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I 23hygiene 1_2012 C.E. article_ sleep apnea I _Appendix Patients answering yes to any of the following questions may need to be referred to a sleep physi- cian. • Do you snore? • Have you ever been diagnosed with high blood pressure? • Has there been any witnessed stopping of breathing or gasping for breath during sleep? • Do you know your neck size? If so, is it more than 17 inches for men or 15 inches for women? • Have you ever been told to use a CPAP or breath- ing machine while sleeping? • Do you and your partner sleep in separate rooms because of your loud snoring? • Do you doze off unintentionally during the day? • Do you often wake up feeling tired or having a headache? • Do you have problems concentrating for long periods of time? _References 1. Pagel, JF, (2012, July 8), The burden of obstructive sleep apnea and associated excessive sleepiness; The Journal of Family Practice, (1–6). Retrieved July 8, 2012 from www.findarticles.com/p/articles/mi_m0689/is_8_57/ ai_n28023915/. 2. ClinicalStaff(2012)MayoFoundationforMedicalEducation and Research (MFMER). 2012, June 29, Mayo Clinic. Definition of Sleep Apnea. Retrieved July 1, 2012 from www.mayoclinic.com/health/sleep-apnea/DS00148. 3. Prinsell, JR, (2002, November), Maxillomandibular Advancement Surgery for Obstructive Sleep Apnea Syndrome; Journal of the American Dental Association, Vol. 133, pp. 1489–1496 [PubMed]. 4. de Almeida FR, Lowe AA, Otsuka R, Fastlicht S, Farbood M, Tsuiki S, (2006), Long-term sequellae of oral appliance therapy in obstructive sleep apnea patients: part 2. Study-model analysis; Am J, Orthod Dentofacial Orthop, 129:205–213 [PubMed]. 5. Friedlander, AH, Walker, LA, Friedlander, IK, Flesenfeld, AL (2000, August), Diagnosing and Co-managing Patients with Obstructive Sleep Apnea Syndrome; Journal of the American Dental Association, Vol. 131, pp. 1178–1183 [PubMed]. 6. Coughlin SR, Mawdsley L, Mugarza JA, Calverley PM, Wilding JP, (2004), Obstructive sleep apnea is independently associated with an increased prevalence of metabolic syndrome; Eur Heart J; 25:735–741 [Abstract/ Free Full Text]. 7. Magliocca, KR, Helman, JI, (2005), Obstructive sleep apnea, diagnosis, medical management and dental implications; Journal of the American Dental Assoc., Vol. 136,(8), pp 1121–1129 [PubMed]. 8. Pételle B, Vincent G, Gagnadoux F, Rakotonanahary D, Meyer B, Fleury B, (2002), One-night mandibular advancement titration for obstructive sleep apnea syndrome. Am J RespirCrit Care Med 165:1150–1153 [PubMed]. 9. George, CF, Smiley, A, Sleep Apnea and Automobile Crashes: 1999 Sleep; Vol. 22, pp. 790–795. 10. Hoffstein, V, (2007, March), Review of Oral Appliances for Treatment of Sleep-Disordered Breathing: Sleep Breath 11 (1): 1–22, Published online 2006, November 29, doi: 10.1007/s11325-0084-8 [Pub Med]. 11. KalanA,KenyonGS,SeemungalTA,WedzichaJA,Adverse effects of nasal continuous-positive airway pressure therapy in sleep apnea syndrome. J Laryngol Otol 1999;113:888–892 [Medline]. 12. Kapur V, Strohl KP, Redline S, Iber C, O’Connor G, Nieto J, Underdiagnosis of sleep apnea syndrome in U.S. communities. Sleep Breath 2002;6(2):49–54 [Medline]. 13. Robertson CJ (2001), Dental and skeletal changes associated with long-term mandibular advancement: Sleep 24:531–537 [PubMed]. 14. Bader JD, Bonito AJ, Shugars DA, (2002), A systematic review of cardiovascular effects of epinephrine on hypertensive dental patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod;93:647–653 [Medline]. 15. Ringquist, M., Walker-Engstrom, ML, Ringquist, A, (2003, July), Dental and Skeletal Changes After 4 years of OSAS Treatment with a Mandibular Advancement Devices:AmericanJournalofOrthodonticsandDentofacial Orthoprosthetics, (1) pp. 53–60. Nancy Costa-Larson, RDH, BS, MHA, has worked in the den- tal field for 20-plus years as well as in the medical commu- nity for three years. Sheworksasanactive clinician and assist- ant clinical director in a non-profit clinic in Birmingham, Ala., working with students from the University of Alabama Dental School providing dental treatments to the uninsured community in the area. Costa-Larson was a delegate in the Massachusetts Hygiene Association Board. She received an associate in science in hygiene at the Springfield Community College, bachelor of science in businessatUniversityofPhoenix,Tampa,andamaster’sin healthcareadministrationfromArgosyUniversityinFlorida. Contactheratwhitesmiles4you@gmailorLinkedIn(Nancy Costa, Sleep Apnea Forum). _about the author hygiene