SOM 2.67% $2.19 somnomed limited


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    Somnomed i feel will have a great year in 2010. The growth of the dental network, european and asian expansion and the recent tie up with home sleep test companies will ensure the growth of oral appliances. Share price seems to have found a bottom at the low 80cent levels.


    The treatment of Sleep Apnea was once surgery or CPAP and the idea of a dentist treating it seemed outrageous. Dental Sleep Medicine and Oral Appliances are taking central stage in the field of sleep medicine and sleep disordered breathing. It turns out that most of the ENT surgeries for treating sleep apnea and snoring showed high morbidity (patients problems post surgery) and poor success. In fact most patients who had UP3 surgery or Uvulopalatopharyngealplasty still required CPAP to control their sleep apnea. The LAUP and Radiofrequency surgeries while still painful had lower morbidity but showed no increase in effectiveness.

    CPAP is still considered by some sleep physicians to be the Gold Standard of treatment but the majority of patients reject CPAP treatment for a wide variety of reasons including skin problems like facial ulcers and acne. Sinus problems associated with CPAP include sinus pain, sinus stuffiness, worsening of problems with allergies, sinus pain, sinus infections, sinus fullness and dry mucosal tissues in the nose and sinuses. Patients have reported all bronchitis, pneumonia, dry throat, and stomach bloating and vocal cord irritation symptoms.
    Ear pain, ear stuffiness or Eustachian tube dysfunction, dizziness, middle ear infections or otitis media, and itchy and uncomfortable feelings inside the air canal have also been reported. There was a case reported of both a mother and son who experienced ongoing vertigo after only a few days of CPAP that took weeks to resolve.

    Dental Sleep Medicine is rapidly becoming a major treatment for treating mild to moderate obstructive sleep apnea, UARS, snoring, sleep disordered breathing and restless legs related to apnea and sleep disordered breathing. Unfortunately many patients do not know about oral appliances as an alternative treatment to sleep apnea. This is sometimes because physicians are not used to referring patients to dentist and because dentists often fail to inform physicians about the treatment they render to patients. The American Academy of Sleep Medicine has accepted oral appliance therapy and Dental Sleep Medicine as a first line treatment for mild to moderate sleep apnea and as an alternative to CPAP for severe sleep apnea when patients do not tolerate CPAP

    The majority of patients fail CPAP therapy with a recent report saying that over 60% of patients discontinue treatment with CPAP. There are two primary problems with CPAP compliance, discontinuation of CPAP therapy and insufficient time of CPAP use. The research has shown that to receive the full effects of CPAP therapy patients require daily use of their CPAP for 7 to 7 1/2 hours. Research has also shown that even among the 40% of patients who actually utilize their CPAP machines usage is only 4-5 hours a night and 4-5 nights a week. In spite of research that shows this is insufficient treatment it is the same standard that is considered a success in CPAP treatment for research purposes. If wearing CPAP 7-7 1/2 hours seven days a week was the definition of CPAP success then the numbers of successful patients reported in the literature would plummet. This is an unlikely scenario since CPAP manufacturers finance most research on CPAP or there is a quid pro quo where the CPAP companies provide equipment used for studies gratis.

    There is a group of patients who are extremely successful with CPAP treatment. Approximate 25% of patients love their CPAP machines from day one and continue to use it on a regular basis. Some studies show that patients who do not tolerate therapy initially never become accustomed to its use while other studies show improved CPAP success when there is excellent approach by trained sleep techs or DME providers to the delivery and problem solving needed for most patients to achieve success.

    Patients given a choice between oral appliances and CPAP chose appliances 20 to 1 over CPAP

    Almost half of adults snore. And the problem is worse with overweight persons.

    What Makes the Snoring Noise?
    Snoring occurs when there is a partial obstruction to the free flow of air through the mouth and nose. The sound occurs when loose structures in the throat, like the uvula and soft palate, vibrate as air passes over them.

    Snoring can get worse when the muscles in the back of the throat are too relaxed either from drugs that induce sleep or alcohol consumption.

    Snoring can be serious both socially and medically.

    Snoring & Relationships
    Snoring can disrupt marriages and cause sleepless nights for bed partners.

    Snoring & Health
    Medically, snoring can be the precursor of obstructive sleep apnea that has been linked to heart failure, high blood pressure and stroke. In its own right, snoring has been linked to Type II Diabetes. Sleep apnea usually interrupts loud snoring with a period of silence in which no air passes into the lungs. eventually the lack of oxygen and the increase carbon dioxide will awaken you forcing the airway to open with a loud gasp.

    Heavy Snoring & Heart Disease
    Heavy snorers are also more likely to suffer a heart attack while asleep than non-snorers. Blood pressure changes caused by snoring may lead to blockage of the coronary arteries and increase the risk of heart disease.

    Sleep medicine dentists can control snoring with an oral appliance.

    Drowsy driving
    A Canadian study reported that people with sleep apnea are twice as likely to be in a car crash. They reported that even people with fairly mild sleep apnea had an increased risk of serious crashes.The truckers's associations are informing truck drivers of sleep apnea's seriousness.

    Medically, sleep apnea is associated with:
    Heart Failure

    Coronary occlusion

    High blood pressure
    Heart beat irregularity
    Erectile dysfunction

    Mental impairment

    Increased risk of sudden cardiac death during sleep hours
    Impact of sleep apnea on the economy
    25 million American suffer from sleep apnea. Of these 200,000 each year are involved in Motor Vehicle Accidents because of sleepiness problems. 38,000 die each year from complications of sleep apnea (i.e. heart attack, stroke etc.)

    Cost of health care for sleep apnea patients in the ER or ICU is in excess of $50,000 per patient. The total estimated cost in the United States alone is $ 1.9 billion.

    Productivity ratio is at least 10% less in people who suffer from sleep apnea.
    That is estimated to costs the US economy $ 75 billion each year

    (Statistics are estimates by the American Sleep Apnea Association)

    Although there is no dental cure for snoring or sleep apnea, an oral appliance can hold the airway in the back of the throat open during sleep and prevent collapse.

    Sleep apnea can be controlled by a sleep medicine dentist who provides oral appliance therapy.
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