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Treating sleep apnea without CPAP

Joi Freemont, DDS
Conditions
January 11, 2019
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It was 4:00 a.m. when I made it to my parents’ home. My mother called me to say that my father was having a hard time breathing. I could hear him struggling in the background. I ran inside to see my mother cradling my father on the floor — not breathing. I performed CPR on the man that gave me life! CPR on the person who just three months earlier joined me as we renewed our CPR certifications together.

He had a heart attack following an episode of sleep apnea. He died a few hours later.

Sleep apnea. What is that? I had heard about it but knew very little. I always knew my father snored. I did too. But so what? What was the big deal with snoring? Doesn’t everybody snore?

My father, Dr. James Freemont, was a physician, an OB/GYN. When he died, he was not only chief of staff but the president of the hospital — the “Go-To Guy.” He delivered almost 8,000 babies during his career and loved the gift of life. Now he was gone. He was my hero and my idol. My life was forever changed.

Immediately after I lost my father, I began to study this disease and learned that over 70 million people don’t even know they have sleep apnea. I was in that number. My whole family soon got tested — my mother, two brothers and I — and all of us have it! We were walking time bombs and didn’t know it.

As I poured over my father’s medical records, it was amazing to me that all of the signs were there. He had high blood pressure. He was overweight. He smoked. He had glaucoma. He snored. But he went to the doctor — not only his primary care physician but a cardiologist! I wondered why none of the pieces in his health history led anyone to request a simple sleep study.

The week prior to his death he had a week-long stay in the hospital following a scare. That’s when he was diagnosed with having severe obstructive sleep apnea (OSA). They scheduled an appointment with the pulmonologist to get a CPAP in two weeks but time ran out. Why didn’t they give him one before he was discharged?

Five months after we said goodbye to my father I was on my way to attend the first of many courses on sleep apnea. Since then, my dental practice has focused on treating patients who are CPAP non-compliant and intolerant. It’s sad to say that I witness more times than I can count the number of patients that I treat who have hypertension or diabetes who have never had a sleep study. Over 30 percent of people with hypertension have sleep apnea and 85 percent of those with Type 2 diabetes have it, but it’s still going undiagnosed.

Furthermore, there are those with OSA who are never given treatment options by their doctors when they are told they have it. I’m met with a blank stare when I bring this up during our consultations. They never knew that there was anything other than a CPAP. The CPAP sits in a closet, the patients suffer, and their doctors aren’t doing anything about it.

When I was diagnosed, I knew immediately that I was never going to wear a CPAP. It was a bulky machine that had to be plugged up and put over my face at night. I couldn’t imagine what my husband would say. Armed with the knowledge that surgery and an oral appliance were options, I chose the oral appliance. I now have first-hand experience and can relate with my patients when they tell me their CPAP experience.

I sadly get pushback from a few physicians who are forced to give our mutual patients sleep studies. I’m even embarrassed when I learn of the doctors who won’t order a sleep study because they don’t think their patients need one despite their risk factors. I’m not sure if it’s a God complex or pride. I know that I’m “just a dentist,” but I’m also just a daughter who doesn’t want anyone else to go through what I did — especially if it can be prevented.

Joi Freemont is a dentist and can be reached at Freemont Dental.

Image credit: Shutterstock.com

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