Why We Do This
My name is Brett Brocki, I am the founder and CEO of N3Sleep and DreamSleep. I began this mission to transform sleep medicine because of my own experiences.
I once thought it was normal to wake up every hour from 11pm until 6am checking my email, answering messages, reading news. I simply accepted it and said, “that’s just how I am”. But a close friend alerted me that this irregular sleep pattern could be a red flag for a serious health problem. I was hesitant at first, but I agreed to seek help. I saw my primary care dr, an ENT, a pulmonologist, my dentist and was directed through their standard protocol, beginning with a few tests that were “inconclusive.” I was eventually referred to a sleep lab for an in-lab evaluation.
Soon, I was in the sleep lab, completely wired up and the polysomnography technician says to me “Now look, I need you to sleep on your back and then I will bring in the CPAP.” I was confused. I looked at him and said “I don’t sleep on my back. I sleep on my side or stomach.” His replied, “No. YOU don’t understand. This is insurance driven and I need you to sleep on your back.”
I was absolutely furious. I could tell I was only a number to this guy. He needed the test to register the right numbers so I could be prescribed a CPAP. This mindset was putting my life and many others in jeopardy. But what could I do? This was “the standard protocol” and there I was, so I slept as naturally as possible and in the morning I was diagnosed with severe Obstructive Sleep Apnea (OSA) and prescribed a CPAP.
I could not wear the CPAP. For many reasons, I just couldn’t tolerate it. Turns out I am not alone – only 17% of CPAP users can wear the device for more than 4 hours a night, 21 nights per month – and that is considered “compliant” in the literature1. So treating a sleep disorder for only half the night, 7 out of 10 nights is “compliant”? That didn’t sit well with me.
I knew there had to be a better way.
Now, if you know anything about me, you know I won’t stop until I’ve found the best solution to a problem. That is just who I am. And, I only know one way to do that: Attack the problem head on and create the change. So I dove head first into all of the literature and expert advice on sleep apnea.
I eventually discovered Oral Appliance Therapy: An FDA approved dental appliance that treats OSA by advancing the lower jaw during sleep, reducing airway obstruction. I immediately recognized this as simpler, more direct way of addressing my problem. And also one that didn’t involve sleeping with a hose attached to my face. It was quiet, relatively comfortable and easily portable which was key given how much I travel. Best of all? It worked. I was sleeping soundly through the night. Sleep testing showed my apnea events had reduced significantly. I lost weight and just felt better. So, if this was so great – an FDA approved medical device for treating OSA – why did it take me so long to find it? Why didn’t I get this first, before the CPAP, which was more expensive and cumbersome?
This question and my background in dentistry drove me to find out why patients were falling through the cracks. I found the problem was woven throughout the whole healthcare system for sleep. To start, the systems for screening were incomplete and driven by patient self-report – even though the research tells us most suffer from sleep apnea unaware. And I know from my own experience that I thought my symptoms were just part of getting older.
Second, the treatment for sleep apnea is dominated by the CPAP. Now, don’t get me wrong – there are many patients out there who need a CPAP – it may be the only effective therapy for their condition. That determination needs to be made by a physician. But many patients are getting pushed into CPAP because their healthcare providers are unaware of alternative treatments for mild to moderate cases, or CPAP intolerant / non-compliant cases like mine. This systemic CPAP absolutism leads many suffering from sleep apnea to avoid testing and diagnosis because of “fear of the mask”. Or, when they are told it’s the only option they end up not using their machine. Either way, the result is their condition goes untreated, which can not only make the sleep apnea problem worse, it can exacerbate other health problems, ultimately putting their lives in danger.
So why is Oral Appliance Therapy not more widespread? It is FDA approved to treat Obstructive Sleep Apnea. It is relatively well tolerated (about 80% of OAT users wear it every night2). And it is as effective as CPAP on real-world health outcomes like daytime sleepiness, quality of life, cognitive performance, high blood pressure, endothelial function and cardiovascular morbidity.
I discovered there were several reasons that OAT is not more widespread:
- OAT requires both a physician and dentist to work together for testing, diagnosis and treatment
- Most dentists today don’t have the right training to treat sleep effectively
- Problems with medical billing and medical insurance
- Poor awareness of OAT as a viable therapy for OSA
- Poor awareness of OSA symptoms
And that is what N3Sleep and DreamSleep are all about. We are committed to attacking each one of these issues head-on.
N3Sleep is the consulting division that provides dentists with the necessary education and training to deliver oral appliance therapy. We connect dentists and physicians, providing infrastructure and communication tools to ensure that patients don’t fall through the cracks.
DreamSleep is the public outreach and patient portal that connects the public with information and qualified healthcare providers. We raise awareness of symptoms, provide screening opportunities and help people find local providers.
We do all of this for one reason: to save lives. We believe that treating the condition is better than not treating the condition. I want to let people know there is an alternative out there. Don’t fear the treatment, don’t ignore the problem – take care of yourself. Get educated. Get tested. Get help.
Founder and CEO of DreamSleep and N3Sleep.
Individualized Training Plans
N3Sleep provides a state-of-the art training and implementation process tailored to the individual needs of each dental office. We encounter dental sleep teams with varying degrees of experience, so our training programs are designed specifically for the needs of each of our clients. This prescriptive approach will tailor training to meet the individual needs and circumstances of your practice.
Each training plan is tailored to focus on the most critical issues for your practice. Our pre-training process utilizes a series of questionnaires, training manuals and conference calls to understand your practice needs and create a customized training plan.
The DreamSleep Network
DreamSleep is a nationwide network of dentists and physicians committed to raising awareness and fighting sleep apnea. This mission encompasses four initiatives: Raise public awareness of sleep apnea, train dentists to implement dental sleep medicine, create sleep apnea screening, testing and treatment programs for industry and organizations, and connect patients with providers.
1.When adherence is defined as greater than 4 hours of nightly use, 46 to 83% of patients with obstructive sleep apnea have been reported to be nonadherent to treatment. Weaver TE, Grunstein RR. Adherence to continuous positive airway pressure therapy: the challenge to effective treatment. Proc Am Thorac Soc 2008; 5:173.
2.The objective mean use rate was 6.4 +- 1.7 h/night at 1 year follow-up in continuing users, with a regular use rate of 83%. Dieltjens M, Braem MJ, Vroegop AVMT, Wouters K, Verbraecken JA, De Backer WA, Van de Heyning PH, Vanderveken OM. Chest. 2013 Nov;144(5):1495-1502. doi: 10.1378/chest.13-0613.