Newspaper: SUN PUBLICATIONS

Date: 02/06/2004

Day of Week: Friday

Edition: NAPERVILLE SUN

Page: 30

Headline: Oral fix; Dental appliances offer relief to sleep apnea sufferers

Byline: Ann Piccininni

Credit: STAFF WRITER

PhotoBy: Chuck Cass / Staff photographer

Caption: Mary Ellen Hughes, a dental health educator at Sherman Oaks Dental in Naperville, models a custom oral appliance for the treatment of sleep apnea. The appliance is worn like a retainer while the patient sleeps. Dentist Lydia Sosenko offers this and many other appliances to patients who suffer from sleep apnea.

Title: Business

Notes: Also in BS, p60. In DG, 2/12/2004, p20.In WS & GE, 2/13/2004.

The quest for uninterrupted sleep took Charles Eccher to Aurora, then Minnesota and, finally, to Naperville.

It was in Dr. Lydia Sosenko's dental office that he found relief.

"I've tried everything else," said the Sugar Grove resident, who was diagnosed with sleep apnea three or four years ago.

Apnea is a condition wherein patients' breathing stops or pauses during sleep when the airway becomes blocked, wreaking havoc with sleep cycles.

Sosenko was able to prescribe and fit him with a specially designed dental appliance that pulls the jaw forward, thereby moving tissue out of the airway and allowing continuous sleep.

Before Eccher saw Sosenko, he sought help in a medical clinic, where he underwent sleep studies.

"Then I went up to the Mayo Clinic. They fitted me with a CPAP machine," he said.

Patients with any degree of apnea can benefit from the Continuous Positive Airway Pressure, or CPAP, machine. The device looks like a hose that is strapped over the nose and is connected to a pump that delivers pressurized air to the patient.

"CPAP is still the gold standard of care," Sosenko said.

She said the CPAP can be used in combination with dental appliances. In some patients, surgery is indicated, while in other cases, appliances can be used alone, she said.

In Eccher's case, all that is needed to treat his apnea is the dental appliance. Though the CPAP is highly effective, he said, he is happy to have found an alternative.

"I was getting claustrophobic (with the CPAP)," he said.

Also, he said, the machine's tubes and wires are cumbersome, and the hum it makes was disrupting his wife's sleep.

Now he has discontinued the CPAP treatments and replaced them with the dental appliance.

"It's not the most comfortable thing, but from the get-go, it did a splendid job," he said.

Sosenko calls her practice on Sherman Avenue in Naperville "Dental Sleep Medicine of Illinois." She works in conjunction with primary care doctors to diagnose and treat sleep problems, including apnea. Those with mild apnea, she said, often benefit from specially fitted dental appliances.

The presence of apnea, she said, often becomes apparent when patients are chronically fatigued.

"You don't sleep well. You don't get through all the sleep stages you need to," she said.

Apnea is not a rare problem.

"It is about as common as asthma or diabetes -- very underdiagnosed, though," said Sosenko, who has maintained her Naperville dental practice for 14 years. "Obstructive sleep apnea is one of the largest sleep disorders out there."

Patients who have it often are snorers.

"A cardinal sign of obstructive sleep apnea is heavy snoring," she said.

Sleep studies can often confirm or rule out the diagnosis, she said.

Sosenko fits many of her apnea patients with dental appliances that pull the lower jaw forward, thereby pulling tissue away from the airway. Another type of appliance Sosenko treats her patients with holds the tongue in a forward position.

Sosenko said the dental appliances she prescribes are effective for patients with mild sleep apnea. The appliances are not appropriate for those with moderate or severe apnea, she said.

"Where I come into play is in mild cases. Sometimes all they need is an oral appliance," she said.

She said appliance treatment options are well suited to people who like to camp and people who travel frequently, because CPAP machines are not easily transported.

Sosenko said more than 20 major dental appliances aimed at treating apnea are on the market.

She prescribes them based on each patient's lifestyle and medical needs.

It usually takes two visits to Sosenko's office to get a dental appliance made.

"I take molds of their mouth, very similar to tooth-whitening molds. I ask the patients a lot of questions -- about their lifestyle demands, how they sleep," she said.

Follow-up visits also are required, she said, to check for side effects such as jaw soreness or a change in teeth alignment.

"Most of it is reversible and adjustable," she said.

The most common problems with apnea appliances, Sosenko said, are drooling and intermittent jaw pain upon waking. Pain usually can be mitigated with jaw exercises, she said.

Sosenko said the appliances are used on adult patients, not on children. They usually last anywhere from one to seven years and can be relined yearly.

Most appliances cost about $2,000, Sosenko said. The expense is often covered by medical insurance, provided a diagnosis of sleep apnea has been confirmed by a sleep study, she said.

"It's not cheap," admitted Eccher, who said his insurance covered about 80 percent of the cost.

To him, the expense is worth it.

"I'm happy," he said.