide variety of oral appliances. Many courses are taught by appliance manufacturers but patients may suffer if the doctor only has a single appliance he is familiar with using. Dr Shapira teaches an in depth course to small groups (six or less) dentists and their teams to insure that each doctor thoroughly understands the numerous intricacies of both sleep medicine and dental sleep medicine. To insure that his doctors provide the highest level of service and quality he works with each doctor on a monthly basis to solve problems and help interpret sleep studies. He limits his class to six new doctors to insure that learning is personalized and that there is sufficient time for follow-up consultations. Many of the doctors Dr Shapira have mentored have seen dental sleep medicine become a major percentage of their practice.

Dr Bill Blatchford is the leading dental practice management consultant in the United States and he regularly refers his clients to Dr Shapira because he has seen such positive changes in the practices of dentists who have had this training. Dr Shapira lectured on sleep apnea and dental sleep medicine at a "Purple Cow" seminar that Dr Blatchford presented several years ago. Hundreds and hundreds of dentists have viewed his lecture on DVD and become involved in the treatment of sleep apnea and snoring as a result.

The individual small group learning experience and long term follow-up is key to striving for excellence in Dental Sleep Medicine. In the 1990s Dr Shapira was a frequent lecturer at the American Academy of Anti-Aging Medicine (A4M) and a lecture he gave in 1998 on Anti-Aging Dentistry was printed as a chapter in a medical textbook on Anti-Aging Medicine.

Dr Shapira was one of the first dentists to lecture to physicians on the oral health connections of gum disease and overall health and on Dental Sleep Medicine. He also has a passion for the treatment, prevention and elimination of migraines and headaches utilizing Neuromuscular Dentistry. His research as a Visiting Assistant Professor at Rush Medical Schools Sleep Disorder Center in the 1980s showed hat there were numerous similarities between male sleep apnea patients and female patients with TMJ disorders, Chronic Pain and Fibromyalgia. The National Heart Lung and Blood Institute later issued a report "The Cardiovascular and Sleep-Related Consequences of Temporomandibular (TMJ) Disorders".

I Hate Headaches LLC is a new company created by Dr Shapira and Page 1 Solutions to expose the public to neuromuscular dentistry and the unique role it plays in treating and eliminating chronic headaches and migraines. The website is a leading resource for information on headaches and TMJ disorders and the value of neuromuscular dentistry in alleviating these problems and improving the quality of patients' lives.

Patients that live in the Chicago or Milwaukee metropolitan areas or anywhere in Northern Illinois or Southern Wisconsin can contact Dr Shapira at his office.

Call Today: 1-8- NO-PAP-MASK or 1-800-TM-JOINT or contact Dr. Shapira through his websites:

Dr. Shapira is currently searching for a New York qualified sleep apnea dentists to join his I Hate CPAP program and neuromuscular dentists to join his I Hate Headaches program.

Dr Ira L Shapira is an author and section editor of Sleep and Health Journal, President of I HATE CPAP LLC, President Dato-TECH, and has a Dental Practice with his partner Dr Mark Amidei. He has recently formed Chicagoland Dental Sleep Medicine Associates. He is a Regent of ICCMO and its representative to the TMD Alliance. He was a founding and certified member of the Sleep Disorder Dental Society which became the American Academy of Dental Sleep Medicine, a founding member of DOSA the Dental Organization for Sleep Apnea. He is a Diplomate of the American Board of Dental Sleep Medicine, a Diplomat of the American Academy of Pain Management, a graduate of LVI. He is a former assistant professor at Rush Medical School's Sleep Service where he worked with Dr Rosalind Cartwright who is a founder of Sleep Medicine and Dental Sleep Medicine. Dr Shapira is a consultant to numerous sleep centers and teaches courses in Dental Sleep Medicine in his office to doctors from around the U.S. He is the Founder of I Hate CPAP LLC and Dr Shapira also holds several patents on methods and devices for the prophylactic minimally invasive early removal of wisdom teeth and collection of bone marrow and stem cells. Dr Shapira is a licensed general dentist in Illinois and Wisconsin.

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Ira Shapira
Sleep and Health Journal
Gurnee, Illinois
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