Parker County Today March 2016 | Page 51

our health: SLEEP When It’s Been A Hard Day’s Night Working in tandem, a local doctor and dentist strive to help end fitful and unhealthy sleep. BY MEL W. RHODES S PA R K E R C O U N T Y T O D AY collaborative effort to help treat “the whole patient.” As a dentist involved with sleep therapy, she said part of her job is to know the condition of a patient’s oral airway, to discern whether there may be conditions which could be problematic. If such conditions are discovered, she refers the patient to a sleep doctor. But she often receives referrals from doctors, particularly Dr. Olusegun Oseni of Lung and Sleep Specialists of North Texas in Weatherford, who is board-certified in Internal Medicine, Pulmonary, Critical Care and Sleep Medicine. According to Dr. Oseni, “Because it is still unrecognized and most people do not appreciate the consequences of sleep apnea on their health,” OSA is one of the most undiagnosed and untreated medical conditions of the day. Asked how a typical case might unfold, Dr. Romack replied: “Say a patient realizes they probably do have a problem — they snore; are excessively fatigued; or someone has told them they gasp and choke during sleep — and they go to see Dr. Oseni. He runs them through a sleep test — it could be an overnight sleep test, it could be a home sleep test — and consults with them.” “I prescribe MRDs to patients who have mild-moderate OSA who are unable to tolerate or decline CPAP therapy. It works and has helped a lot of my patient’s symptoms,” said Dr. Oseni. “I like [the] MRD because it is better tolerated and not as overbearing compared to CPAP therapy. CPAP therapy; however, still remains the [preferred] therapy … with patients that have more than MARCH 2016 leep. We spend a third of our lives doing it, but do we realize just how critical a good night’s sleep is to overall well-being? “It’s really crazy how much our sleep impacts our entire body … everything about our body,” said Dr. Deborah Romack, DDS, a local specialist in dental sleep medicine who upon graduating Baylor College of Dentistry in Dallas in 1998 moved to Weatherford and joined Cosmetic Family Dentistry. According to her, sleep disorders cause or contribute to a long litany of ailments, hypertension, heart attacks, even sudden cardiac death. “But there are also direct connections with Obstructive Sleep Apnea (OSA) and memory issues,” she explained. “Forgetfulness. A feeling of fuzziness and not being able to think correctly. There’s a connection with diabetes. There’s actually a connection, believe it or not, with glaucoma ….” Sleep apnea, or temporary cessation of breathing during sleep — lasting at least 10 seconds — long has been treated by the wearing of a CPAP (Continuous Positive Airway Pressure) mask worn by the troubled sleeper at night. Dr. Romack referred to the CPAP as the “gold standard” in OSA therapy, but she is obviously very enthusiastic about a relatively new therapeutic device, an “oral appliance” sometimes called a MRD (Mandibular Repositioning Device) that for many patients makes sleep therapy more convenient, more comfortable. Dr. Romack’s work in the sleep disorder field is actually done in tandem with local sleep doctors — a moderate-severe OSA.” Dr. Oseni explains the condition and various treatments or therapies used to address the problem and, based on knowledge obtained during the sleep tests and resulting consultations, makes recommendations. If patients chose oral appliance therapy, Dr. Romack receives copies of tests, etc., and Dr. Oseni’s prescription for the appliance. She brings the patient in for examination and consultation. Once satisfied he or she is a suitable candidate for the oral appliance, “We go ahead and fabricate the oral appliance,” said Dr. Romack.  To ensure the appliance fits perfectly, she measures the oral airway with Echo Vision (EV). “We take impressions, send it off to the laboratory and about three weeks later, their custom-made oral appliance comes back, and I have them in and seat it in their mouth,” Dr. Romack said.  Over a period of about six months she sees the patient to adjust and further calibrate his or her new oral appliance, fine tunes the fit. Once Dr. Romack feels the person and device are more or less in sync, she refers the patient back to Dr. Oseni who may perform more sleep tests. There are over 120 different oral appliances or MRDs currently being marketed, Dr. Romack said. However, “only a select few” are both FDA-approved and Medicarecleared — and according to her, that’s big. It means the research is there and the devices she uses have undergone rigorous testing. It also means the therapy is more affordable for many people. “I’ve been doing this since 2003,” explained Dr. Romack, “and just recently — over the last two years — have really picked up steam with it. And that is because of the Medicare clearance — Medicare pays for it and medical insurance is helping with the cost as well.” This, she said, includes Tricare military insurance. The oral appliance — designed to help specialists like Drs. Romack and Oseni correct underlying problems associated with sleep apnea — is a two-piece device held together by 49