This textbook provides a comprehensive introduction to the novel concepts of pneumopedics and craniofacial epigenetics. Clinically, these mechanisms are delivered through biomimetic oral appliance therapy. The text, therefore, covers both genetics and epigenetics of craniofacial development, as well as growth and development of the craniofacial architecture. Despite being complex subjects, the style of writing allows the general reader to assimilate this information and sets the scene for how these principles might best be utilized. For example, the clinical application of biomimetic tooth movement achieved through epigenetic orthodontics is presented. Prior to pneumopedic treatment, the significance of craniofacial diagnostics and treatment planning is discussed, before detailing the principles of designing a biomimetic oral appliance. Next, the book goes over the practicalities of clinical adjustments of oral biomimetic devices. Moving onto patient selection and management, the book also provides an overview and introduction to pediatric craniofacial epigenetics, which touches upon the preventive aspects of healthcare, including nutrition. This section is followed by an introduction to sleep and sleep disordered breathing in both children and adults, which includes a comprehensive approach to the potential elimination of obstructive sleep apnea. Finally, clinical biomimetic correction is illustrated with examples of non-surgical upper airway remodeling using various cases. The book also contains a Glossary containing definitions of common terms as well as an Appendix of documents that might be useful for both implementation and further study.

This issue of Sleep Medicine Clinics focuses on Dental Sleep Medicine and includes topics on: Clinical Evaluation for Oral Appliance Therapy; Bruxism and Obstructive Sleep Apnea; Obstructive Sleep Apnea's Connections with Clinical Dentistry; Avoiding and Managing with Oral Appliance Therapy Side Effects; Predicting outcomes with Oral Appliance Therapy; Oral Appliance Therapy and Temporomandibular Disordres; Dental Sleep Medicine in the Military; and Pediatric Considerations in Dental Sleep Medicine

Millions of people suffer from obstructive sleep apnea (OSA). The apparent medical implications of this disorder are multiple. Although the most effective treatment for this problem is positive airway pressure (PAP), many patients do not adapt well to this form of therapy. Oral appliance therapy, although less effective, is a more easily tolerated treatment. The integration of sleep medicine and oral appliance services presents an innovative new approach to treating sleep apnea. As physicians and dentists consider the oral appliance treatment alternative, questions abound. What are the patient management and insurance ramifications? What specific clinical expertise is required? How do dentists and physicians integrate diagnostic and treatment protocol and procedures? The Medical Dental Guild's new Sleep Medicine and Oral Appliance Therapy manual provides physicians and dentists essential, concise information as they consider adding oral appliance therapy services to their existing practices. To optimize the use and effectiveness, the practitioner must be adequately informed. Sleep Medicine and Oral Appliance Therapy breaks down bureaucratic and clinical conundrums allowing successful integration of new technologies and services. The field of sleep medicine presents a unique opportunity for physicians and dentists. With the help of the Medical Dental Guild, providers can explore this new opportunity with the confidence that comes from comprehensive understanding.

The book focuses on biomedical innovations related to the diagnosis and treatment of sleep apnea. The latest diagnostic tools are described, including sleep laboratory equipment, wearables, and even smartphone apps. Innovative medical devices for treatment are also covered, such as CPAP, Auto-PAP, hypoglossal nerve stimulation, phrenic nerve stimulation, acoustic brain stimulation and electrical brain stimulation. This is an ideal book for biomedical engineers, pneumologists, neurologists, cardiologists, physiologists, ENT physicians, pediatrics, and epidemiologists who are interested in learning about the latest technologies in treating and diagnosing sleep apnea. Chapter 12 is available open access under a Creative Commons Attribution 4.0 International License via link.springer.com.

Advance your dental practice by tapping into the booming field of oral appliances for the treatment of sleep apnea. Dental Sleep Medicine Basics is the first and only book teaching the step by step clinical aspects of Dental Sleep Medicine. This book highlights the background of sleep apnea and the role of a dentist in treating it. It is organized in the step by step fashion that facilitates efficiency and thoroughness allowing a dentist to not only help patients with sleep apnea, but also get paid for it. The use of illustrations and descriptions will help to understand each step. Mark Collins DDS, DABDSM a seasoned dentist in dental sleep medicine presents the clinical guide to treat obstructive sleep apnea, including: Background on sleep apnea and current treatments available How to screen patients for obstructive sleep apnea The thorough and proper comprehensive examination An understanding of appliance choices Proper bite and appliance impressions Potential complications and corrections Templates and sample forms for your practice Guidance on medical billing, including Medicare Sleep apnea plagues millions of Americans, keeping them and their families from getting adequate rest, often for years (even decades) at a time. With only a few viable treatments available, most sleep apnea sufferers feel they have little recourse. Where surgery and apnea masks fail, dental sleep medicine and oral appliances may succeed. Containing illustrative pictures and thorough explanations, Dental Sleep Medicine Basics is a step-by-step guide to help get your clinical treatment of the disorder off the ground and start treating the millions of sufferers who need your help today. This is a comprehensive clinical guide with everything you need to treat obstructive sleep apnea. Dr. Mark Collins DDS, DABDSM a private practice dentist that has taught hundreds of dentists dental sleep medicine, published articles on dental sleep medicine, served on the credentialing committee with the AADSM, was the first facility accredited by the AADSM in the state of Arizona, and designed dental sleep management software.

In recent years, the spectrum of therapy for sleep-related breathing disorders has been immensely enriched by numerous innovative surgical procedures and techniques. Deciding which therapy is most appropriate for which patient is often a difficult matter, especially in light of the non-surgical alternatives. This book analyses the efficiency of the recognised surgical procedures; it is rooted in evidence-based medicine. Indications, techniques, complications, and specific follow-up treatments in the realm of sleep medicine have been compiled in the form of a primer. The authors are directors of one of the largest otolaryngological sleep laboratories in the world and perform approximately 1,500 surgical sleep medicine procedures per year. The complete surgical and sleep medicine know-how of the authors, as well as the experience of numerous international courses on sleep surgery, have been incorporated into this volume. It is therefore the fundamental textbook for sleep medicine surgeons.

Introduction 'Bocca della Verità' or 'Mouth of Truth' is the logo of the Unit for the Study and Therapy of Sleep Respiratory Disorders at the University of Rome 'La Sapienza'. It was chosen because its round shape with surprised expression, small nose and open mouth mirrors the typical face of a patient with OSAS (pre-therapy). The stone (diameter 1.75 m) in fact represents the face of a screaming faun and was originally found in the Mercury Temple area. According to popular legend, anyone putting his hand in the mouth will have it cut off if he has told a lie. When I first became involved in the field of OSAS about ten years ago, I had no idea that this activity would become foremost in both my professional and my academic life. My curiosity was aroused when a patient of mine, an extremely fat patient, whom I had been following for a long time regarding a hearing problem, asked me for a prescription for CPAP. He had read in a newspaper that this device could solve his nocturnal respiration and diurnal hypersomnolence problems. Suddenly, I was confronted with documentation on snoring, OSAS, polysomnography, upper airway surgery, and positive pressure devices. I was then, and still am now, a Professor of Audiology. Audiology was and still is the object of my love, but it is mainly a speculative discipline. It involves physics, electronics, psychology, rehabilitation, and great possibilities for basic research. However, only rarely does an audiological patient obtain full satisfaction clinically. Patients with neurosensorially-based deafness can be rehabilitated, but with difficulty; conductive hearing loss is light and recovers automatically in most cases; in a few cases, the patient can be packed up and delivered to the ear surgeon or audioprosthetic technician. Vertigo is dramatic, but recovers spontaneously or after long-term rehabilitation, or it is categorized as a neurological symptom. Tinnitus is frustrating and the audiologist centers most of his time and energy on trying to convince the patient to forget it. In fact, it is very rare to see a patient affected by an audiological disease recover after intervention by an audiologist. Furthermore, most patients are either very old or very young. With OSAS patients, things are very different. The patient is usually at the peak of his life; he has serious disturbances in his social, familial, and working spheres; he is sedentary and is often a manager with a disordered of lifestyle (does not partake in any sport; smokes and drinks too much), he has become irritable, apathetic, and is starting to worry about dying during the night or suffocating. He has been followed for years for his arterial hypertension and latent arrhythmia. He, or often she, is a snorer and, after complaints from their partner, sleeps in a separate room. His sex life is affected, and he often gets up during the night convinced that he has prostatic problems too. Unfortunately, for many years, no-one thought that these kinds of patients should consider consulting an otolaryngologist, and, at the same time, otolaryngologists never thought of taking care of this pathology. As soon I started to see the first cases and was able to solve their obstruction, the number of patients being referred grew dramatically, as did my skill in this field. It was a really rewarding job. After years of hyperspecialistic practice, I returned to patient care in its entirety. Sometimes, a simple intervention such as nasal septoplasy or tonsillectomy, i.e., one of those interventions so often underestimated by more expert colleagues, was able to solve some of the serious problems of life. In the meantime, specific new techniques came into being: radiofrequencies, oral appliances, diode lasers, tongue suspension devices, while, at the same time, diagnostic instrumentation such as polysomnography became more flexible and could more easy to be applied to obstructive disorders. By 1997, my department was in an uproar about OSAS since I had got most of my colleagues interested in becoming involved, and the first sponsor was my former chief, Roberto Filipo, who gave me his approval, space to work in, and encouragement to overcome all the problems. My other colleagues, and I would like to mention all of them here: Giorgio Bandiera, Maurizio Barbara, Gian Antonio Bertoli, Ferdinando D'Ambrosio, Elio De Seta, Simonetta Masieri, Antonio Minni, Simonetta Monini, Virgilio Pizzichetta, Mario Patrizi, Maurizio Saponara, and Antonino Sciuto, either directly or indirectly, also offered to put their experience into writing various sections for this book. A specific section was also organized at the Institute, and I was able to coordinate some of our residents who have recently taken on the task of apostles, spreading the knowledge they acquired on OSAS during their time with us to other hospitals in the region. I must mention them too, since very often they did most of the work, and in OSAS, that is a lot of work: Francesca Auriti, Angelo Clarici, Fulvio Di Fulvio, Arianna Mattioni, Angela Mollica, Maria Laura Panatta, Barbara Pichi, Raniero Pucci, Mario Rinaldi, Rocco Roma, Anna Sambito, Ilenia Schettino, Rocco Schettino, Emanuela Sitzia, Artur Zajmi, and others. The diagnosis and treatment of, and scientific research into, OSAS is a multidisciplinary task, and I succeeded in involving many professors from related disciplines at the hospital of the University 'La Sapienza': Carlo Cannella for Alimentation and Human Nutrition, Eugenio Gaudio for Anatomy, Giuseppe Calcagnini for Cardiology, Vincenzo Bonifacio and Debora Giannini for Endocrinology, Adolfo Francesco Attili for Gastroenterology, Franco Angelico for Internal Medicine, Giorgio Iannetti for Maxillo-Facial Surgery, Giuseppe Amabile for Neurology, Maria Pia Villa for Pediatrics, Alessandro Perrone and Ilio Cammarella for Pneumology, and Carlo De Dominicis for Urology. They used their experience in treating these patients and present their results in their contributions to this book. During the same period, the diagnosis and therapy of OSAS was spreading fast to all otolaryngological units at universities and hospitals throughout Italy. It was easy for me to share my enthusiasm, and thus we built up a network of close cooperation. Any otolaryngologist will know these contributors so well that it would be easy for him to find their papers in this book, but still I want to mention those who were closest in advising and helping me: Marco Fusetti from L'Aquila, Luigi D'Angelo and Vieri Galli from Naples, Pietro Ferrara, Riccardo Speciale and Salvatore Restivo from Palermo, Oskar Schindler from Turin, and Maurizio Maurizi and Vittorio Pierro from Rome. The time was now ripe to confront the world nomenclature on OSAS. The dream to share a rendezvous with all (or most of) the prominent people from all the disciplines involved in both the clinical and scientific research on OSAS was realized in 1997 at the 'ROMA OSAS - First International Conference on the Diagnosis and Therapy of Snoring and OSAS', which was followed by a second meeting in the year 2000, and a third in 2002. I only have to mention the names of the presidents of these conferences to testify to the high quality that was achieved: Giovanni Bonsignore, Gisle Djupesland, Roberto Filipo, Christian Guilleminault, Meir Kryger, Elio Lugaresi. It would be inappropriate to mention here only some of those who also took part, and there are too many to mention them all, since they are all equally important. I was very honored to ask them for and to receive papers for this book. Some of the abstracts presented at these conferences are also included in this book as highlights on various subjects, due to their particular relevance. And so, finally, you now know how this book was born. It is the collection of an enthusiastic beginner who persuaded his friends and/or colleagues from his department, his university, his country, and the entire scientific community, to submit papers on the basics and state-of-the-art of relevant topics regarding snoring and OSAS, which, hopefully, in its turn will help those other enthusiastic beginners who wish to improve their knowledge on the care of apneic patients. Also, even though many of the chapters are written by participants at the ROMA OSAS Conferences, this book is not an abstract volume of those meetings. It does, however, represent the scientific development unearthed on those occasions. For this reason, I think it would also be a valid textbook on OSAS from an otolaryngological point of view. After the many thanks due to the contributors, my final thanks must go to the person who had the patience to cooperate with me on the editorial work: Peter Bakker of Kugler Publications. My confrontations with him were often thorny, but we both had the same goal in mind: to offer you the best possible product. We hope that you will agree with us that this book will be a useful addition, both to your practice and to your continuing education. Mario Fabiani