Past president of AADSM discusses oral sleep appliances in podcast

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Dr. Nancy Addy, a dentist and past president of the American Academy of Dental Sleep Medicine, was recently interviewed on NPR’s Cool Science Radio on the topic of “New Treatments for Sleep Apnea.”

Dr. Addy talks with the hosts of the show about the science of sleep apnea, and how those cumbersome and noisy CPAP machines are starting to be replaced by a simple oral device.

22-million Americans suffer from sleep apnea and if you’re one of them, or if you share a bed with one of them, you’ll definitely want to listen in.

Listen to the podcast at the link below!

If you have any questions about sleep apnea or oral sleep appliances please feel free to contact Dr. Fox.

Millions of Sleep Apnea CPAP Machines, Ventilators Voluntarily Recalled by Philips

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Philips issued a voluntary recall for millions of its sleep apnea machines and life-sustaining ventilators after it found that foam used in the breathing devices may degrade into particles and be ingested or inhaled by users.

Philips says they will continue to monitor reports of potential safety issues as required by medical device regulations and laws in the markets in which it operates. The foam may also give off chemical emissions. Exposure to foam particles or emissions is potentially toxic, the manufacturer said and may cause cancer, among other health risks. To date, there have been no reports of death as a result of these issues.

The recall involves an estimated 3 million to 4 million devices globally, based on the company’s production and shipment data. Over half of the devices were sold in the U.S., with the majority of them being the first-generation DreamStation products.

“We deeply regret any concern and inconvenience that patients using the affected devices will experience because of the proactive measures we are announcing today to ensure patient safety,” said Frans van Houten, CEO of Royal Philips. “In consultation with the relevant regulatory agencies and in close collaboration with our customers and partners, we are working hard towards a resolution, which includes the deployment of the updated instructions for use and a comprehensive repair and replacement program for the affected devices. Patient safety is at the heart of everything we do at Philips.”

List of recalled Philips CPAP machines, ventilators

  • E30 (Emergency Use Authorization)
  • DreamStation ASV
  • DreamStation ST, AVAPS
  • SystemOne ASV4
  • C Series ASV, S/T, AVAPS
  • OmniLab Advanced Plus In-Lab Titration Device
  • SystemOne (Q series)
  • DreamStation CPAP, Auto CPAP, BiPAP
  • DreamStation GO CPAP, APAP
  • Dorma 400, 500 CPAP
  • REMStar SE Auto CPAP
  • Trilogy 100 Ventilator
  • Trilogy 200 Ventilator
  • Garbin Plus, Aeris, LifeVent Ventilator
  • A-Series BiPAP V30 Auto Ventilator

Click here for steps consumers can take.

The company is sending letters to users with instructions for registering online to have affected devices repaired or replaced. Anyone who doesn’t receive a letter should call Philips at 877-907-7508.

Philips is advising those with affected devices to discontinue using them and work with a doctor to determine the best option for next steps of treatment. Dr. Fox may be of help with a temporary appliance for treatment, or consideration with your physician if oral appliance therapy could be an option as an alternative treatment for obstructive sleep apnea.

Contact Fox Dental with any questions or to schedule a consultation.

Chronic Fatigue and Obstructive Sleep Apnea

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What is sleep apnea?

Sleep apnea is a sleep condition in which abnormal breathing patterns occur during sleep. Those who are living with sleep apnea can have multiple extended pauses in their breath while they’re asleep. These lapses in breathing can lead to lower quality sleep and affect the body’s supply of oxygen which can have potentially serious health consequences. In the United States, it is one of the most common forms of sleep disorders, affecting both children, adults, and people of both sexes, though it is most common in men.  It’s estimated that between 2-9% of adults suffer from sleep apnea, though it is believed that many cases go undiagnosed. Sleep apnea can occur at any age but it is most common in older adults. Although the prevalence of sleep apnea in the United States has decreased in recent years it is still a constant in many parts of the world and in some cases is on the rise. 

What is chronic fatigue syndrome?

Chronic fatigue syndrome is a debilitating disorder in which a patient experiences extreme fatigue lasting for at least six months. This fatigue is often worsened with physical or mental activity but cannot be improved by resting. One of the hallmarks of the disorder is it cannot be fully explained by an underlying medical condition. Some of the symptoms of chronic fatigue syndrome include sleep that doesn’t rejuvenate, issues with memory, focus, and concentration, and dizziness that gets worse when going from laying down to standing up.

Some other symptoms include:

  • Sore throat
  • Headaches
  • Enlarged lymph nodes in the neck or armpits
  • Unexplained muscle or joint paint

The exact cause of chronic fatigue syndrome is still not fully known to doctors, but some factors may include viral infections, immune system problems, hormonal imbalances, and physical or emotional trauma. Doctors will examine the cluster of symptoms for at least six months to determine whether or not someone has chronic fatigue syndrome, working to rule out other possible causes. 

The connection between chronic fatigue and sleep apnea

Although many people with chronic fatigue syndrome experience disruptions in their sleep, the actual connection between sleep and chronic fatigue is not well understood. A study found that most of the chronic fatigue syndrome patients in the study also had a sleep disorder. The researchers further stated that it could be worth considering that sleep disorders like obstructive sleep apnea may be playing a part in causing or exacerbating chronic fatigue symptoms. Other research has shown a staggering amount of people who suffer from chronic fatigue syndrome also suffer from a sleep disorder at the same time. 

Another study found that 58% of their patients had a previously undiagnosed sleep disorder such as obstructive sleep apnea. They suggest that one possible cause of chronic fatigue syndrome is because of how many people in the study had an undiagnosed sleep disorder. This suggests that sleep disorders may be often overlooked when physicians make an attempt to figure out what’s going on with their patients. 


It’s necessary for physicians to more deeply consider the role sleep disorders may be playing in causing chronic fatigue syndrome rather than just pinning the disorder to psychological causes as is often the case. These psychological disturbances may have a root cause in the patient’s physical health rather than emotional. Conditions like obstructive sleep apnea may be at the root of the problem. If you’re experiencing any of the symptoms described here, it would be a good idea to talk to us about it. At Fox Dental, we have several different options for treating your obstructive sleep apnea, including dental appliances that are far less invasive than traditional CPAP. Schedule a visit today and we’ll work with you to get you on the path to less fatigue and a better night’s sleep. 

AASM study finds high risk of sleep apnea in young veterans with PTSD

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According to the American Academy of Sleep Medicine (AASM), a study of young U.S. veterans shows that the probability of having a high risk of obstructive sleep apnea (OSA) increased with increasing severity of post-traumatic stress disorder (PTSD) symptoms.

The study involved 195 Iraq and Afghanistan veterans who visited a VA outpatient PTSD clinic for evaluation. Results show that 69.2% of participants had a high risk for sleep apnea, and this risk increased with PTSD symptom severity. 93% of study participants were men, and their mean age was 33 years. Every clinically significant increase in PTSD symptom severity was associated with a 40% increase in the probability of screening as high risk for sleep apnea.

The American Academy of Sleep Medicine reports that obstructive sleep apnea is a common sleep disease afflicting at least 25 million adults in the U.S. Sleep apnea warning signs include snoring and choking, gasping, or silent breathing pauses during sleep.

Dr. Fox is here to help. Contact our office with any questions.

To get help for PTSD, veterans can call the Veterans Crisis Line at 1-800-273-8255 and press 1, text 838255, contact a local VA Medical Center, or use the online PTSD program locator on the VA website.

The Impact of Drowsy Driving

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Drowsy driving poses a serious risk not only for one’s own health and safety, but also for the other people on the road. Being drowsy affects your ability to drive safely even if you don’t actually fall asleep at the wheel. Drowsiness makes drivers less attentive, slows reaction time, and affects a driver’s ability to make decisions.

According to the National Sleep Foundation, about half of U.S. adult drivers admit to consistently getting behind the wheel while feeling drowsy. About 20% admit to falling asleep behind the wheel at some point in the past year – with more than 40% admitting this has happened at least once in their driving careers.

Impact of Drowsiness on Driving

Driving while drowsy is similar to driving under influence of alcohol. Driving after going more than 20 hours without sleep is the equivalent of driving with a blood-alcohol concentration of 0.08% – the U.S. legal limit. A driver might not even know when he or she is fatigued because signs of fatigue are hard to identify. Some people may also experience micro-sleep – short, involuntary periods of inattention. In the 4 or 5 seconds a driver experiences micro-sleep, at highway speed, the vehicle will travel the length of a football field.

Drowsy Driving Crashes

According to the National Highway Traffic Safety Administration, every year about 100,000 police-reported crashes involve drowsy driving. These crashes result in more than 1,550 fatalities and 71,000 injuries. The real number may be much higher, however, as it is difficult to determine whether a driver was drowsy at the time of a crash.

A study by the AAA Foundation for Traffic Safety estimated that 328,000 drowsy driving crashes occur annually. That’s more than three times the police-reported number. The same study found that 109,000 of those drowsy driving crashes resulted in an injury and about 6,400 were fatal. The researchers suggest the prevalence of drowsy driving fatalities is more than 350% greater than reported.

Too Tired to Drive?

The following are signs and symptoms of drowsy driving, according to the American Academy of Sleep Medicine:

  • Frequent yawning or difficulty keeping your eyes open
  • “Nodding off” or having trouble keeping your head up
  • Inability to remember driving the last few miles
  • Missing road signs or turns
  • Difficulty maintaining your speed
  • Drifting out of your lane

Untreated obstructive sleep disorders can lead to other health consequences. Contact our office Fox Dental with any questions.

What is Acid Reflux? | Acid Reflux and Sleep Disorders

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Though they may not know it, a wide variety of people of all ages suffer from acid reflux. The common symptoms associated with acid reflux are burning sensations in the stomach, chest, and/or throat. These conditions are not the only way people are affected, however. Asthma, problems with swallowing, repeatedly losing your voice, and a rough, dry cough are among other ways people are affected. Commonly, when someone has one or more of the above conditions at a chronic pace, it is called Gastroesophageal Reflux Disease (GERD).

Acid Reflux and Sleep Disorders

GERD can lead to one or many symptoms affecting the quality of sleep. These include:

  1. Obstructive Sleep Apnea
  2. The breathing In of stomach acid while asleep
  3. Disrupted sleep due to irritation caused by the acid reflux symptoms. 

Sleeping puts you in a vulnerable position as it increases the chance of stomach acid moving up further in the body. It can even reach up the back of one’s mouth. Sleep apnea is a major culprit that worsens acid reflux and increases the chance of GED. During the day the gravity of your body helps limit the effects from occurring due to people usually being in an upright position for the majority of the time. 

How To Limit The Effects of Acid Reflux and Have A Good Night’s Sleep

Helping Yourself Sleep Better With Sleep Apnea and Acid Reflux:

The best way to assist yourself in a more comfortable and less disturbed sleep naturally is through gravity. Positioning your body in a slightly elevated position while sleeping can help. 

Here are some tips on what you can do:

  • Placing a pillow or two under your back to elevate your upper body
  • Raising the head of your bed by a few inches 
  • Sleeping in a reclining chair which is positioned slightly upright
  • Not sleeping or laying down right after eating.

Lifestyle changes can also help reduce or terminate the effects of acid reflux. These include:

  • Sustain a healthy weight (being overweight increases the chance for stomach acid)
  • Wearing loose clothing (tight clothing put pressure on your stomach)
  • Stop Smoking (Decreases functionality of the stomach)

Using Medication

If the self-help sleeping methods fail, there are both over-the-counter and prescribed medicines that can be taken to help relieve stomach acid. While these work, most come with potential side effects and have to be taken on a regular basis. Not everyone wants to constantly take medicine. If you feel this way, there are other methods of relief and neutralization. 

How Dental Sleep Medicine Can Help

Acid reflux issues can be greatly reduced or even terminated once an underlying sleep apnea issue is addressed. To treat this, specialty dentists such as Dr. Fox can create oral appliances molded to fit your mouth. These can be used to keep your throat open when sleeping and assist in the comfortability & effectiveness of sleep. 

How Does Weight Affect Sleep Apnea?

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Sleep Apnea is a sleeping disorder where the person who has it repeatedly stops breathing throughout the night. Some tell-tale signs and symptoms of this are loudly snoring, gasping for air during sleep, morning headaches, insomnia/difficulty staying asleep and/or a severe tiredness in the morning despite getting a good amount of sleep. 

So, How Does Weight Affect Sleep Apnea?

There are a variety of health indicators that can affect the development of sleep apnea, and out of all those conditions, obstructive sleep apnea is most prevalent in those who are overweight or obese, roughly 60-90%

The reason for this is because of the weight formed in a person’s neck fat once a certain level of excess weight is reached. This fat then has a highly likely chance of causing a blockage in one’s air passageway during sleep, this is what causes people to snore. This is why snoring is seen as one of the most prevalent sleep apnea symptoms. 

How Does Excess Weight and Sleep Apnea Affect Health?

As sleep apnea is developed in those with excess weight, a series of complications have the chance to develop. Your cardiovascular system is the most harmed and will be negatively affected in several ways. It raises blood pressure, increases heart rate, and alters the flow of oxygen and carbon dioxide within your body. The resulting effects of this are an increased risk in stroke, heart attack, diabetes, and other related problems. 

On the opposite end of the spectrum, developing sleep apnea raises your possibility of gaining weight. This is because of the increased pangs that happen when you stay awake longer. Staying up with a lack of sleep leads to an increased comfort eating intake of food and drinks. As your body is exhausted it tells you to continue to fuel yourself. When you are able to get good sleep, this switch is not activated in the brain because sleep is your rejuvenating fuel rather than food. 

So, Does Losing Weight Help With Sleep Apnea?

Sleep apnea symptoms can diminish drastically when you are able to lose weight to a healthy level. If you are able to get help with your sleep apnea, then weight loss has been seen to become easier to accomplish. 


This article examined the effects of sleep apnea and its correlation to someone’s weight. If you are able to catch on to sleep apnea or notice weight gain early on, it will be easier to prevent the complications from the other. Always consult with your doctor first if you feel like you may have signs of sleep apnea. 

Contact us at Fox Dental with any questions!

Are Dental Sleep Appliances Covered By Medical Insurance or Dental Insurance?

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What is Dental Sleep Appliance Therapy?

We can help by fitting a custom-made oral appliance that repositions your lower jaw and prevents airway collapse while you are sleeping. An oral sleep appliance can be an initial mode of treatment or an alternative to CPAP and other surgical options. Often, it can be used in combination with CPAP machines for a reduced, more comfortable setting. Learn more about what we can do here

The Run Down: How Are Oral Sleep Appliances Covered? 

It may be unclear to you if dental sleep appliances would fall under medical or dental insurance. Dental plans DO NOT cover oral appliances. However, if you have a medical diagnosis of sleep apnea, a majority of the time your medical insurance is able to cover the costs of appliances. This is all dependent on what your medical insurance covers, don’t hesitate to contact us if you would like assistance in figuring out if you are covered.

How Can Dr. Fox Help You Lower Costs?

The opportunity to significantly reduce the costs of oral appliances becomes available once you have seen a sleep dental expert such as Dr. Fox. The sleep appliances you will receive at Fox Dental are custom to your needs and Dr. Fox is able to connect you with a qualified physician who can diagnose you. We are one of the only qualified sleep dentists in the Central PA area who are tapped in-network with medical insurances. 

Medical insurances want to make sure you have a confirmed case of sleep apnea before they deem it appropriate to cover your sleep device. Through working with physicians in our network, we are able to assist you in correctly diagnosing your sleep-related issues and providing specialized treatment to solve those issues for you. It is very rewarding to us when we can help solve our patient’s needs and give an increased quality of life. 

Obstructive Sleep Apnea in Type 2 Diabetes

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Studies show that about 71% of people with type 2 diabetes may have sleep apnea. For sleep apnea to have a relationship with diabetes might come as a surprise, but physicians and scientists have noted some suggestive patterns.

Obstructive sleep apnea (OSA) is one of the major causative factors of sleep disturbance and it is also commonly found in patients diagnosed with Type 2 Diabetes because it’s associated with glucose intolerance and insulin resistance. Obesity is a key moderator of the effect of OSA on type 2 diabetes. Obesity contributes to OSA as increased neck fat leads to obstruction of the upper airway during sleep. However, chronic exposure to intermittent hypoxia and other pathophysiological effects of OSA affect glucose metabolism directly, and treatment of OSA can improve glucose homeostasis.

Since sleep apnea and diabetes appear to be linked, researchers have tried to determine if treating the sleep disorder might help improve a patient’s diabetes. However, studies that have examined the effect of using continuous positive airway pressure or CPAP therapy, have shown mixed results. 

As research continues, it’s clear that doctors should talk to diabetic patients about sleep. Some form of treatment is always encouraged, as untreated obstructive sleep apnea can lead to other health consequences. 

We’re here to help! Contact us at Fox Dental.

Daylight Saving Time Change: Spring Forward

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Many things can be disruptive to your sleep and some of them have serious health consequences. Getting enough sleep and getting quality sleep can often be a challenge with outside disruptions. Twice a year, that disruption comes in the form of Daylight Saving Time and Standard Time transitions. This Saturday we will set the clocks ahead one hour and here are some helpful tips to make that adjustment to your body go a little smoother heading into Spring.

Tips to prepare ahead for Daylight Savings: 

  1. Go to bed 15 or 20 minutes earlier each night before the time change. 
  2. Begin to adjust the timing of other daily routines that are “time cues” for your body. 
  3. This Saturday night, set your clocks ahead one hour in the early evening. Then go to sleep at your normal bedtime. (Daylight Saving Time begins on Sunday, March 14, 2021, at 2:00 A.M.  On Saturday evening, our clocks need to “spring forward” one hour.)
  4. After the switch forward, head outdoors for some early morning sunlight. 
  5. Stick to your usual bedtime to get plenty of sleep before the workweek begins on Monday.

How Does Daylight Saving Time Affect Sleep?

Humans are guided by circadian rhythms, which are 24-hour cycles that regulate sleep and other key bodily functions such as appetite and mood. These rhythms are largely dependent on light exposure. In order to reset each day, they must be synchronized with natural light-darkness cycles in order to ensure healthy, high-quality sleep.

The transition between Daylight Saving Time and Standard Time is characterized by more morning darkness and evening light. This can essentially “delay” your sleep-wake cycle, making you feel tired in the morning and alert in the evening. Circadian misalignment can contribute to sleep loss, as well as “sleep debt,” which refers to the effect of not getting enough sleep on a regular basis.

Humans are most vulnerable to sleep deprivation in early March, as they transition from Standard Time to Daylight Saving Time. One study found that the average person receives 40 minutes less sleep on the Monday after “Springing Forward” compared to other nights of the year. 

It is estimated over 30 million Americans suffer from sleep apnea and most go undiagnosed. Some form of treatment is always encouraged, as untreated obstructive sleep apnea can lead to other health consequences. Contact our office at  717-761-0341.