In this podcast, Dr. Nammy talks about the flaws with traditional sleep apnea solutions. Then, she covers several alternative treatment options including oral appliances and myofunctional therapy.
John Maher: Hi. I am John Maher, and I’m here today with Dr. Nammy Patel, founder of Green Dentistry in San Francisco, California, helping patients recognize the vital connection between dental health and whole body health, and author of the bestselling books, Age With Style: Guides To A Youthful Smile & Healthy Living, and Total Wellness: Understanding the Link Between Your Teeth and Your Health.
Today we’re talking about solutions for sleep apnea. Welcome, Dr. Nammy.
Dr. Nammy Patel: Thank you for having me, John.
Types of Sleep Apnea
John: Sure. Dr. Nammy, what is sleep apnea, and are there different types of sleep apnea?
Dr. Nammy: Absolutely. There are so many types of sleep apnea. Sleep apnea means that your breathing pauses, so you actually stop breathing for a few seconds at a time while you are unconscious in your dream state of sleep.
When we sleep, we go to sleep, but then there’s times when our bodies and our muscles are paralyzed because our body’s focused on healing, and during that time, our breathing is occurring. It should be very autonomic, and sometimes the tongue muscle falls to the back of the throat and it blocks the airway, and that’s what we call sleep apnea.
When the lower part of the airway is blocked and we can’t get air in, that is known as sleep apnea. Now, that’s obstructive sleep apnea, meaning there’s an obstruction in that spot.
There’s also another type of sleep apnea called central nervous system sleep apnea, and that’s a little bit more rare, but that just means that your body does not produce a chemical for you to continue breathing while you’re asleep at night. That is a chemical that is the issue. In obstructive sleep apnea, the actual problem is an obstruction, which is usually the tongue.
Drawbacks to Traditional Sleep Apnea Treatments
John: Okay. And so what are some of the traditional methods for treating sleep apnea, and what are the drawbacks of those methods?
Dr. Nammy: When we look at the sympathetic nervous system, which is your rest and digest nervous system, and we look at your autonomic nervous system, which is kind of on autopilot, the number one thing for central sleep apnea, it’s a chemical, so there has to be a pill that’s going to solve the problem. Nothing else will solve the problem.
And the second, for an obstruction sleep apnea, the majority of the time, it’s a CPAP, so it’s a continuous positive pressure. And what that continuous positive pressure does is allows air to be forced through the nose or the back of his throat and down.
Now, the problem with that is, a lot of times, when the obstruction is in the mouth, it doesn’t matter if you force air up through the nose. The tongue still falls back and you’re not really getting the quality that you really need, so CPAPs are not my favorites.
Problems Caused by CPAP Machines
John: And why is that? What kind of problems can CPAPs cause?
Dr. Nammy: Number one, it’s very uncomfortable. It is very uncomfortable to wear a mask. It also forces pressure to go down the nose. Your sinuses get really dry, and it’s just plain uncomfortable. And it has a lot of disruption because there’s these headbands that you have to secure the mask with. The mask sometimes leaks, and makes you feel claustrophobic, and it really disrupts your sleep more than… It actually hurts more than it actually helps for many patients, and that’s why they come to me, and they want to seek out treatments.
Daytime-Nighttime Appliance for Sleep Apnea
John: Okay. So what is the DNA appliance, and how does that address sleep apnea?
Dr. Nammy: The DNA appliance is a daytime-nighttime appliance, is what it’s called, and how does it address sleep apnea? Now, one of the things we said earlier is that obstructive sleep apnea means there’s not enough space for the tongue, so the tongue falls back.
And so, the DNA appliance actually helps activate the stem cells in the palate and the lower arches to create more space for the tongue, so it can create that suction that it actually needs so you have a patent or an open airway.
Vivos Therapeutics for Sleep Apnea
John: And then there’s another solution called Vivos therapeutics. What is that? What solutions does it offer? Is it different from the DNA appliance?
Dr. Nammy: Actually, Vivos owns the DNA appliance. Vivos is a big company that has multiple appliances for sleep apnea. There’s not only the DNA appliance. There’s the mmRNA, there’s a Versa. There’s a lot of different types of appliances that are available for patients if they have sleep apnea, and we have to diagnose where the problem is.
A lot of times, patients have sleep apnea because their sinuses are congested. Sometimes people have sleep apnea because their tongue falls back, or they have a combination of both of them, and so there’s different appliances to be able to help with getting to the root cause of why they have the apnea, and so that patients can get better breathing and in health and wellness.
mmRNA Oral Appliances for Sleep Apnea
John: Do you want to talk a little bit more about any of those other types of appliances? You mentioned the mmRNA one?
Dr. Nammy: The mmRNA is just like the DNA. It actually makes space, actually expands the arches, except it has a device that pulls the jaw forward as well, and that allows for the… It’s also very thin. It’s more comfortable, and it ensures that your tongue is positioned forward, so you don’t have sleep apnea while you are sleeping.
Earlier I said the CPAP is the number-one gold method for sleep apnea. Now the mmRNA is also FDA-approved. There’s also the Versa. There’s a lot of different products that are FDA-approved as appliances to be able to help with sleep apnea, and it’s mainly because the masks are really uncomfortable, the CPAPs are really uncomfortable. So, the FDA has approved a lot of oral appliances that will help patients with sleep apnea get the rest that they really need.
Other Alternative Treatments for Sleep Apnea
John: Are there any other alternative methods or therapies that might help to address sleep apnea besides these types of appliances?
Dr. Nammy: Absolutely, absolutely. This is exciting, exciting stuff to talk about. There’s myofunctional therapy, so training the tongue to be in the proper place. There’s also devices that you can put into the mouth. I’m not a big fan of those because it’s a foreign object that’s in your mouth, or like an electrode that stimulates the tongue while you’re sleeping. I really don’t want a cell phone in my throat while I’m sleeping, so definitely not my favorite.
But myofunctional therapy is really wonderful, and training the tongue to become stronger. The truth of the matter is, all of us, as we get older, are going to have some form of sleep apnea because all of our muscles start losing the collagen fibers, which cause them to be a little loose. And at some point, mostly everyone, 80% to 90% of the population, ends up getting sleep apnea. What we can do is if we can strengthen that tongue, just like we do with the rest of our muscles in our body, it can dramatically decrease sleep apnea, which I’m a really big fan of.
Using Multiple Modalities to Treat Sleep Apnea
John: And can you combine different methods or treatments for sleep apnea? For example, could you do a DNA appliance, but then also do one of these alternative therapies as well?
Dr. Nammy: Absolutely. Absolutely. That’s actually what makes therapy so comfortable in my practice is I combine several modalities together. And when I combine several modalities together, it’s really wonderful, because a patient is able to learn about what the problem is, where their issues are, and how they can improve it. Really, my goal is that each person is empowered for a lifetime, that they’re independent of me and really taking best care of themselves so that they can cure themselves of sleep apnea, and have a long, healthy life.
How to Select the Right Treatment
John: And it sounds like there’s a lot of different methods, different devices that you can use. How do you determine what treatment method makes the most sense for each patient?
Dr. Nammy: In my practice, I like to do several tests, and the first test I do is a sleep study. Second is posture analysis. I do an exam of the mouth. We also do a CT scan where we analyze the sinuses, the back of the throat, the tongue space, and also the TMJ.
All of that combined together is how I decide which treatment I’m going to provide for the patient and for how long. I also like to add supplements. I have a functional medicine background, so I really enjoy adding different supplements, and making the process a lot easier and more comfortable and long-lasting, which is the most important for me.
Contact Green Dentistry for Sleep Apnea Treatments
John: All right. Well, that’s really great information, Dr. Nammy. Thanks again for speaking with me today.
Dr. Nammy: My pleasure.
John: And for more information about Green Dentistry, visit the website at sfgreendentist.com, or call 415-433-0119.