EPAP Fusion dotMAD™

• Nasal dilation from the expansion of the nasal valves can increase the overall upper respiratory system pressure by simply lowering the velocity of the air (Bernoulli’s Principle). Reduced resistance to airflow and increased overall airway pressure can mitigate, to varying degrees, the fluctuations of the caliber of the oro- and hypo-pharyngeal regions during the varying sleep stages. The direct result of this is a more stable supply of air to the lung and therefore oxygen to the hemoglobin of the blood. The increased airway pressure helps improve physiologic homeostasis during sleep by reducing changes in oxyhemoglobin saturation, which can have profoundly beneficial long-term effects on health. Calming the sympathetic nervous system in that process is necessary for the physiologic cellular repair that occurs in the undisturbed depths of Delta and REM sleep stages. Unfragmented sleep is also crucial to avoid the hazards of excessive daytime sleepiness associated with abnormal sleep cycles. 
• The EPAP device is held in a fixed position to the nostrils to enhance the effect of the restricted nasal exhalation. When the EPAP valves restrict on exhalation, the diaphragm has greater contraction to produce a higher overall back-pressure. This augments the effect of the dilated nasal valves and the dilation of the pharynx using the MAD. 
• In some patients the pressures created can begin to equal those of pump generated PAP (CPAP, BiPAP, AutoPAP, etc.). Thus, using EPAP augmentation of the effects of oral appliance therapy can be accomplished without the complex equipment and, in many patients, compliance killing effects of flow generators and sleep-damaging strapped interfaces (masks). 
• Using the oral appliance for stable retention of PAP interfaces eliminates many of the negative side effects of traditional PAP therapy. The goal and effect of these products is to increase patient compliance with therapy and to provide a much higher quality of sleep and of life.  
• Nasal airway function should be optimized for the maximal effect of EPAP augmentation  

*Clinical and technical support available at Comfort Acrylics, Inc. Laboratory or Visit www.comfortacrylics.com  

*Contact Dr. Richard Moore, DDS, ABDSM at Comfort Acrylics, Inc., digital division Ph: 360-834-9218

*Patents and trademarks are pending at the USPTO and owned by dotMAD, LLC. All rights reserved.