Dentist’s Device Ends Nightmare for Snoring Fireman’s Co-Workers

Fireman Jim Gorman says he was a “hard-core snorer” whose rumblings in repose were so loud that the guys at the fire station threw books, pillows and ashtrays at him to shut him up.

“Walls cracked and pipes broke when I snored,” he said, exaggerating a bit about the temblors triggered by his snores at the San Francisco International Airport station. “We’ve got 10 people sleeping in the dorm and I was keeping them all up.”

No longer, though, thanks to a plastic mouthpiece made by a dentist that appears to cure not only Gorman’s snoring but a more serious problem as well.

Gorman, like millions of others, suffers from sleep apnea--he stops breathing for excessive periods while asleep. A monitoring device from the Sleep Disorders Center at the Stanford University Medical School showed that he ceased breathing for up to 45 seconds many times a night.

Gorman underwent an operation frequently given to apnea patients, removing tissue from his breathing passage, but that did not completely solve his problem. He did not want to use an uncomfortable treatment that forces air through his nose and mouth from a pump, so he opted for a new device created by Cupertino dentist Dr. Kent J. Toone.

Toone, who had been fiddling with a design described in the British Medical Journal, made a mouthpiece for Gorman that not only helped Gorman’s apnea but also ended his snoring.

Can Be Fashioned Quickly

Toone calls his device SNOAR, an acronym for Sleep and Nocturnal Obstructive Apnea Reducer. He says any dentist can fashion one quickly, easily and for a fraction of the cost of other apnea treatments.

“SNOAR is designed to treat the medical condition of sleep apnea patients,” Toone said. “I do not purport this to be a cure for snoring. However, a side benefit is to stop snoring in some people.”

Toone cautions that although his device has worked well for about 10 patients he has treated, it will not work for those who snore because of problems such as a deviated septum or blockage of the nasal pharynx.

Gorman says he, his wife and his buddies at the fire station are grateful for SNOAR.

“It works good,” he said. “It took me a couple of weeks to get used to it. The first week I was sore because my jaw wasn’t used to it. It’s shaped like false teeth and feels like you have a brace on your front teeth. It makes the jaw jut out a little and forces you to keep your mouth open so you breathe easier.

“But the main thing is I don’t snore anymore,” he said. “So the wife doesn’t hit me and the guys in the Fire Department stopped throwing things at me.”

Sleep apnea sufferers, many of whom are overweight, often have thicker tissue in the airway that reduces the opening available, causing them to struggle for air and produce a loud snore when the airway opens somewhat and air rushes in.

Apnea sufferers may awaken, toss around and go back to sleep, only to repeat the scenario dozens or even hundreds of times a night.

If someone under stress with apnea also has a heart problem, the condition can be life-threatening. Sleep disorder experts believe that may explain why many people die in their sleep.

“Not everyone who snores has apnea, but just about everyone with apnea snores,” said Dr. Dean Edell, a TV medical commentator whose report about the British article last April led a patient to ask Toone to try to make the device. The article was written by Dr. Bruce A. Soll and dentist Dr. Peter T. George.

Stanford’s sleep clinic did not recommend the mouthpiece for Gorman and does not endorse its use, although doctors there are open-minded.

“It could be a cure for snoring and it may help people with apnea, but so far all the information we have about it is anecdotal,” said Dr. German Nino-Murcia, director of the clinic. “Nobody has studied 20 or 25 patients to see if the testimonials about it correspond with an objective study in a sleep lab. We would love to have a scientific study published that we can look at.”

Plans to Publish Soon

Toone, who plans to publish an article soon in a medical journal, says SNOAR is intended for cases where surgery is not needed or the patient does not want it, or in tandem with surgery to achieve better results, as with Gorman.

“Dentists have a singular approach to sleep apnea which has not become mainstream in sleep disorder centers,” said Stuart L. Rawlings, spokesman for the Assn. of Sleep Disorder Centers and the Stanford clinic.

“There are a number of dentists who have come up with certain devices which they say work, but there aren’t many sleep centers sending people out to dentists,” he said. “It is very significant, though, that dentists have taken an interest in the field and are joining in the experiments. They have more experience in their own area and have a unique contribution to make.”

The preferred treatment for apnea, he says, is called “continuous positive airway pressure,” or C-PAP, which allows patients to get “a perfect night of sleep because no apneas are allowed to take place.”

In the treatment, a mask fitted over the nose and mouth is attached to an air pump that sits at the side of the bed, and a regulated flow of air is pumped into the breathing passage.

Surgery is an alternative for patients “when they find C-PAP too uncomfortable or are too embarrassed to sleep with it every night,” he said.

Jaw Surgically Advanced

One type of surgery involves making an incision in the front of the jaw and advancing the jaw forward, away from the breathing passage, to make more space for breathing.

Another operation, with the jaw-breaking name uvulopalatopharyngoplasty, involves cutting away tissue in the breathing passage, such as part of the palate, tonsils, pharynx, adenoids or tongue.

A C-PAP machine costs about $1,000 to buy, or $100 a month to rent. The jaw operation costs about $6,000, and the tissue removal surgery costs about $2,000 to $3,000.

For only about $350, the SNOAR device seems to work just as well for some patients.

“For patients with snoring problems, the cost is relatively small, and the cost in pain and suffering is nonexistent,” Toone said.