HIGHLAND PARK, IL, October 21, 2014 /24-7PressRelease/ —
Better sleep – better health is the slogan of Sleep Well Illinois. Identifying and treating all undiagnosed sleep apnea patients is a game changer in health care management.
HIGHLAND PARK, IL, October 21, 2014 /24-7PressRelease/ — Sleep Apnea is now out of the closet and the medical community and the public is becoming increasing aware of the warning signs and dangers of this disorder. Unfortunately, in spite of this knowledge 90% of patients with sleep-disordered breathing remain undiagnosed.
Spouses of patients with sleep apnea are very familiar with the primary warning sign, loud snoring. Even spouses of snorers lose 15% of their sleep according to a Mayo Clinic Study. A recent study showed better outcomes when all patients were evaluated for sleep apnea prior to surgery. Research at Rush Medical School in Chicago by Dr Rosalind Cartwright showed that snoring and sleep apnea levels correlated with increased divorce rates.
There is probably no easier method of reducing health care costs than universal screening and testing of patients for sleep apnea. There is a 600- 900% increase in heart attacks and strokes in patients with untreated sleep apnea. It is associated with hypertension, diabetes, and endocrine problems including thyroid levels, insulin resistance, sex hormones, cortisol levels, growth hormone levels and metabolic problems.
Patients with untreated sleep apnea experience more cognitive problems, short -term memory loss and are prone to more rapid onset of dementia and Alzheimer’s disease. Between 80-95% of patients with ADD and ADHD have sleep apnea and many early behavioral disorders are associated with poor sleep. Early diagnosis and treatment could drastically improve their lives and eliminate or decrease the numbers of children with these problems. Treatment prior to age 7 is extremely important but the earlier treatment is instituted the better for the child.
The last few years of changes in medical reimbursement have been particularly hard on physician’s incomes forcing them to see greater numbers of patients on a daily basis to maintain their income levels with many offices seeing decreasing income occurring on an ongoing basis.
These changes are ushering in a new era of corporate medicine where large hospital groups are buying out independent practices and changing the face of medicine in the United States.
While there can be enormous benefits associated with the advent of corporate control of medicine there are also inevitable changes in how care is delivered. Physicians have less and less time with their patients.
There are also many physicians who do not want to be employed by large hospital groups. Physicians have always been entrepreneurs and that has led to many of the advances in modern medicine. New ideas do not come from systems that keep down costs but from independent doctors and researchers finding new ways to improve the health of their patients. Corporate medicine by its nature is more homogenized.
There are numerous fields in medicine where there has been resistance to the corporate model. Concierge medicine has been romanticized on TV shows and movies. When you talk to patients who work with concierge doctors they often sing their praises. The secret is their increased income allows them to spend more time with each patient.
Sleep Medicine was a field of medicine populated by physicians seeking to drastically improve the lives and health of their patients. Drastic cuts in insurance reimbursements have hurt independent sleep centers as well as hospital based sleep centers.
There are some Independent Sleep Medicine groups that are doing extremely well and enjoying increasing incomes, exceeding most of the independent physicians that refer to them. This is especially true of practices that have their own DME’s or durable medical equipment companies. The majority of sleep apnea patients are still undiagnosed under the current paradigm.
Sleep Well Illinois is changing the face of sleep medicine in Illinois. New technology allows home sleep testing of sleep apnea without the problems associated with spending the night in a sleep lab. The new model encourages physicians to institute a universal screening protocol within their offices with no capital outlay or financial risk. This is a model that works extremely well for independent practitioners and for large corporate hospital groups.
These programs will bring in substantial revenues to medical practices and will follow the best guidelines of The American Academy of Sleep Medicine. This program will not do sleep tests on all patients but rather do a screening questionnaire on all patients and only test those patients who are at risk. All home sleep studies are scored and reports written by Diplomate of the American Board of Sleep Medicine who practice medicine in Illinois. Local Illinois Sleep Specialists are an essential element in creating a health based evaluation and treatment system.
Cardiologists will probably see the greatest percentage of patients who should have sleep studies. A recent test day in a Lake County, Illinois cardiology office showed 87.5 % of patients should be tested. Nationally, it is expected that approximately 60-65 % of patients in cardiology offices should have sleep studies. The screening form that Sleep Well Illinois utilizes is the Weisfogel Sleep Screener that utilizes the Epworth Sleepiness Scale and various cardiovascular risk factors as well as the presence of snoring or witnessed sleep apnea. Dr Weisfogel was the nations first Board Certified Cardiologist to be Boarded in Sleep Medicine.
Early screening of cardiovascular patients will drastically reduce the number of Emergency Room visits and should increase hospital revenues by drastically reducing hospital readmissions. Patients with untreated sleep apnea are more likely to have heart attacks and strokes in their sleep then when exercising. There is a tremendous strain on the cardiovascular system during apneic events.
Each time a patient has an obstructive apnea episode the airway collapses and a period of suffocation or asphyxiation occurs, leading to a drop in oxygen of at least 4% and possibly as high as 30, 40 or even 50%. During the beginning of the apnea episode the heart rate slows down (Bradycardia) when the carbon dioxide level becomes too high an alarm goes off in the brain (wake up dummy or you will die) and there is an arousal (EEG) and the patient gasps for breath setting of a sympathetic rush (physiologic panic attack) and accompanying tachycardia (rapid heart rate). This may also be accompanied by arrhythmia or A-fib. This may happen 5-15 times an hour and be considered mild sleep apnea, 15 – 30 times an hour or as often as every two minutes and be considered moderate sleep apnea or it can be severe and happen 30 or more time an hour sometime over 100 time an hour. A new study that was just published shows increased risk of A-Fib n patients undergoing Bypass surgery in patients with sleep apnea.
Obstructive Sleep Apnea as a Predictor of Post Coronary Artery Bypass Graft Atrial Fibrillation: A Systematic Review and Meta-analysis
Qaddoura, Amro et al.
Canadian Journal of Cardiology
Published Online: October 14, 2014
There is an adverse effect on every body system when sleep apnea is present. The frequency of events and amount of oxygen desaturation are two of the ways severity is evaluated. EDS or excessive daytime sleepiness, loss of short-term memory or other measures, can also test it. Patients with untreated sleep apnea have slower reaction times than patients who are legally drunk.
Internal Medicine, Family and General practice physicians will see smaller percentages of patients requiring Home Sleep Tests. Surprisingly 40 % of internal medicine patients doing the screening questionnaire require further testing. Endocrinology patients and patients in pain management programs are also expected to benefit greatly from sleep screening programs decreasing pain and making management easier.
Weight loss physicians and sleep medicine doctors are also natural partners because increasing weight worsens sleep apnea and patients with sleep apnea have lower metabolic rates and difficulty losing weight. The levels of cortisol, growth hormone and thyroid hormone are largely determined in sleep and affect the metabolic rate as well as Leptin the hormone that turns off appetite.
Sleep Well Illinois is a new company bringing this program to Illinois patients and physicians however thousands of offices on the east coast have already implemented these programs. Founded by Ira L Shapira DDS, D,ABDSM, D,AAPM, FICCMO. Dr Shapira insists that patients diagnosed with mild to moderate sleep apnea are treated according to AASM guidelines and are offered referrals for comfortable oral appliances or CPAP therapy. Patients with severe sleep apnea are referred to Board Certified Sleep Physicians for CPAP titration. CPAP is still considered the Gold Standard for severe sleep apnea but up to 60% of patients do not tolerate CPAP treatment. Oral Appliance therapy has been shown to be an effective alternative to CPAP in an 88 month outcome study of cardiac patients due to higher utilization rates compared with CPAP.
Illinois Physicians Board Certified in Sleep and Diplomats of the AASM read all sleep studies.
Dr Ira Shapira a Highland Park, Illinois resident and a general dentist with offices in Highland Park and Gurnee has been involved deeply involved in Sleep Medicine since 1982 due to his expertise in treating TMJ disorders and chronic pain. Dr Jim Garry who invented the NUK pacifier, which was designed originally as an exerciser to grow larger airways in children who were not breast-fed, trained him.
His interest intensified when he recognized that his 3-year-old son Billy has sleep apnea. He discussed this with his pediatrician and an ENT who thought his snoring & disrupted sleep and nighttime sweating were not a problem. When Billy was 5 years old he was told that he had ADHD, needed to be on Ritalin and could not start Kindergarten.
At this point Dr Shapira had enough, and went straight to the Sleep Center at Rush Medical School and a sleep study was done. His son had severe sleep apnea. His tonsils were removed (adenoids were not a problem) and he had orthodontic widening to increase his airway. He went from a 50% growth curve to a 90% growth curve immediately, had more restful nights, stopped snoring and lost weight. He eventually graduated college Magna Cum Laude, Double Major Double Minor: DRUG OF CHOICE: OXYGEN AND GOOD SLEEP…NOT RITALIN.
Dr Shapira immediately changed the focus of his practice and interests. He became a Visiting Assistant Professor at Rush Medical School under Dr Rosalind Cartwright one of the top minds in the world of sleep medicine and the mother of Dental Sleep Medicine.
His research in the 1980’s concerned the jaw position of sleep apnea patients (primarily old fat males in the early days) as measured by Neuromuscular Dentistry and he found that they had similar jaw positions to female TMJ and headache patients. In 2001 the National Heart Lung and Blood Institute published a report “The Cardiovascular and Sleep Related Consequences of TMJ Disorders” Dr Shapira was one of 20 founding members of the Sleep Disorder Dental Society which later became the American Academy of Dental Sleep Medicine, He was a charter member of DOSA, the Dental Organization for Sleep Apnea. He is a Diplomate of the American Board of Dental Sleep Medicine and of the American Academy of Pain Management
Dr Shapira left Rush in 1991 when his wife was diagnosed with breast cancer and his family needed him. He returned to Rush as an Asst Professor in the late 1990’s when invited by Dr Cartwright to treat patients utilizing oral appliances. He left in 2001 when his wife Elise was diagnosed with ovarian cancer. He founded Chicagoland Dental Sleep Medicine Associates dedicated to finding comfortable treatment alternatives to CPAP and founded the websites www.ihatecpap.com that is widely credited for bringing Dental Sleep Medicine to the mainstream publics attention. He also served as a board member of The Illinois Sleep Society and was involved in setting up the first ever Illinois Sleep Society educational meeting. Dr Shapira does not hate CPAP but named his site for the most common complaint he heard from CPAP users (non-users) “I HATE CPAP!”
While the program is up and running and putting sleep programs into physician offices the offices of Sleep Well Illinois are still under construction as is the website. Dr Shapira is currently running the business in his Highland Park residence and welcomes inquiries. Please call his Gurnee Dental office Delany Dental Care at 847-623-5530 to set up an appointment (phone or office with Dr Shapira) or email him at [email protected]
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 formed Chicagoland Dental Sleep Medicine Associates. He is a Regent and Secretary 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 http://www.ihatecpap.com and of I HATE HEADACHES http://www.ihateheadaches.org. 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. He is currently working with researchers at the University of Illinois and will soon be working with Baylor in Texas. Dr Shapira is a licensed general dentist in Illinois and Wisconsin.