Do You Hate Your CPAP Machine?
At Main Line Snoring Solutions, the team led by Dr. Andrew Lieberman provides individualized alternatives to CPAP therapy for patients affected by obstructive sleep apnea.
Having practiced dentistry in the Philadelphia area for more than 20 years, Andrew L. Lieberman, D.M.D., has earned his reputation as one of the area’s premier dental health professionals. While he offers the full gamut of general and cosmetic dentistry through his practice, Bryn Mawr Dental Arts, many patients seek him out for something far different than improving the aesthetics, function, and overall health of their smiles—namely, treatment for the sleep-related breathing disorder known as obstructive sleep apnea, or OSA.
“It’s a hugely impacting disease,” says Dr. Lieberman, the owner of Main Line Snoring Solutions. “Tens of millions of people in this country are undiagnosed with the condition. It’s a very misunderstood disease that affects so many aspects of a person’s health.”
Nearly 30 million adults in the United States have OSA, according to estimates from the American Academy of Sleep Medicine, about 23.5 million of whom are undiagnosed. Other resources suggest the condition affects as many as 50 million to 70 million Americans.
One of the most noticeable signs of OSA is loud snoring, though other symptoms include excessive daytime fatigue, trouble concentrating during the day, and awakening abruptly with fits of gasping or choking, in some cases 30 or more times an hour. OSA can also contribute to more serious health concerns, such as high blood pressure, cardiovascular disease, stroke, depression, and sexual dysfunction. Research suggests that, although rare, the abnormal heart rhythms caused by OSA could even lead to sudden cardiac death.
“It’s such a serious issue that employers in certain fields—CDL drivers, pilots, traffic controllers—often test employees for OSA,” Dr. Lieberman says. “I help people whose careers mandate that they are actively treated for the condition, but I’m treating people as young as 16 to as old as 96. As part of my practice, I also work with high school, college, amateur, and professional athletes to help them understand the correlation between sleep quality and athletic performance, and help them maximize their athletic potential.”
His interest in OSA began with his understanding of the scope and severity of the problem. He then devoted his time to learning as much as he could through “a few hundred hours” of continuing education and training, as well as through the mentorship of fellow general dentist and OSA guru Stephen A. Gershberg, D.M.D. In the process, he gained insight into the challenges of treating the condition, specifically relating to continuous positive airway pressure, or CPAP.
A CPAP machine includes a mask that fits around an individual’s nose and mouth that delivers continuous air at a high enough pressure to keep the person’s airway open. The machine enables the wearer to breathe normally and, therefore, get a good night’s sleep—if they can tolerate the treatment.
“CPAP does effectively treat OSA, but most patients don’t like these machines,” Dr. Lieberman says. “They’re noisy, they’re uncomfortable, they’re cumbersome to travel with, and they’re often intolerable to the person who has to wear it and their sleep partner. CPAP tends to be the first line of defense, which has a lot to do with Medicare, but there are other options.”
He cites oral appliance therapy, in which a patient wears a custom oral appliance that has been carefully measured, calibrated, and titrated by a specially trained practitioner such as himself. The oral appliance opens the airway by moving the lower jaw forward, thereby reducing the risk of obstruction from the tongue during sleep.
“Many patients who have not yet been diagnosed with OSA have been referred to me by another healthcare professional,” he says. “I have a network of referring doctors and dentists who send patients to me who have already expressed an unwillingness to use CPAP, often because they just can’t tolerate it or because they refuse to accept it as an option.”
Rather than make the OSA diagnosis himself, Dr. Lieberman co-treats patients with their referring physician and existing dentist to ensure the best possible outcome. For those who have not yet received a diagnosis, he often facilitates the treatment process by referring the individual to a sleep doctor for a sleep study and an accurate OSA diagnosis—mild, moderate, or severe.
Once the patient has been properly diagnosed, Dr. Lieberman can then discuss treatment options, including oral appliance therapy. Each oral appliance is customized to accommodate the patient’s specific anatomy and to address the precise cause of their OSA.
“That’s why it’s important to go to someone who understands how these appliances function and how to keep an appliance from causing issues like malocclusion, TMJ pain, or other problems you didn’t have in the first place,” Dr. Lieberman adds. “It’s not a one-size-fits-all scenario, where I have a whole shelf of appliances just ready to go. My team creates each one by working in conjunction with the patient’s referring doctor and dentist.”
Main Line Snoring Solutions is one of a relative few in the area to participate in Medicare, and is licensed to provide durable medical equipment for the treatment of OSA. Dr. Lieberman and his staff work closely with clients to navigate treatment, including contacting the patient’s insurance provider to secure benefits.
Dr. Lieberman welcomes physicians and dentists from around the area to contact him and learn more about oral appliance therapy as a solution to OSA. His sole goal: to work with these care providers as a means of addressing a serious health issue for their patients.
“A lot of people don’t even know oral appliance therapy is an option, and there was a time when I didn’t fully understand it either,” he says. “Most patients are ecstatic that they have found this option, and their sleep partner is so much happier, too. It helps to improve every aspect of a patient’s life—work, home, travel, relationships. This is a big issue that affects a lot of people, and I’m here to try to help them make the right decision in solving the problem.”
Andrew Lieberman, D.M.D.
Qualified Member American Academy of Dental Sleep Medicine
Bryn Mawr Dental Arts | Main Line Snoring Solutions
14 S. Bryn Mawr Ave., Suite 200
Bryn Mawr, PA 19010
brynmawrdentalarts.com
mainlinesnoringsolutions.com
(610) 527-6704
Andrew Lieberman, D.M.D.
Qualified Member American Academy of Dental Sleep Medicine
Bryn Mawr Dental Arts | Main Line Snoring Solutions
14 S. Bryn Mawr Ave., Suite 200
Bryn Mawr, PA 19010
brynmawrdentalarts.com
mainlinesnoringsolutions.com
(610) 527-6704
Photos by Alison Dunlap
Published (and copyrighted) in Suburban Life magazine, June 2023.
