Posted on

New Technology

Exciting New Project/Study

Over the past 8 years, Dr. Alpher has been working on a project related to advances in oral appliance titration and how to condense the entire process from beginning to end. He was recently awarded a research grant to implement this study and will be working jointly with several other medical professionals and researchers to accomplish this process.

With Dr. Alpher’s extensive knowledge of the causes, symptoms and consequences of Obstructive Sleep Apnea this study with the innovative and advanced technology will allow easier and more efficient and accurate treatment for the patient. He is hopeful that this process will aid in patient compliance and success, and the ability to treat a wider range of patients who suffer with OSA.

Dr. Alpher is using an ICAT 3D imaging system, which produces detailed imaging of the entire head and neck. It was specifically custom designed for Dr. Alpher and is the only one of it’s kind in the country.
The entire scan of the head and neck takes a mere 8 seconds and produces color images of the complete sinus system, nasal structures and cervical spine, including C1-C7.

This clinical study is aimed at diagnosing and accessing the effectiveness of therapy in active and retired athletes of all sports utilizing new smartphone technology.

The first part of the study will be screening former players who may be at risk for OSA, which is over 40% according to multiple studies. Once a diagnosis and treatment plan are established, the qualified practitioners will implement either CPAP or Oral Appliance therapy.

The second part of the study will focus on 10 players who are now successfully being treated with an oral appliance. The new smartphone app, which is currently under development, will be used to streamline the titration process by determining the best jaw position/settings for unobstructed sleep. This study has the potential to make the entire process of a diagnosis and treatment simple and precise.

At present, when a patient receives an oral appliance it takes several appointments to correctly calibrate the most effective and comfortable position. This process is expensive and time consuming for the patient and presents a considerable challenge to the sleep dentist.
It is extremely important to determine the correct settings otherwise a risk of moving the mandible too far anteriorly, which has the potential to cause jaw joint pain and/or TMD (temporomandibular joint dysfunction). The current standard of care is to titrate over the course of 3-6 appointments. With this innovative technology the specialized dentist will now have the ability to deliver and adjust the appliance in a single visit.

Posted on

Better Sleep



Typing text here to

Purpose in life by day linked to better sleep at night

Older adults whose lives have meaning enjoy better sleep quality, less sleep apnea, restless leg syndrome

July 10, 2017
Northwestern University
Having a purpose in life means you are more likely to sleep better at night with less sleep apnea and restless leg syndrome, reports a new study. Cultivating a purpose in life could be drug-free strategy to improve sleep, scientists said. The study participants were older adults — who tend to have more insomnia and sleep disturbances — but researchers said the findings are likely applicable to the broader public.

Having a good reason to get out of bed in the morning means you are more likely to sleep better at night with less sleep apnea and restless leg syndrome, reports a new Northwestern Medicine and Rush University Medical Center study based on older adults.

This is the first study to show having a purpose in life specifically results in fewer sleep disturbances and improved sleep quality and over a long period of time. Previous research showed having a purpose in life generally improves overall sleep when measured at a single point in time.

Although the participants in the study were older, researchers said the findings are likely applicable to the broader public.

“Helping people cultivate a purpose in life could be an effective drug-free strategy to improve sleep quality, particularly for a population that is facing more insomnia,” said senior author Jason Ong, an associate professor of neurology at Northwestern University Feinberg School of Medicine. “Purpose in life is something that can be cultivated and enhanced through mindfulness therapies.”

The paper will be published in the journal Sleep Science and Practice.

Individuals have more sleep disturbances and insomnia as they get older. Clinicians prefer to use non-drug interventions to improve patients’ sleep, a practice now recommended by the American College of Physicians as a first line treatment for insomnia, Ong said.

The next step in the research should be to study the use of mindfulness-based therapies to target purpose in life and resulting sleep quality, said Arlener Turner, the study’s first author and a former postdoctoral fellow in neurology at Feinberg.

The 823 participants — non-demented individuals 60 to 100 years old with an average age of 79 — were from two cohorts at Rush University Medical Center. More than half were African American and 77 percent were female.

People who felt their lives had meaning were 63 percent less likely to have sleep apnea and 52 percent less likely to have restless leg syndrome. They also had moderately better sleep quality, a global measure of sleep disturbance.

For the study, participants answered a 10-question survey on purpose in life and a 32-question survey on sleep. For the purpose in life survey, they were asked to rate their response to such statements as, “I feel good when I think of what I’ve done in the past and what I hope to do in the future.”

The next step in the research should be to study the use of mindfulness-based therapies to target purpose in life and resulting sleep quality, Turner said.

Poor sleep quality is related to having trouble falling asleep, staying asleep and feeling sleepy during the day. Sleep apnea is a common disorder that increases with age in which a person has shallow breathing or pauses in breathing during sleep several times per hour. This disruption often makes a person feel unrefreshed upon waking up and excessively sleepy during the day.

Restless leg syndrome causes uncomfortable sensations in the legs and an irresistible urge to move them. Symptoms commonly occur in the late afternoon or evening hours and are often most severe at night when a person is resting, such as sitting or lying in bed.

Story Source:

Materials provided by Northwestern UniversityNote: Content may be edited for style and length.

Journal Reference:

  1. Arlener D. Turner, Christine E. Smith, Jason C. Ong. Is purpose in life associated with less sleep disturbance in older adults? Sleep Science and Practice, 2017; 1 (1) DOI: 10.1186/s41606-017-0015-6

Cite This Page:

Northwestern University. “Purpose in life by day linked to better sleep at night: Older adults whose lives have meaning enjoy better sleep quality, less sleep apnea, restless leg syndrome.” ScienceDaily. ScienceDaily, 10 July 2017. <>.
Northwestern University. (2017, July 10). Purpose in life by day linked to better sleep at night: Older adults whose lives have meaning enjoy better sleep quality, less sleep apnea, restless leg syndrome. ScienceDaily. Retrieved February 7, 2018 from
Northwestern University. “Purpose in life by day linked to better sleep at night: Older adults whose lives have meaning enjoy better sleep quality, less sleep apnea, restless leg syndrome.” ScienceDaily. (accessed February 7, 2018).


Below are relevant articles that may interest you. ScienceDaily shares links and proceeds with scholarly publications in the TrendMD network.



Typing text here to copy

Posted on

Can Technology Help You Sleep?: Dr. Alpher Discusses Sleep with CNBC

Dr. Elliott Alpher Tackles the Question in CNBC Interview

WASHINGTON, D.C. – Here’s the dilemma. You need to sleep, but nothing seems to work to help you relax and drift off to dreamland. So, you turn to technology and find a plethora of phone apps, along with other digital and electronic aides designed to improve your sleep. But the question is whether these modern equivalents of “counting sheep” offer any real benefits.

In an article for CNBC, Dr. Elliott Alpher, a dental sleep medicine expert in practice in Washington, D.C., said only one thing can help you fall asleep. “The available technology monitors how you’re sleeping but it doesn’t literally help you sleep. The only thing that helps you sleep is turning off the technology,” Dr. Alpher told CNBC.

The article also included interviews with Arianna Huffington, whose Thrive Global initiative works to help people live healthier, and Randall Redfield, co-founder and CEO of Dreampad –
a “smart” pillow that plays music to help people relax and fall asleep.

All three experts agreed that our 24/7 lifestyles are major factors in the lack of sleep and stress we endure. Dr. Alpher told CNBC that across the globe, people are operating at a sleep deficit, thus increasing their stress levels. He said most people suffer from poor sleep hygiene.

“People think they can “make up” the lost hours, but the body doesn’t function well without proper rest,” Dr. Alpher said.

In the CNBC article, Alpher advised turning off technology in the bedroom, keeping a journal by the bed where you “empty your brain” before you go to sleep. He also said to avoid alcohol and heavy meals at least four hours prior to bedtime.

“Alcohol, caffeine and spicy foods are stimulants,” Dr. Alpher told CNBC.

Alpher warned that using technology to help you sleep could mask the need to be evaluated for a serious sleep or breathing disorder. He told CNBC that one serious sign is snoring, which is “the body’s warning sign that something is wrong with your breathing.”

Dr. Alpher told CNBC that if your sleeping partner snores, the detrimental effects are much like secondhand smoke. Alpher added that snoring is just one sign that you may have a serious disorder. In the article, he warned that sleep and breathing disorders are linked to a host of life- threatening illnesses such as high blood pressure, strokes, heart attacks and emotional disorders. In children sleep and breathing disorders have been linked to attention deficit disorder and behavioral problems.

Read the full article here.

Posted on

Is it Snoring or Sleep Apnea?


About 90 million Americans suffer from snoring activity during sleep. While half of these people are “simple snorer’s” or primary snorers, the other half may have a serious sleep disorder called Obstructive Sleep Apnea (OSA). The two conditions are often inaccurately used interchangeably and may be incorrectly treated as a result. While OSA will almost always leads to loud and frequent snoring, snoring does not always indicate OSA.

Understanding the differences between sleep apnea and primary snoring is the first step to effective treatment of both conditions. For all the people across the country who are getting nudged or elbowed throughout the night from frustrated bed partners, it’s important to know what their snoring means, and how they can silence it.

Do your research

Knowing the difference between the two conditions is key in determining proper treatment. Snoring is the result of tissues in the throat relaxing enough that they partially block the airway and vibrate, creating a sound. Depending on an individual’s anatomy and other lifestyle factors such as alcohol consumption and body weight, the sound of the vibration can be louder or softer.

Loud frequent snoring is one of the indicators of OSA, which is a chronic condition characterized by pauses in breathing or shallow breaths during sleep. When people with OSA fall asleep, they can stop breathing for a few seconds to a minute or more. Both conditions can be caused or made worse by obesity, large tongue and tonsils, aging and head and neck shape.

Do talk to your doctor

If you or your partner is a frequent loud snorer, stops breathing, gasps or chokes during sleep, experiences excessive restlessness at night or feels sleepy during the day, you may want to bring it up with your doctor to see whether a sleep study is necessary. Taking this first step to get tested prior to beginning any treatment prevents inaccurate self-diagnosis, inadequate treatment, and/or premature dismissal of the problem. Your primary care physician will be able to refer you to a sleep specialist.

Do get treated

Snoring treatments range from lifestyle alterations, such as weight loss, a decrease in alcohol consumption and changing sleeping positions, to oral devices, nasal strips and even surgery. Treatment of OSA, however, often involves CPAP , a blower connected by a tube to a mask that fits over the mouth or nose, blowing air so that a continuous pressure in the airway is maintained. This constant pressure keeps the airway from collapsing allowing normal breathing.

While CPAP is very effective, some sleep apnea patients experience difficulty using a CPAP machine, as it can be uncomfortable, embarrassing or just inconvenient. A new technology was recently developed called Expiratory Positive Airway Pressure (EPAP), which many OSA and snoring patients have found success with. Provent Sleep Apnea Therapy is an alternative to CPAP that requires no mask, no machine, and no electricity. It is FDA cleared and clinically proven for the treatment of OSA. The non-invasive nasal device uses a MicroValve design that attaches over the nostrils and is secured in place with hypoallergenic adhesive. The valve opens and closes, redirecting air through small holes to create resistance when breathing out. Because Provent is a small, single-use, disposable device, it’s discreet and convenient. This device works across OSA severity, body mass index (BMI), age, gender, race, and it fits into most lifestyles. Provent is only available by prescription.

EPAP technology

EPAP Technology is also used in a snoring treatment, Theravent Advanced Nightly Snore Therapy. Also FDA cleared and clinically proven, Theravent is an over-the-counter nasal device that fits gently over the nostrils and creates positive pressure in the airway during exhalation. In clinical studies, 79 percent of bed partners reported that Theravent quieted their partner’s snoring. Talk to your doctor to see if EPAP therapy is right for you.

Don’t dismiss snoring as “natural”

Often, snoring can be dismissed as a natural part of aging. While it’s true that snoring can increase over time with age and weight gain, it should not be accepted as an ordinary and standard juncture in life. It can and often should be treated – for the sake of the snorer and their partner.

Don’t underestimate the health risks

More than just a noisy nuisance, snoring and sleep apnea can have serious health ramifications. OSA sufferers usually move out of deep sleep into light sleep when their breathing pauses, and this lessens sleep quality. OSA can also trigger the release of stress hormones, change how your body uses energy, and make you feel tired and sleepy during the day. In addition, there are several potential negative health effects of inadequate sleep, such as weight gain, memory loss, skin aging and more.

There is also evidence that OSA leads to a greater risk of high blood pressure, heart attack, stroke, congestive heart failure, atrial fibrillation, diabetes, certain cancers and even sudden death. Treating either condition can decrease these risks.

Don’t forget that while you’re sleeping, others are not.

While the snorer may not feel that the condition is disrupting his or her sleep, the partner being kept up all night by the noise may feel differently. Relationships can severely suffer if partners are irritated about being kept awake or having to sleep in separate rooms. Over 41 percent of women who say they need a good night’s sleep instead have it interrupted by a snoring partner. The lack of sleep or need for nighttime separation can foster resentment and decrease intimacy in relationships.

There are additional health risks from lack of consistent high-quality sleep, including being more prone to accidents, difficulty focusing, impaired attention and alertness, as well as other serious risks such as heart disease, stroke and diabetes. This lack of sleep can promote weight gain while also accelerating the aging of the skin and brain.


Your health depends on getting enough sleep. If you or your partner experiences any symptoms of snoring or sleep apnea, consult a doctor. There are treatments, and you can get your restful nights back.

Authored by Dennis Hwang, MD

Medical Director, Kaiser Permanente Fontana Medical Center
Co-Chair Sleep Medicine, Southern California Permanente Medical Group

Posted on

Lack of Oxygen and the Health Consequences

It is a known fact that oxygen is a basic human need for physical survival and while suffocation is the result when an individual completely lacks air, dangerous conditions occur as a result of low oxygen over an extended amount of time. Normal blood oxygenlevels are approximately 85mm Hg.

Hypoxemia is a condition of deficient oxygen levels in the blood (oxygen desaturation as low as 60mm Hg) , which can cause hypoxia – a low amount of oxygen that is able to reach the cells and tissues. Some symptoms of hypoxia are:

  • shortness of breath while resting
  • waking up out of breath
  • severe shortness of breath after physical activity
  • feelings of choking
  • wheezing
  • frequent cough

Chronic obstructive pulmonary disease (COPD) is a lung disease that obstructs airflow from the lungs, and those who suffer from COPD have difficulty breathing and have increased chances of developing heart disease and lung cancer. 30% of people with COPD die of cardiovascular disease. COPD sufferers may also experience symptoms such as:

  • depression and other mood disorders
  • fatigue
  • headache
  • confusion
  • high blood pressure, or hypertension
  • pulmonary hypertension
  • increased heart rate

Heart disease is the leading cause of death in the U.S. and sleep apnea is associated with high blood pressure, arrhythmia, stroke and heart failure. Heart disease is the leading cause of death in the United States; stroke is the fourth and a leading cause of disability.

Over 80 percent of adults with obstructive sleep apnea (OSA) remain undiagnosed so they have an increased likelihood of health problems, which includes obesity, heart, kidney, and liver disease. OSA and COPD are two diseases that often coexist within an individual and known as an overlap syndrome. There has not yet been a direct link of the two diseases but the overlap presents “sleep-disordered breathing associated to upper and lower airway obstruction and a reduction in respiratory drive.”

The severity of OSA is measured by how many hypopneas occur per hour – the Apnea Hypopnea Index (AHI) through a sleep study or polysomnography (PSG) that also monitors breathing, brain waves, muscle tension, eye movement, and oxygen levels in the blood. The test is painless and home sleep tests are available and highly accurate.

Getting screened, diagnosed and treated is of utmost importance for a better life and CPAP is commonly prescribed for the treatment of OSA, but patients do not regularly adhere to wearing the mask so do not receive the maximum benefits of treatment. A full study in the New England Journal of Medicine showed that CPAP did not reduce heart risks. A factor is due to patient use only about three hours a night and that is insufficient to provide true heart health benefits.

Oral Appliance Therapy (OAT) is the best alternative to CPAP intolerance and patients use the appliance nightly because of its comfort, convenience, and mobility for the patient. Patients can be fitted with special oral appliances that look like orthodontic retainers or sports mouth guards. They are usually made from clear acrylics and all have adjustment features. These appliances dilate or open the airways by repositioning the soft palate and stabilizing the lower jaw and tongue with respect to the soft palate, uvula, and the back of throat, thus increasing the volume of the airway.

Co-authored with Lily Mai

The information provided is for general knowledge and discussion about medicine, health and related subjects. The words and other content provided in this article and any linked materials, are not intended and should not be construed as medical advice.

Posted on

National Sleep Week Emphasizes Health Risks of Untreated Sleep Disorders

Good sleep is critical to maintaining good health. Snoring or constant fatigue may be a sign of sleep apnea and symptoms should be screened by a doctor.

WASHINGTON, DC, USA, April 19, 2017 / — Many people are unaware that when they sleep, they literally gasp for air, which deprives the brain of oxygen, unleashing a chain reaction in the body linking to a host of serious health issues including strokes, depression, heart attacks, high blood pressure, type 2 diabetes and ADHD in children.

For most of his adult life, 62-year-old Bill Weimar of Arlington, Virginia was unaware he had a sleep disorder. Because he wants to prevent others from suffering as he did, Mr. Weimar is joining the voices of medical professionals who are urging Americans to take the time to get tested and treated for obstructive sleep apnea during National Sleep Week (April 23-29). View Photos

According to statistics from the American Sleep and Breathing Academy, obstructive sleep disorders affect about 18 million Americans, and that number is on the rise. Additionally, one in 50 people are undiagnosed and untreated.

“When your brain doesn’t get sufficient oxygen, every organ in your body suffers and this can lead to serious health complications and sometimes death,” said Dr. Elliott Alpher, a Washington, D.C. Diplomate in Craniofacial Pain and Dental Sleep Medicine, who has been treating obstructive sleep apnea, facial and jaw pain for three decades. “Unless you get a proper diagnosis and treatment, you are a walking dead person.”

Mr. Weimar’s journey to health and a good night’s sleep began in 1999 with a heart attack. Afterward, he followed his doctor’s recommendation for a rigorous fitness and dietary routine. Despite that, the active commercial pilot, husband and father of two stayed tired all the time. “My poor wife! I don’t know how she put up with me,” Mr. Weimar said. “I snored so loudly my daughter even complained. I never realized I had a sleep apnea problem that was literally draining me of so much of my life.”

It would be another decade before Mr. Weimar received the diagnosis and treatment that saved his life. In the interim, life sent him more challenges and tragedies. In 2004, he underwent two surgical procedures to implant cardiac stents that opened his clogged arteries. Then came tragedy. In 2007, after a two-year fight, Mr. Weimar’s wife of 22-years died of ovarian cancer. He spiraled into a deep depression, stopped exercising and lived only for his two children.

In 2010, Mr. Weimar was diagnosed with prostate cancer and one of his doctors sent him for a sleep test. Like many people, he didn’t realize that Obstructive Sleep Apnea is a killer. According to the National Commission on Sleep Disorders Research, about 38,000 deaths from heart problems, hypertension and strokes are linked to obstructive sleep disorders. In addition, people with untreated sleep apnea are six times more likely to die in a car accident. The National Highway Traffic Safety Administration says drowsy driving is the culprit for an estimated 100,000 accidents and 1,550 deaths each year.

For Mr. Weimar, the sleep study revealed the seriousness of his condition. “My oxygen level was 64%,” Mr. Weimar recalled. However, he could not tolerate the standard treatment – a continuous breathing machine (CPAP), which tethered him to a continuous oxygen supply while he slept.

A recommendation from his therapist led Mr. Weimar to see Dr. Elliott Alpher, whose use of conservative, non-surgical techniques to treat TMD, TMJ and sleep disorders have helped thousands of people get healthy. He counts among his patients members of the NFL Players Association. After an extensive exam and computerized diagnostics to build a custom oral appliance, Mr. Weimar says Dr. Alpher literally gave him back his life.

“The first time I put the oral appliance in my mouth, my oxygen levels immediately went to 98%. My energy level increased and this allowed me to deal with my life. I came off the medications for depression. I have energy and focus.” Mr. Weimar said. “I cannot begin to tell you how fortunate and how amazing I feel because of this device that I wear every night that helps me breathe and allows me to sleep. I must emphasize the importance of getting oxygen to the body, which needs rejuvenation and rest every day. If your partner is snoring, tell them and encourage them to get tested.”

Posted on

Dr. Alpher Continues Efforts to Help Transportation Industry with Sleep and Highway Safety


Media Contact:

Lily Mai (202) 795-7111 –

Dr. Elliott Alpher, DDS, D’ASBA and the American Sleep and Breathing Academy (ASBA) are excited to update you on our tremendous progress with the transportation industry. We have come a long way since we started on this journey four years ago, tirelessly continuing to bring awareness by educating policymakers and leaders on the effectiveness of Oral Appliance Therapy (OAT) for the treatment of obstructive sleep apnea. Former Congressman Marty Russo, who was successfully treated for OSA and experienced the revolutionary benefits of OAT heard about our obstacles and believed that more people should be aware of the benefits of OAT and joined our efforts.

During the summer 2013, in response to regulations for commercial truck drivers with sleep apnea to be treated with either CPAP or surgery that were under consideration by the Federal Motor Carrier Safety Administration (FMCSA) and Medical Advisory Board (MAB), Dr. Elliott Alpher along with experts that included David Gergen, Dr. Richard Klein, Dr. Rick Bonato and NFL great Derek Kennard presented an OAT solution to the Secretary of the Department of Transportation and cabinet. At the conclusion of that meeting, the group agreed that oral appliances along with new micro-recorder compliance —a device that indicates that the truckers are wearing their sleep device coupled with home sleep testing—would be a superior and much easier alternative to CPAP or major surgery.

The American Sleep and Breathing Academy has been actively involved in championing sleep and airway awareness. In May 2016, ASBA members advocated on behalf of OAT by inundating the Federal Motor Carrier Safety Administration’s (FMCSA’s) and Federal Railroad Administration’s (FRA’s) Advanced Notice of Proposed Rulemaking (ANPRM) in proposed rule-making to screen, diagnose, treat, and track compliance of Obstructive Sleep Apnea (OSA) in individuals occupying sensitive positions in highway and rail transportation with scientific research to support OAT. That same month, Dr. Alpher met with and received Congresswoman Anna Eshoo’s support to co-host and to enlighten Members of Congress on the dangers of undiagnosed sleep and airway problems. “Our goal is to work together with the transportation industry leaders, regulators, and transportation personnel to diagnose and treat OSA while maintaining highway safety with as little operational disruption as possible,” says Dr. Alpher.

Dr. Alpher and the ASBA’s most recent achievement to date is collaboration with the Owner-Operator Independent Drivers Association (OOIDA) with 158,000 members in all 50 states and Canada who collectively own and/or operate more than 240,000 individual heavy-duty trucks and small truck fleets. The OOIDA mission is to serve owner-operators, small fleets and professional truckers, and work to maintain a fair and efficient business climate for all truck operators, promote highway safety and responsibility among all highway users. OOIDA Director of Operations, Tom Weakley will be a guest speaker at this year’s annual Sleep and Wellness conference hosted by the ASBA on April 21-22 in Phoenix, AZ. He will be presenting the OOIDA’s position and concerns on the present recommendations for the limited treatment options and how the Medical Review Board has used and, to some extent, tried to limit any other treatment modality other than CPAP.

Posted on

It’s World Sleep Day – Gasping for Air is Potentially Dangerous

World Sleep Day is an annual event, intended to be a celebration of sleep and a call to action on important issues related to sleep, including medicine, education, social aspects and driving. It is organized by the World Sleep Day Committee of World Sleep Society (founded by WASM and WSF) and aims to lessen the burden of sleep problems on society through better prevention and management of sleep disorders. World Sleep Day is held the Friday before Spring Vernal Equinox of each year. Future dates will be: March 16, 2018, March 15, 2019 and March 14, 2020.