SLEEP APNEA - A PROBLEM WE CAN TACKLE

BY INTERVIEWS AND WRITINGS, AND WITH PERMISSION FROM DAVE GERGEN, DEREK KENNARD AND ROY GREEN

The concept of jaw position as a fundamental piece of sports performance is not new. Dr. Harold Gelb introduced this concept in his early work in the 1970s. The culmination of his work in improved performance was the 2000 Baltimore Ravens who triumphed over the New York Giants to win Super Bowl XXXV. Every player on the team wore a custom oral appliance that positioned the jaw in Dr. Gelb’s Jaw position called the Gelb 4/7 position. Since that time, professional sportsmen all over the world have been adopting a daytime mouth guard to protect them from injury and improve their performance.

In recent years, awareness of the potentially life-threatening effects of obstructive sleep apnea (OSA) has begun to rise, but there’s still widespread confusion about who can be affected by the disorder. Most of those who are aware of the dangers of OSA believe that it affects only overweight and unhealthy people. In fact, even some of the best athletes in the world suffer the consequences of OSA, especially players in the National Football League. According to a 2009 study by Mayo Clinic, 46% of players in the NFL and 60% of linemen suffer from sleep apnea. The problem is endemic and has even affected draft results. For example, sleep apnea took a toll on the 2007 #1 NFL draft pick JaMarcus Russell, who played for the Oakland Raiders.

HISTORY OF PRO PLAYER HEALTH ALLIANCE

David Gergen rolled out of bed on December 4, 1982, and had his career “aha” moment. Gergen knew he was going to be an orthodontic technician, and he knew he was going to help people all over the country. Since then, he has built one of America’s most successful dental labs in Phoenix, Arizona, revolutionized the sleep industry through oral appliances and special programs, and was once voted top dental laboratory technician in the country.

Derek Kennard had been seeing a doctor about his sleep trouble twice a year for eight years but had been unable to reach a resolution. He’d reached the uncomfortable conclusion that sleep apnea was something he’d just have to live with. Unfortunately, there was a much more difficult lesson about sleep apnea in store for him. When his younger brother, Donald, passed away from cardiac arrest brought about, in part, by sleep apnea, Kennard felt a new urgency to find a solution to his problem and was receptive when David Gergen approached him at the clinic.

Mark Walczak, a former tight end for the Phoenix Chargers, also faced health trouble associated with sleep apnea and achieved good results with a dental device.

“WE REACHED OUT TO OTHER PLAYERS WE’D PLAYED WITH, AND AGAINST, THE NATIONAL FOOTBALL LEAGUE, AND THE PLAYERS UNION, AND WE STARTED TESTING PLAYERS.”

The players’ friends could see how much Kennard’s and Walczak’s lives improved. Another former teammate, Roy Green, who also had problems with his health, was intrigued enough to ask and pursue a solution—and Kennard, Walczak, Green, and Gergen realized their sleep stories and solutions were something worth sharing. They formed the Pro Player Health Alliance with the goal of helping other NFL players.

After noticing NFL players seeking treatment for their obstructive sleep apnea, Gergen decided there was an urgent need to spread awareness of the disorder throughout the United States. His response was to form Pro Player Health Alliance (PPHA), which brings current and former professional football players to different communities throughout the U.S. to promote awareness of sleep apnea. “Pro Player Health Alliance was created to treat the sleep health needs of retired NFL players,” explains Gergen, “while at the same time raising awareness of sleep apnea as a silent killer.”

PPHA events have reached thousands of people and have the potential to reach many more, potentially the entire NFL fan base. The beauty of PPHA’s efforts is that they benefit everyone involved: the public meets their sports heroes while becoming informed on the life-threatening risks of sleep apnea; players receive treatment for this debilitating condition, which means better athletic performance and more exciting games; dental practitioners, especially those who help host PPHA events, are able to attract attention and patients to their sleep practices; and dental sleep appliance labs like Gergen’s are able to conduct more research and develop improved oral appliance solutions.

“We reached out to other players we’d played with, and against, the National Football League, and the players union, and we started testing players,” Green said.

The Pro Player Health Alliance has tested over 200 former and current NFL players and has seen great results. Roy Green said, “We heard stories that were so unbelievable. Lives were changing. We decided to reach out to our communities, to everyone we know. We know this is saving lives. This is helping so many people. It’s just become a passion of ours, so that’s what we do now. We’re feeling so much better, and we know so many people are unaware that it is sleep apnea that they’re suffering from. Just a simple test and a simple appliance can change lives.”

Along with Kennard, Walczak, and Green, Eric Dickerson, Mike Haynes, and Larry Fitzgerald Jr., other NFL greats like Warren Moon, Marcus Allen, Dave Krieg, Nesby Glasgow, OJ Anderson, Bart Oats, Carl Eller, Preston Pearson, J.T. Smith, Lincoln Kennedy, Ed “Too Tall” Jones, Isiah Robertson, Chuck Foreman, and Nick Lowery, have all also received oral appliance sleep apnea treatment and subsequently teamed up with PPHA. Together, these players have visited schools, held meet-the-players events for fans, and even hosted golf-tournaments to spread a simple message: get diagnosed for sleep apnea, get treated, and get a good night’s sleep. As Derek Kennard explains, “You can’t put a price on a good night’s sleep.”

Eric Dickerson, another Heisman Trophy winner and NFL Hall of Famer, also suffered from terrible morning headaches and needed extensive dentistry due to sleep apnea. However, Dickerson is sleeping better than ever after receiving treatment for his OSA by Dr. Harry Sugg, in Dallas, Texas. Dr. Sugg placed Dickerson in a Gergen’s Orthodontic Lab Herbst appliance for night-time use and a Gelb Splint to prevent overclosing for daytime use.

Tony Dorsett, a former Heisman Trophy winner and NFL Hall of Famer, claimed he was “snoring like a freight train” before being diagnosed with sleep apnea. Then he received his dental sleep device, a Herbst appliance custom fit by Gergen’s Orthodontic Lab. Now that he breathes well while he sleeps, he proudly boasts, “Superman ain’t got nothing on me.”

Members of the Pro Player Health Alliance travel around the country promoting sleep wellness and they are surprised by how few people know about sleep apnea, the negative effects it can have, and how easy it can be to treat. They have seen some of their former heroes limping around, not feeling well. When questioned, these guys invariably say something about their poor quality of sleep. With a proper diagnosis and treatment, these guys who thought they were on the back nine, without much to look forward to, are active again and enthusiastic about life.

The bottom line is that sleep apnea is a problem we can tackle!

What’s next? In addition to continuing to promote awareness and treatment for sleep apnea with the PPHA, recently, Gergen has been working with NFL Hall of Famer Mike Haynes and NFL All-Pro Derek Kennard, who are both active in the POP Warner communities. Together, they are working on a new appliance that could potentially reduce concussions and improve performance on the playing field.

SPOTLIGHT ON PRO PLAYER HEALTH ALLIANCE FOUNDER: DAVE GERGEN

In a 2012 dental conference in Las Vegas, Dr. Gelb paid Gergen a high compliment, saying, “David Gergen is the finest technician ever to live. He is heads and tails above the competition.” Gergen was honoring Dr. Gelb for his 65th year in dentistry at the presentation, and Dr. Gelb mentioned, “There are two legends in this room.”

Sleep medicine specialist Rudi M. Ferrate, MD, DABSM, complimented David Gergen for his strength of character, his passion for excellence, and his desire to help as many people as possible, adding, “He could easily sit back and enjoy the fruits of his business, but instead he spends his time and resources promoting education and awareness of sleep disorders. He is single-handedly the most important force bringing sleep physicians and sleep dentists together and now is using his skills and reputation to bring everyone else on board—from legislators to sports legends.”

DENTAL DEVICES HELP MORE THAN JUST FOOTBALL PLAYERS….

For more than 20 years in Phoenix, Gergen spent the fall coaching POP Warner football and high school football. Most of the important lessons of his life were learned either watching football legends, creating challenges for himself on the field, or teaching children the values of courage and teamwork on the field. It comes as no surprise that Gergen, father of nine children, would focus a good deal of his professional life on helping children achieve their goals. Gergen is a certified dental technician, and some would say a master technician that children and adults have relied on for excellent results.

HELPING CHILDREN BREATH BETTER:

In his professional life, Gergen worked to straighten teeth for cosmetic reasons, and to help create functional oral structures for patients with severe trauma or developmental issues. Recently, some of his attention has turned to the efects of poor jaw position on children. “A small airway often forces children to breathe through their mouth and posture their head forward resulting in rounded shoulders and back problems,” explains Gergen. “Continuing this position over many years will create permanent changes in posture. Poor breathing habits can result in heart and lung problems in later life.”

After 30 years of establishing better jaw and tooth function through orthodontics, Gergen decided to focus on the airway. His pediatric sleep appliance, Gergen’s Bionator, is a direct result of his experience and experimentation. Gergen is eager to demonstrate to physicians and the public that oral appliances are an effective solution for sleep and airway problems.

Gergen’s Bionator is worn on the child’s upper and lower teeth, and gives dentists an opportunity to guide the growth of patients’ teeth— more importantly, the jaw and the airway. Expansion of the upper jaw will create more room for the tongue to posture forward and open the airway.

“The simple shape and construction of the lower appliance will help stage the growth of the child’s teeth, allowing the dentist to control the growth rates of the teeth for maximum cosmetic and palliative effect,” said Gergen. “One of the best parts of the treatment is that while growth is being controlled, the jaw is held slightly forward, creating an open airway that produces better and deeper sleep patterns.” Children undergoing standard orthodontic care have noticed their grades improve, sometimes dramatically. In the past, this improvement has been attributed to improved self-image or a growth spurt. Today, experts have measured the improved sleep patterns and the increase in airway size that comes from a better jaw position. These patients breathe better at night, and wake up more able to deal with the demands of the day.

Professional Drivers: According to a study by the University of Pennsylvania sponsored by the FMCSA and the American Trucking Association, 28% of truckers have mild to severe cases of sleep apnea. This is an alarming number, considering that there are over 3 million truckers on American highways. In 2013, Gergen appeared before the Department of Transportation to request that an assessment for sleep apnea be required for commercial truck drivers. On October 17, 2013, H.R. 3095, which sets standards for the evaluation of truck drivers for sleep apnea, was signed into law. Also in 2013, on behalf of the entire dental sleep community, David Gergen testified before the Department of Transportation to request that dentists be able to order home sleep tests for their patients. Increased testing may help reverse the trend of undiagnosed sleep apnea.

“ACCORDING TO A STUDY BY THE UNIVERSITY OF PENNSYLVANIA SPONSORED BY THE FMCSA AND THE AMERICAN TRUCKING ASSOCIATION, 28% OF TRUCKERS HAVE MILD TO SEVERE CASES OF SLEEP APNEA. THIS IS AN ALARMING NUMBER, CONSIDERING THAT THERE ARE OVER 3 MILLION TRUCKERS ON AMERICAN HIGHWAYS.”

Dental Education: In August 2011, Gergen’s first sleep training program was presented to a group of 25 doctors in Sonoma, California, and Gergen’s Orthodontic Lab team and training programs have gotten better since then. They maximize on their experience, developing specialties as educators and covering topics thoroughly in their seminars and meetings. They were selected by Henry Schein to participate in their dental sleep apnea programs. Their seminars emphasize long-term education and self-developing practices.

Dr. Archie Roberts, retired NFL player and founder of the Living Heart Foundation and NFL HOPE program, has been one of the Gergen team’s keynote speakers. Roberts established a strong correlation between OSA and heart disease in the general population. He asked Gergen to be the sleep apnea director in the HOPE program that the Living Heart Foundation launched at the Mayo Clinic in Scottsdale, Arizona.

David Gergen serves the dental sleep community as the Executive Director of the ASBA Dental Division. The ASBA Dental Division is a for profit group that has partnered with the not for profit American Sleep & Breathing Academy. For more information visit www.americansleepandbreathingacademy.com and click on Dental Division.

This article is for informational and commercial purposes about the Pro Player Health Alliance and the Herbst oral appliance. Views set out are those of the authors and do not necessarily reflect the official opinion of the ASBA.