ROANOKE TIMES
Copyright (c) 1997, Roanoke Times
DATE: Sunday, February 9, 1997 TAG: 9702100013
SECTION: VIRGINIA PAGE: B-8 EDITION: METRO
DATELINE: CHARLOTTESVILLE (AP)
SOURCE: CHRIS SNOWBECK\THE (CHARLOTTESVILLE) DAILY PROGRESS
SNORING ISN'T a mere annoyance; it could be a sign of sleep apnea. A custom-made device fashioned by a Virginia dentist might just help.
Ron Rosenthal wants to make sweet, almost-silent nights out of snorers' nocturnal overtures.
With a toll-free number and license plate that spell out ``Dr. Snore,'' the Charlottesville dentist is making a colorful pitch to help people with sleeping disorders.
The trick of his trade is a $600 custom-made dental appliance that snorers wear at night.
Because he is only making appliances, Rosenthal can fill his office with antique dental and barber equipment rather than the expensive chairs found in most dental offices.
And where other offices pipe in relaxing instrumental music, Rosenthal's will feature the rousing harmonies and sentimental strains of barbershop quartets.
``I'll probably sing along,'' said Rosenthal, who sings in quartets and says the origins of dentistry can be found in the history of barber shops.
But treating snoring is not simply about stifling the lumberjack who saws nightly logs. It's about treating sleep apnea, a potentially life-threatening breathing disorder characterized by repeated collapse of the upper airway during sleep.
``It's just incredibly common, and it's a problem that's been completely unrecognized,'' said Dr. Paul Suratt, medical director of the Sleep Lab at the University of Virginia. ``Ron's involvement in the field is a recognition of how common this problem is.''
Several factors seem to contribute to constricting a sleeper's airway, including obesity, the location of the tongue in the mouth, the position of muscles that attach to the airway and a fat pad near the throat, Suratt said.
Apnea is a stopping of airflow for more than 10 seconds. During that time, the sleeper stops breathing and, in some instances, snaps awake. Disruptions throughout the night result in daytime drowsiness.
Sleep apnea might be as common as some better-known diseases, according to the National Institutes of Health. NIH literature includes estimates that 4 percent of middle-aged men and 2 percent of middle-aged women meet minimal criteria for sleep apnea syndrome.
The syndrome is more prevalent in men and older people.
``Not everybody who snores has sleep apnea,'' Suratt said. ``But everybody who has sleep apnea snores.''
Rosenthal's dental appliances help some sleepers by moving forward the lower jaw.
``In people who have problems with snoring and sleep apnea, the problem is because of a constriction in the airway in the back of the throat,'' Rosenthal said. ``In the constricted area, air has to go through much faster.''
When the uvula and soft palate that dangle in the throat are ``exposed to the high wind, it flaps just like a flag,'' he said. ``When we bring the lower jaw forward, it brings the tongue with it'' and expands the airway.
The appliances Rosenthal will make have been used in some cases at the university for a few years, said UVa dentist Brian Hoard.
``The dental appliance therapy to treat it is kind of catching on,'' Hoard said. ``With any appliance that you hook onto teeth in somebody's mouth, you have to watch the teeth you're hooking on to.''
The appliances don't work for everyone, Hoard said.
The treatment is ``a bit of a trade-off because they have to learn to wear this appliance in the mouth,'' he said. ``That may eliminate snoring because you can't get to sleep at night.''
Consumers can go to their neighborhood pharmacy for cheaper sleeper interventions, such as nasal strips and do-it-yourself dental appliances.
But Rosenthal said the strips don't alleviate the constricted airway at the back of the mouth. Do-it-yourself appliances could damage a patient's gums, he said.
Hoard said he, too, is skeptical of over-the-counter remedies. At UVa's sleep disorder center, snoring and sleep apnea problems are diagnosed in an interdisciplinary setting that can steer patients toward a variety of remedies, Hoard said.
Suratt, the founder of the center, began studying sleep disorders in the early 1980s, when researchers had trouble finding people to study.
Now, the Sleep Research Center performs 70 sleep studies per month, in which researchers analyze what gives sleepers fits in the night.
One of the many questions about snoring and sleep apnea researchers consider is why the sleep problems affect so many more men than women.
``Some studies suggest that something about testosterone causes it,'' Suratt said.
The way men carry their fat may also be an issue, he said. Fat in women tends to go to the legs, Suratt said, while men tend to carry it around their bellies and necks.
Even if more men are afflicted with snoring and sleep apnea, they share their pain with their spouses.
``Snoring affects two people, not just one,'' Rosenthal said. ``The person who is listening to the snoring is not asleep.''
LENGTH: Medium: 98 lines ILLUSTRATION: PHOTO: AP. Along with helping snorers - and their spouses - getby CNBa good night's sleep, Dr. Ron Rosenthal has a liking for antique
dental and barbershop equipment.