There’s nothing so rejuvenating than a good night’s sleep, but for many of those suffering with sleep-disordered breathing (SDB), sleep may not be refreshing. But did you know that your sleep position can play a role in a good night’s sleep?

SDB disorders, such as obstructive sleep apnea (OSA), are caused by repeated episodes of upper airway obstruction during sleep. This interrupted sleep can result in health hazards such as daytime sleepiness, hypertension, stroke, heart failure, diabetes, depression, and the possible development of mental disorders.

Having postural stability is important and is our foundation to be able to stand and walk independently. However, studies have shown that poor posture while sleeping or your choice of sleep position can lead to sleep deprivation, which in turn creates negative effects on a person’s daytime stability. 
 
 The results of poor sleep can reduce alertness levels and lower body temperature, which along with reduced oxygen saturation levels, can lead to unsteadiness an increased risk of falls, especially in older people. SDB has also been shown to alter reflexes and reaction time while driving, as reported in a study published in the BMJ Journals.

How Your Sleep Position Affects Your Health

The position in which you sleep can have an impact on your overall comfort and health, and certain sleep positions may be recommended for those suffering from sleep apnea.

Sleeping on your Back

Sleeping on your back (supine position) is a good position for those who can breathe well. Your body gets good support, and by raising the feet above the heart, it can help alleviate swelling of the feet and ankles (edema) to reduce the impact of congestive heart failure. This is also the preferred position for infants and can reduce the risk of sudden infant death syndrome (SIDS). On the other hand, for those who have trouble breathing, sleeping on your back can allow your lower jaw and tongue to shift back and obstruct the airway, leading to sleep apnea.

Sleeping on your Side

Sleeping on your left or right side (lateral position) with the legs drawn up into the fetal position may be a better solution to reduce the effects of sleep apnea and snoring. It helps keep your airways open. This position also has its drawbacks though. While lying on your side, your internal organs can shift and put pressure on the heart and lungs, causing the heart to work harder or reducing the lungs’ ability to take in air. Shoulder, hip and lower back pain can become issues in time.

Sleeping on your Stomach

The least common sleep position is on your stomach (prone position). It can avoid the problems associated with back sleeping and prevent organ shifts within the chest. It can also lead to neck pain, as the head must be turned to one side or another, and it may be harder to breathe with the weight of body limiting the diaphragm’s ability to take in air.

Sleeping Upright

You can also sleep in a position where your head is upright, as in a recliner chair or with a wedge pillow or adjustable bed. This position prevents airway collapse and may diminish problems commonly associated with sleep apnea. The downside is that you can’t easily change positions.

Address Sleep-Disordered Breathing with Airway & Sleep Group

For diagnosis and treatment of sleep apnea symptoms, contact Airway & Sleep Group at (571) 244-7329. Or complete our convenient online contact form.  www.airwayandsleepgroup.com

Airway and Sleep Group/Dr. Liliana Calkins of Reston, Virginia was honored to be selected for the Best of Reston Award for two years in a row (2022 and 2023) in the Sleep Clinic category by the Reston Award Program.

“On behalf of Airway and Sleep Group, I am delighted to know that our efforts to serve the Reston region are recognized with this award,” said Dr. Calkins. “We are diligent about providing exceptional care to our patients to improve their quality of life.”

Dr. Liliana Calkins was recognized in 2019 by Continental Who’s Who as a Pinnacle Professional of the Year in the field of Medicine in recognition of her role as Specialist in Orthodontics and Craniofacial Orthopedics. She graduated first in her class at dental school at National Autonomous University of Mexico City (UNAM) earned her certification in orthodontics with honors. Dr. Calkins is a founding member of Airway and Sleep Group of Northern Virginia and a member of numerous prominent professional organizations.

The Reston Award Program

The Reston Award Program is an annual program that honors the best of local business in the Reston community with the mission to recognize the small business community’s contributions to the U.S. economy. Companies that have shown the ability to use best practices, and those that implemented programs to generate competitive advantages and long-term value are chosen for the Best of Reston awards.

Each year, the Reston Award Program identifies companies that have achieved exceptional marketing success in their local community and business category, with a focus on quality, not quantity. These local companies enhance the positive image of small business through service to their customers and the Reston community, and make the Reston area a great place to live, work and play.

Various sources of information are gathered and analyzed to choose the winners in each category. Winners are determined based on the information gathered internally by the Reston Award Program team and data provided by third parties.

About Airway and Sleep Group

Airway and Sleep Group is a practice in Reston, VA specializing in treatments for sleep apnea, craniofacial orthopedics, TMJ and orthodontics. Our goal is to treat our patients’ conditions by correcting the shape and functionality of their mouth, tongue, jaw and bite through state-of-the-art methods. 

Contact Airway & Sleep Group

To learn more about the services provided by Airway & Sleep Group, visit our website or listen to our podcasts. Contact us at 571-244-7329 to schedule an appointment. In-person and virtual consultations are available.

What Is iNap?

There’s a new patient-centered treatment to help anyone with mild to severe sleep apnea a patient-centered and user-friendly solution for comfortable, restful sleep: iNAP®.

How iNAP Works

iNAP creates intermittent negative airway pressure, reducing and nearly eliminating sleep apnea symptoms by keeping the airway open, allowing patients to breathe naturally and sleep peacefully. During sleep, iNAP delivers a gentle suction inside the oral cavity that moves the soft tissues forward and stabilizes the tongue away from the airway. Simply insert the latex-free interface at bedtime and click the power button. 

The iNAP device is compact, light, and portable — it’s about the size of a smartphone with twice the thickness. It also requires the oral interface and tubing set, a saliva container (6”x3.1”x1.4”), and dry pads. It’s available by prescription through your specialist at Airway and Sleep Group.

Produced by Somnics, iNAP is touted as “the most comfortable sleep apnea solution” available. There’s no mask or headgear, the device is portable, and the pressure is adjustable with an optional prescription device. No humidification is needed. However, those using it must breathe well through their nose at night.

Patients can download the iNAP Lab+ app and pair it with their iNAP One® device to monitor their treatment. Information collected from the iNAP console can help evaluate usage and treatment data.

Who Is a Candidate for iNAP?

You may be an iNAP candidate if you’ve been diagnosed with obstructive sleep apnea. Speak with your sleep physician at Airway & Sleep to learn if this treatment is right for you. In clinical studies, it was effective for patients with mild, moderate, and severe OSA, but it may not work for all patients.

The ability to breathe through the nose is essential for this treatment, as the oral interface seals the mouth, tongue, and soft palate during use. However, it does not interfere with braces or Invisalign® aligners. It may also be helpful for mild teeth grinding and bruxism.

Will Insurance Cover iNap?

The FDA cleared iNAP in May 2020. It has since been approved for prescription by all 50 states. Although iNAP is eligible for coverage for those whose employers offer HSA/FSA benefits, insurance isn’t yet covering the treatment. Thankfully, two options are available to help patients who have to pay out of pocket:

1. The iNAP Club Membership: Resupplies are sent quarterly, with free shipping. A three-month trial is required, after which the patient can cancel anytime.  
2. The iNAP Ownership Program (out-of-pocket purchase pricing): Patients can use the device for up to three months, and if they return it, they’ll be reimbursed the total price minus a $250 restocking fee. 

Somnics is currently working with commercial and federal insurance carriers such as Medicare to establish coverage and reimbursement for this new therapy and its supplies.

Airway & Sleep Group

If you’ve been diagnosed with Obstructive Sleep Apnea and wish for better sleep, solutions are available. And Airway & Sleep Group is here to help. Our physicians diagnose and treat sleep disorders and airway obstruction to help our patients improve their quality of life.

To learn more about iNAP and to schedule your in-person or virtual appointment with Airway & Sleep Group in Northern Virginia, please contact us at (571) 244-7329 or complete our convenient online contact form. 

Airway and Sleep Group’s Dr. Liliana Calkins, Specialist in Orthodontics & Craniofacial Orthopedics hosts this podcast as an Introduction to Orofacial Myology with Mary Frances, founder of Sound Mouths.

https://airwayandsleepgroup.com/
https://soundmouths.com/

Get Relief For OSA Symptoms

Snoring can annoy a sleep partner, but it can also indicate a more serious health risk. It’s often associated with obstructive sleep apnea (OSA). Thankfully, technological advances, such as tongue stimulation, have led to treatments that are providing relief!

Obstructive sleep apnea (OSA) is prevalent in approximately 33% of American adults aged 30-69 years, with 55% of those cases falling within the mild range. It’s often associated with habitual snoring, poor quality of life, and a significant increase in the risk of cardiovascular and metabolic disease.

Until now, treatment options have included positive airway pressure (PAP), oral appliances, and hypoglossal nerve stimulation, which only treated the disease while the subject was asleep. However, those using PAP did show improvements in sleepiness, functional status, cognitive function, and blood pressure when used for more than 5.5 hours per night. Surgery on the upper airway was rare. 

One of the problems with these treatment devices is getting people to use them. Adherence to medical recommendations is low, with studies showing that 50% of PAP patients use it fewer than 4 hours a night. 

What is eXciteOSA?

Technological developments have presented a new treatment that can be used while the subject is awake: Signified Medical Technologies’ eXciteOSA®.

eXciteOSA is an FDA-authorized prescription medical device designed to be used once daily for six weeks to retrain the tongue and upper airway muscles. After that period, therapy can be reduced to at least twice weekly for long-term maintenance.

The tongue stimulation device is composed of four components:

• A control unit (suitable for multi-patient use)
• A washable mouthpiece (for single-patient use)
• A smartphone app that pairs with the control unit to control therapy via Bluetooth, enabling the user to initiate sessions and control intensity.
• A physician portal for remote monitoring and long-term patient management

For more information, see our previous blog post on eXciteOSA.

eXciteOSA® Offers Tongue Stimulation Treatment for Obstructive Sleep Apnea

eXciteOSA is an intraoral neuromuscular electrical stimulation device designed for the once-a-day treatment of primary snoring and mild obstructive sleep apnea. It targets an underlying cause of OSA, specifically the inadequate responsiveness of the upper airway dilator muscle.

The largest muscle in the upper airway is the tongue (genioglossus). It can experience greater fatigability and reduced endurance in those who have OSA. Research has shown that providing neuromuscular electrical stimulation, or tongue stimulation, can improve muscle endurance, as associated with an underlying shift from fast-twitch to slow-twitch muscle fiber composition. Slow-twitch fibers are used for sustained, long-duration activities and play a role in maintaining an open upper airway during breathing and closing off the airway while eating. Fast-twitch fibers are used for short-burst power activities like chewing, swallowing, respiration and speech.

eXciteOSA applies electrical stimulation directly to the tongue for just 20 minutes per day while you’re awake. Those using eXciteOSA for tongue stimulation have shown significant improvements in snoring, OSA severity, sleepiness, and sleep quality.

Related: NIH sleeping tongue study

Learn More About Tongue Stimulation to Help Treat OSA and Snoring with Airway & Sleep Group

If you’d like more information about eXciteOSA and the latest treatments for OSA and snoring, contact Airway & Sleep Group at 571-244

Advanced Sleep Apnea Treatments

Sleep apnea is a dangerous condition as it can create complications in one’s health — some of which can be severe or even life-threatening. Since sleep apnea can create an increase in pressure in the blood vessels around the heart, even some of the heart chambers themselves, thus increasing your risk of high blood pressure (hypertension). It can also increase the risk of heart attack, stroke, and abnormal heartbeats/atrial fibrillation.

At Airway and Sleep Group, we look for ways to help alleviate sleep apnea to improve your quality of life and protect your health. One such therapy we recommend is Signifier Medical Technologies’ eXciteOSA®, the world’s first clinically-proven daytime therapy for mild obstructive sleep apnea and primary snoring. 

According to recent estimates, 55 million adults in the U.S. suffer from obstructive sleep apnea, with more than half being mild cases. For these individuals, their quality of life suffers, with analysis showing a 224% increased risk of developing hypertension, an 83% more likely diagnosis of diabetes, and a 59% potential for abnormal fasting glucose.

The eXciteOSA® technology has shown reductions in both objectively measured and bed partner reported snoring, along with significant improvements in disease severity and sleep quality. 79% of sleep apnea patients achieved beneficial results, and 90% experienced reduction in objective snoring time.

What Is eXciteOSA and How Does it Work?

eXciteOSA is a daytime therapy device for sleep disordered breathing, used to improve daytime sleepiness and sleep quality.

One of the leading causes of OSA is the lack of endurance by upper airway muscles during sleep. The tongue falls back and blocks the upper airway. The eXciteOSA device uses neuromuscular electrical stimulation (NMES) to exercise and train the upper airway muscles, working both the intrinsic and extrinsic tongue muscles to help prevent airway collapse while sleeping. It physiologically retrains the tongue and upper airway to maintain the tongue’s natural position during sleep.

See a video demonstration how eXciteOSA works.

The stimulation device is used for just 20 minutes a day while you’re awake. It involves a mouthpiece device that’s applied to the tongue once a day for six weeks, and a smartphone app to control the stimulation intensity and provide guidance, information, and therapy reminders. It’s both comfortable and painless. Take the 2-minute assessment to see if you’re a candidate, then contact a healthcare professional at Airway and Sleep Group to schedule your sleep study and obtain your prescription.

eXciteOSA is the only daytime therapy for primary snoring and mild obstructive sleep apnea authorized by the FDA (Food & Drug Administration). It’s also the only commercially-available device to be used while awake. Others are meant to be used during sleep.

eXciteOSA: Daytime Treatment for Sleep Apnea With Airway & Sleep Group

At Airway & Sleep Group, we take your health seriously and are always looking for the latest and best innovations to improve your quality of life. The eXciteOSA device is the first of its kind, and we’re glad to make this technology available to you to help with mild obstructive sleep apnea or snoring issues.

If you live in Northern Virginia, contact Airway & Sleep Group. We serve residents throughout the Northern Virginia and the DC metropolitan area. To schedule your appointment to learn more and see if you’re an eXciteOSA® candidate, contact us at 571-244-7328, or visit airwayandsleepgroup.com

With the world’s focus on “going green,” we want to do our part. In addition, we want to provide our patients with the finest diagnostic tools available. That’s why at Airway & Sleep Group we combine the two by offering Green X scanning. 

What is Green X?

Produced by Vatech, Green X is a highly-advanced 3rd generation compressed sensing technology that combines low-dose radiation X-ray scans with high-quality 3D images for use by dental and medical professionals. 

Benefits of Green X

The Largest Single Scan FOV Range

One of the greatest benefits of Green X is its ability to offer a wide range of selectable fields of view (FOV). This enables doctors to choose the optimum FOV mode while at the same time minimizing the radiation exposure to areas not of interest. Scans from five FOVs can range from a single tooth capture to an entire facial view, and can include the full arch region, sinus and left or right TMJ to suit most oral surgery cases and multiple implant surgeries.

Lowest Dosage

It is a common belief that inferior images are associated with low radiation. However, this is not true of the Green X technology. With reduction of up to 70% lower radiation than other types of scans, achieving clinically-diagnosable image quality is possible. In addition, its FOV range ability to focus directly upon the area in question reduces overall radiation to other parts of the face and neck.

Highest Quality Imagery

Green X is a highly-advanced 4-in-1 digital X-ray system incorporating panoramic (Pano), CBCT, Cephalometric (Ceph) (optional) and Model scan with high-resolution images.

• Pano = panoramic wrap-around X-ray of the face and teeth
• Ceph = lateral/side view X-ray of the face
• CBCT = cone beam computed tomography using a cone-shaped X-ray beam to capture an overall view of the entire mouth, jaw, nasal and throat areas, in 3D images that show bone, airway and soft tissues

The Fastest Scan Time

Green X is fast, which minimizes exposure and offers quick diagnostic capabilities. Image speeds range from Ceph scans at 1.9 seconds and CBCT scans at 2.9 seconds, to Pano scans at 3.9 seconds.

What the Improved Green X Imaging Means to You

Not all communities offer access to high-resolution imaging centers. But because we strive to provide our patients with the best and most improved diagnostic services available, we made the choice to invest in Green X Imaging.

Your quality of dental care is important. So is your overall health. If we can provide superior imaging while reducing your exposure to radiation, it is in everyone’s best interest. And as technology continues to improve and innovate, Airway & Sleep Group will continue to upgrade its services. It’s our commitment to our patients and our community.

Airway & Sleep Group

Airway & Sleep Group diagnoses and treats sleep disorders and airway obstruction through craniofacial orthopedics, TMJ treatments, orofacial myofunctional therapy, and interceptive orthodontics in order to provide our patients with quality sleep and an overall improvement in their quality of life. To do so, we find it important to invest in continuing education and improved technology.

To learn more about Green X or to schedule an appointment with Airway & Sleep Group, please contact us at (571) 244-7329 or complete our easy-to-use online contact form. 

When the jaw is too narrow, your doctor or dental professional may suggest a palatal or maxillary expansion. This widens the jaw to make room for teeth in younger patients, to correct or improve the way the upper and lower jaws work together, and improve breathing. It can also broaden your smile.

Maxillary Expansion in Adults

Two types of palatal maxillary expansion techniques are generally used in adults: the MSE Expander non-surgical device (best for ages 17-35) and surgically-assisted maxillary expansion (SAME). 

MSE Expander: With the non-surgical expander, a fixed orthodontic appliance is attached to the back molars, crossing over the upper arch. It applies a gentle force to push against the teeth and expand the palate and the jaw.

SAME: Because the bones are already developed in an older patient, SAME is used when appliance expanders are unable to do the job on their own, or for moderate or severe cases. In this instance, the doctors makes small cuts along the jaw to create symmetrical segments that can be broadened or adjusted over time.

SAME is both safe and effective, and performed under general anesthetic. Following surgery and recovery, the treatment can take several months to a year to achieve the desired result, with incremental adjustments to expand the palate. 

Some minor discomfort may occur in the first few days as your body adjusts to the expansion pressure. You may even see spaces appearing between your front teeth over time as the bones separate. Once the expansion is complete, orthodontic treatments can close the gaps between your teeth. Good stability is expected in the long term, with no significant relapse.

Why Would I Need Palatal Maxillary Expansion?

At Airway & Sleep Group, we are most concerned with your ability to breathe and sleep properly. The palatal maxillary expansion procedure is often used to resolve issues related to obstructive sleep apnea (OSA) or temporomandibular joint dysfunction (TMD), or to open airways and the nasal cavity to improve breathing. Other reasons for its use can include modifications for crooked or crowded teeth, or a crossbite.

A narrow bone structure in the face could be causing OSA or TMD. We may suggest a sleep study to study the amount of air flow during sleep, and how much carbon dioxide is in the blood. We’ll also monitor for sleep interruptions and things like brain activity and heart rate. If we discover that poorly-aligned teeth or a small jaw are the cause, we may recommend a maxillary expansion to solve breathing issues.

Sleep Apnea and Adult Palatal Maxillary Expansion at Airway & Sleep Group

At Airway & Sleep Group, we help improve sleep-disordered breathing issues through a number of treatment techniques, including adult palatal maxillary expansion. If you are suffering from sleep apnea, come talk to us.

Airway & Sleep Group is conveniently located in Reston, Virginia to serve patients throughout Northern Virginia and the Washington D.C. metropolitan region. Contact us to schedule an appointment at 571-244-7329, or use our convenient online form.