Author: Michael Kelley

  Obstructive sleep apnea is a serious sleep disorder characterized by pauses in breathing, with repeated stops and starts during sleep. According to the National Health Sleep Awareness Project, at least 25 million adults in the US are afflicted with obstructive sleep apnea, a chronic disease that increases the risk of high blood pressure, heart disease, Type 2 diabetes, stroke, depression, obesity and erectile dysfunction.   “Obstructive sleep apnea [OSA] is effecting the health of millions of Americans, and the patient population is not getting any smaller, “according to Dr. Jose “Joel” De Ocampo, MD medical director at Arrowhead Pro Sleep Center and with double board certification from the American Board of Psychiatry and Neurology and the American Academy of Sleep Medicine.   “The effective treatment of sleep apnea is one of the keys to success as our nation attempts to reduce health care spending and improve chronic disease management.”   Despite the increasing prevalence of OSA, a large majority of patients with this ailment still remain undiagnosed. Arrowhead Pro Sleep, the first Sleep Center of Excellence to be recognized by the Arizona Cardinals, is operating with a brand new model for screening and testing patients.     The goals of Arrowhead Pro Sleep ‘APS’ are to address this need by initiating a screening process for all patients presenting to physicians’ offices, regardless of physician specialty, and to subsequently test and treat all patients who screen positive for OSA.   Working with APS is the Pro Player Health Alliance which was formed so professional athletes suffering from sleep apnea could receive treatment regardless of the players insurance or ability to pay. Derek Kennard [COWBOYS/CARDINALS Center & Guard], co founder of Pro Player Health Alliance ‘PPHA’ was diagnosed with Sleep Apnea and given only one choice of treatment, a CPAP (Continuous Positive Airway Pressure) machine.  After trying his CPAP for a few months Kennard met David Gergen who turned out to be a future co founder of the PPHA.   After conversing for a few minutes and noticing some very dark circles under Kennard’s eyes, Gergen asked Kennard if he was feeling OK.  Kennard followed by saying, “I was just recently diagnosed with Sleep Apnea and the problem is I can’t wear that mask.”  Gergen, who owns Gergen’s Orthodontic Lab, one of the largest manufacturers of dental/sleep appliances in the country informed Kennard that there were other options such as an oral appliance.  Kennard responded with “I will try anything.”  Within one week of this conversation, Kennard was wearing an oral appliance and sleeping through the night.  His Sleep Apnea, which was severe, was completely reduced to    A couple of weeks later, Kennard’s brother who also suffered from sleep apnea, passed away in his sleep with his CPAP sitting on his shelf  (he couldn’t wear “the mask” either).  Kennard called Gergen and told him about his brother saying, “ We can’t sit by and let this keep happening… so many people I know, including many of my brothers from the NFL, are suffering.  We need to help them.”  The PPHA was officially formed the following week.  To date the PPHA is responsible for treatment of over 400 athletes including, icons such as Eric Dickerson [ex LA Rams, Indianapolis Colts Running back] and Roy Green [ex CARDINAL/EAGLES Wide Receiver & Cornerback].     In addition, APS and PPHA hope to increase awareness of treatment options for patients with OSA. “95% of all patients diagnosed with OSA are just given a CPAP as their only option.  “Many patients such as Derek and Eric are simply not able to tolerate a CPAP.  PPHA has done an incredible job of presenting the oral appliance as a great alternative for patients who cannot tolerate CPAP. We at APS are committed to doing the same.”   In addition to his laboratory Gergen is also the CEO for the American Sleep and Breathing Academy.  The Academy puts dentists and physicians together so they can work as a team toward one goal, successful patient treatment.  “For too long the dentists and the oral appliance have been an afterthought in the world of sleep,” said Gergen.  “At the Academy we are opening physicians’ eyes to the success rate of oral appliances.  While CPAP has been the standard for sleep treatment it’s achilles heel is patients don’t use it as much as they should.  There are so many incredible dental practitioners that we know who can help these patients who have been diagnosed and do not know of anything but a CPAP.  Our job at the Academy is to help get these patients treated by letting physicians know that there are other choices available to their patients.  In fact in mild and moderate cases it is the preferred treatment.”   Using the philosophy of mild/moderate OSA patients’, being treated with oral appliances before they ever try a CPAP is one of the new APS programs.  “The program is successful for a few reasons, “Krystal Reynosa, Manager at the sleep center.  “Number one we assist with providing education to both physicians and their patients as to all the possibilities of different sleep treatments.  “Every patient is shown all his or her options.  They are shown demo models of both CPAP and appliances.  They are even given brochures on surgical possibilities, weight loss options, etc.  The sleep physician ultimately recommends which treatment is best for the patient.  By educating the patient and helping with a choice of recommended treatment we have increased the likelihood of patient compliance.”  Number two; we put in a strict follow up protocol where all patients are retested after six months of treatment.  If their treatment is not deemed successful we change the treatment to a different modality.  We keep doing this process until we have exhausted all of the options.  This protocol has led to a documented success rate of over 90%.”     Perhaps the most exciting thing for APS is the ability to work with the NFL’s Arizona Cardinals. “Football players in particular are at risk for sleep apnea a lot of which can be traced to the average neck size of NFL players.  Men whose neck size is 16.5 or larger are more than twice as likely to have sleep apnea as someone with a neck size smaller than 16.5 (for women their neck size should be under 15.)  “Being able to work with athletes such as Roy Green, Eric Dickerson, and Charles Barkley just to name a few is a dream come true for me,” said Reynosa.  To be able to not only work with these incredible athletes but to actually help them become healthy has been an incredible experience for me.  90% of the population who suffer from sleep apnea are not even aware of it, so we are going to work as hard as possible to ensure that screening is being done in as many physician offices across the country as we can.”   Stay tuned throughout the year to hear about the progress of Arrowhead Pro Sleep     http://www.arrowheadprosleep.com/  

Invitation from Mark Brnovich | Speaker at ASBA Sleep and Wellness Conference 2017   My name is Mark Brnovich (pronounced “Burn-O-Vich”), and I am attorney general for the state of Arizona. I’ll be heading to the American Sleep and Breathing Academy’s (ASBA) “Sleep and Wellness” meeting, scheduled for April 21-22 in Phoenix, AZ, and I look forward to seeing you there. You may ask: Why does a government lawyer care about sleep medicine? The answer is that poor sleep affects so many aspects of life, particularly when it comes to highway safety. Whether accidents are caused by public vehicles or private cars, they often lead to legal headaches and human misery. A recent meeting with the CEO of the ASBA, David Gergen, along with the Association’s executive director, Alan Hickey, helped to explain the connection between sleep health, public safety, and my job as a public servant. After conferring with Gergen and Hickey, I’ve decided to make a presentation at the ASBA Meeting. Alberto Gutier, director for the Arizona Governor’s Office of Highway Safety (GOHS), will also be speaking. Officials in Arizona are paying attention to the human toll of poor sleep on the nation’s highways. The job of the GOHS is to develop, promote, and coordinate programs that influence public and private policy by increasing public awareness of highway safety issues. As sleep professionals, you are uniquely qualified to address the sleep component of highway safety. I’ll be at the ASBA Meeting to let you know our thinking on this topic, but I’ll also be there to learn from you. What policies can we put in place to make Arizona’s highways safer? How can these policies be implemented nationwide? These are valid questions, and I look forward to exploring them with you. I recently attended a Bob Dylan concert and as Dylan stood there singing “The Times They are a Changin'”, I realized that he was right back then and hes right today. The times they are a changing – oral appliances have a bright future in the field of sleep medicine. The very next day I put in a disk of one of my favorite bands, The Grateful Dead, and if we are all going to “just keep truckin’ on,” I want Arizona drivers to do it safely. Make sure you register for the Sleep and Wellness conference at http://sleep-conference.com Mark Brnovich | Arizona Attorney General Mark Brnovich is a lawyer and politician from the state of Arizona who currently serves as Attorney General of Arizona. It’s the largest law office in Arizona, with approximately 430 attorneys and over 1,000 employees.

Nearly 17 years ago when I started my sleep journey as an outsider, excited to learn from and be mentored by the grandfather of dental sleep medicine – the late Dr. Ed Spiegel. I attended and eventually helped teach courses that spawned a whole new generation of dental sleep medicine practitioners and watched Dr. Spiegel share truly groundbreaking techniques that were far ahead of their time.   The ripple effect of these programs and the countless lives that have been saved by this teaching is what keeps me going today but we are still not there, not even close. Too many dental offices are blissfully ignorant and even the ones who are doing this could be doing it so much better – this is what drives me to continue honing and sharing this message with others; “Do no harm, learn correct techniques, improve your skills, provide excellent patient care and we can all make a profound difference”.   As someone who has witnessed first-hand the rise and decline of several dental organizations and academies related to sleep medicine, I spoke with American Sleep and Breathing Academy CEO David Gergen about their goals for dentists. He explained that their mission is to make a dent in the sleep universe. This Academy wants to make peoples lives better and grow their dental practices. Instead of just preaching WHY dentists and dental teams need to be involved, the focus is on HOW to actually do it… successfully!. A novel idea that seems to have been missed by other organizations over the years. It is in this regard that I’m pleased to be sharing my small piece of the dental sleep medicine puzzle at the Sleep and Wellness conference, April 21-22 in Phoenix, AZ.   Register at http://sleep-conference.com   John Nadeau     Vice President | Sleep Group Solutions John Nadeau Vice President of Sleep Group Solutions will introduce a process for screening, case presentation and clinical records that enables dental practices to increase case acceptance, reduce time and increase overall treatment efficacy with oral appliances by incorporating real-time objective measurements of airway parameters. This lecture will include a hands-on demonstrations that also incorporates analysis of vertical dimension as an important parameter in determining oral appliance starting position.

The American Sleep and Breathing Academy (ASBA) is pleased to announce two new mini-residencies in dental sleep medicine. With Dr. Jay Gerber on faculty at the University of West Virginia and Dr. Kevin Mueller at Midwestern University in Phoenix, AZ, the ASBA is proud to have expanded elite programs covering the east and west coast.   Each of the mini-residencies’ sessions will be overseen and taught by ASBA diplomates who have a combined experience of over a century treating obstructive sleep apnea patients with oral appliance therapy. The curriculum will be unparalleled featuring hands on sessions, patient perspectives, lectures from the most successful dental sleep experts in the country, case presentations for mild-severe patients, oral appliance selection protocol and how TMD is related to sleep disordered breathing.   Upon completion, the students will understand adult/pediatric obstructive sleep apnea, central apnea, other sleep related disorders, upper airway resistance syndrome, health risks of leaving sleep apnea untreated, treatment of obstructive sleep apnea in a dental office and the ramifications of sleep deprivation. Exclusive online learning material through the American Sleep and Breathing Academy such as webinars, modules and downloadable content will available to students who earn their “Certification of Completion”.   Source: Skylar Faulkner | Public Relations

The U.S. opioid epidemic continues and concurrently, a dramatic increase in prescribed opioid painkillers has increased. Over 2 million Americans struggle with abuse of an opioid pain reliever, and overdose deaths tripled since 1999 according to the American Society of Addiction Medicine (ASAM). Addiction is a pervasive problem afflicting over 21 million people in the U.S. over the age of 12; this is inclusive of addiction to alcohol and illicit drugs, which resulted in approximately 47,000 drug overdoses, according to the 2014 National Survey on Drug Use and Health. Overprescribing opioid painkillers resulted as… To read more of the ASBA Diplomate and Board Member Dr. Elliott Alpher’s Huffington Post Blog, click here.

Dr. David Berg is co-founder and Chairman of the Board of Redirect Health. He helps oversee operations and develops innovative ways to enhance the company’s processes and procedures for identifying the most cost-efficient, high-quality routes for common healthcare needs. After years of operating multi-specialty healthcare practices in Toronto, Canada, Dave relocated to Phoenix and founded Arrowhead Health Centers in 1997. Here, he and his wife, Redirect Health Co-founder Dr. Janice Johnston, put a new healthcare vision to the test. After witnessing evolutions in the industry significantly contributing to rising costs and poorer outcomes, he implemented a new model focused on redirecting resources that were utilized on non-value-adding waste and administration so patients and employers could save time and money. To learn more about Dr. Berg, click here.

The Living Heart Foundation and Pro Player Health Alliance (PPHA), with support from the Professional Athletes Foundation and National Football League Players Association, conducted an NFL retired players overall health screening during the Pro Bowl weekend on January 28, 2017 at the University of Central Florida . Only American Sleep and Breathing Academy (ASBA) dentists were selected as dental sleep experts – Dr. Tara Griffin, Dr. Anthony Scianni, Dr. Zach Holder and Dr. Glenn Macfarlane. “When a player‘s athletic career ends, the level of exercise is reduced dramatically while caloric intake often remains high. This could lead to obesity, along with other serious comorbidities,” said Andre Collins, Executive Director of the Professional Athletes Foundation and NFLPA Director of Former Players. The event was an enormous success that saw over 60 players register and attend. With obstructive sleep apnea being so prevalent among retired NFL players, the dental sleep room was completely filled for the entire duration of the screening which lead to 46 players being found at high risk of having sleep apnea and later being tested for the sleep disorder . Those patients will be referred to and cared for (when medically indicated) by three ASBA dentists in the Orlando and surrounding areas to ensure quality care. Pro Player Health Alliance teamed up with the Living Heart Foundation to provide additional education regarding sleep disorders. The goal of Pro Player Health Alliance is to provide healthy long term solutions for NFL players with sleep disorders and spread awareness together across the nation. David Gergen, President of PPHA, has stated that through Living Heart Foundation and Pro Player Health Alliance, they are looking into expanding the program. For more information on how you can become involved in these screenings contact Pro Player Health Alliance, American Sleep and Breathing Academy or David Gergen directly at 602-478-9713 or via email at gxployer@aol.com.