1. Adult Sleep Apnea

2. Sleep Physiology Respiratory Renal Cardiovascular Body temperature
mucocillary reaction
respiratory rate
renal blood flow
GFR
in BP
in cardiac rate
Decrease

6. Pathophysiology of Obstructive Sleep Apnea

9. Independent Predictors of Myocardial Infarction
Risk Factor
Standard
Overweight
Hypertension
Smoking
Sleep Apnea
Odds Ratio
1.0
7.1
7.8
11.1
23.3

10. Snoring and Stroke
Onset of ischemic stroke occurred most frequently between 6 am and noon
similar pattern as observed for myocardial ischemia, infarction and sudden death
Studies have demonstrated an association between snoring and cerebral infarction (Palomaki et al, Stroke 1989)
280% to 1030% increased risk of stroke with snoring after adjustments for age and BMI

11. Snoring and Ischemic Heart Disease
Koskenvuo et al. (Lancet 1985)
Increased risk of angina in habitually snoring men after adjusting for HTN and obesity
Koskenvuo et al (Br Med J 1987)
4388 men between years of age
Significant relationship between snoring and ischemic heart disease (risk ratio 70%) after adjustment for age, BMI, HTN, smoking, and alcohol

12. Snoring and Sudden Death Shepard (Clin Chest Med 1992)
Evaluated 460 consecutive cases of sudden death in Finnish men (35-76 years old)
Cardiovascular cause of death more common in habitual snorers
Habitual snorers died more commonly while sleeping
Snoring was a risk factor for sudden death between 4am and noon

13. Action of all Mandibular Advancement Devices (MAD)

14. SomnoMed MAST
The SomnoMed MAS is a custom-made device, consisting of upper and lower dental plates with a unique patented fin-coupling component, which allows normal mouth opening and closing. If required, a part can be added to make the device adjustable. This feature provides incremental and adjustable levels of lower jaw advancement, which improves the effectiveness and comfort-level of treatment as the jaw is moved only as far as is required to alleviate snoring and reduce OSA. Key features and benefits of the device include: Permits normal mouth opening Allows speech and drinking Provides full lip-seal Easily adjustable Safe and effective Clinically proven Custom-fitted Additionally, the SomnoMed MAST is made from durable fade-proof acrylic that retains its shape and color for at least four-five years and is covered by a two year manufacturer's warranty.

15. TAP - T