October 2018
Spotlight of the Month
Dr. Roger W. Roubal, DDS
Advanced Dental Sleep Treatment Center, NE
Dr. Roubal’s career has evolved from general dentist to cosmetic dentist to TMD/Sleep, and he is now solely dedicated to sleep. Beginning with his first dental sleep course in 1988 and now being as credentialed as one can be, Dr. Roubal has successfully treated thousands of patients and continues to love to see the difference healthy sleep makes in his patients’ lives.
Favorite Success Stories:
- • I had a young patient come in for her first exam telling me that she had just graduated college, was accepted to law school, and deferred her acceptance because she was so tired she couldn’t stay awake; she was afraid she would fail law school. She is about 5’6” and 125 lb., tried and failed CPAP, and was on legal amphetamines to help her stay awake. Her AHI was under 5, but her RDI was around 30. We fit her with an oral appliance and 3 weeks later she came in so we could see how she was doing. She greeted me with “Doctor, I’m going to law school”.
Tips for Treating Patients:
- • Look at diagnostic sleep study results with caution. I see many initial studies that are under-reporting the true level of apnea.
- • Don’t base clinical judgments on what the patient tells you. I have patients tell me they are not feeling well and our HST’s show no apnea, and vice versa. Also remember that snoring is not reliable in terms of judging OSA severity or presence or absence of OSA. Objective measurement is critical.
- • If a patient complains of snoring with an oral appliance, have them experiment with taping their lips during sleep to see if that changes it. If this doesn’t help, continue with the taping and add Breathe Right Strips or nasal inserts. This will help determine if the nose is the problem.
Not all diagnosed dementia patients truly have dementia. I had an 80-year- old man come into my office who was non-communicative, diagnosed with dementia, and I came to find out that he had an AHI of 66. He failed CPAP because he wouldn’t leave it on his face. I made him an oral appliance and much to my surprise he left it in. He came in 3 weeks later for a sleep check and I had a “normal” conversation with him! He told me he was driving and playing golf again – things he had stopped doing previously. His wife turned to me and said “you gave me back my husband”. We checked his results and he is now at an AHI of 6.6 and years later is still doing great.
Dr. Roger Roubal, DDS
Featured Course
How Breathing Affects Your Sleep
With Patrick McKeown
Sleep impacts every aspect of life. When it becomes interrupted, at a certain point, the body begins to fail. Without proper airflow, sleep cannot be continuous and deep. Which is why acting now to improve your patient’s airway capacity is so important.
Patrick McKeown is renowned for his work to intercept bad breathing habits in children so that they will grow up with the best possible chance for success. Here, he imparts his knowledge, which is as invaluable to the adults as it is to the youth.
Featured Webinar
Bridging the Gap Between Patient Diagnosis & Treatment
Presented by Ryan C. Javanbakht
Join us with Ryan C. Javanbakht to learn more about sleep apnea – the epidemic, and how to effectively overcome obstacles that stand in the way of patient diagnosis.
Webinar topics will cover:
Sleep Apnea: The Epidemic • Getting Patients to say Yes to Sleep Test • Sleep Testing Models: Pros & Cons • Simplified Sleep Test & Diagnostic Solution
Bring Your Questions!
Wednesday, October 10th
at 5 PM PST/ 8 PM EST.
Why am I So Tired All the Time, Even After a Full Night’s Sleep?
Too much sleep can be just as bad as too little sleep.
It’s best to wake in-between deep sleep cycles rather than in the middle of one. Waking in the middle of REM can lead you to feeling groggy during the day. If you wake during non-REM you’re more likely to feel alert and attentive as the day progresses.
Try this 7.5 hours sleep duration for 3 days. If you find yourself waking about 10 minutes before your alarm goes off, you’ve found your perfect bedtime. If however you’re still relying on your alarm clock to wake you up, try moving your bedtime back 15 minutes every 3 days until you find yourself waking just a few minutes before your alarm goes off.
Read the full article to find out how to practice better sleep habits, which foods to avoid to improve your sleep and which healthy choices can increase the quality of your sleep.