Testosterone is very important in the health of both women and men, since it is the hormone that increases the feeling of well-being, helps develop lean muscle, increases libido and sexual pleasure testosterone boosting foods.
The human body needs specific nutrients to produce the right amounts of testosterone. This hormone works independently with respect to other hormones to maintain optimal health and the best thing is that hormones can be increased naturally, thus helping the body to balance its systems.
Many times it is related to men, but it is equally important for women. As you get older, the level of testosterone produced naturally by the body can decrease but we can also add to it environmental factors such as exposure to drugs with statins, herbicides, among others, which make the production of hormones decrease. For men, a low level of testosterone is related to an enlarged prostate, hair loss and some types of cancer.
Women by nature have lower levels of testosterone since their body is more sensitive to that hormone and their health depends on the balance between progesterone, estrogen and testosterone.
To produce testosterone the body needs many different nutrients, and zinc and vitamin D3 are among the most frequently required. Zinc is an essential mineral that is present only in certain foods such as pumpkin seeds, bitter chocolate, garlic, sesame seeds, watermelon seeds, wheat germ, zucchini seeds, chickpeas, among others and their low index results in some symptoms associated with allergies or increasing the level of sensitivity to allergic reactions among numerous other processes that weaken the optimal functioning of the body. In a different way it happens with vitamin D, because the body can manufacture it every time the skin is exposed to the sun, although many people lack this vitamin for the amount of hours they spend without exposing themselves to them due to different reasons.
Stress is a killer of testosterone, because when the body experiences it, it produces cortisol, a hormone secreted by the adrenal glands that reduces the effects of testosterone.
Some elements that can be added to the diet to maintain testosterone levels in order are the following:
The pomegranate has high levels of antioxidants, vitamin A, C, E and iron, so you can increase testosterone levels between 16 and 30% only by taking a pomegranate juice a day, which also improves mood and increases libido. Extra virgin olive oil is a powerful concentrate to increase testosterone; those who consume it daily observe an increase between 17 and 19% in the levels of the hormone in a span of approximately three weeks.
Oysters are known in the world as a food that increases the libido, because they have high concentrations of zinc, likewise, we can mention the anchovies, sardines, wild salmon and cashew nuts. Coconut is a healthy source of saturated fat, which helps a greater production of hormones. Coconut helps the body produce good cholesterol, reduce body fat and maintain weight, this being a way to improve testosterone production. Pumpkin seeds can also be included in the diet, limiting their consumption to one teaspoon daily.
The approaching Christmas. And what better time to give to others and yourself? If you play golf in Madrid you can take advantage of the Christmas holidays to ask your loved ones for gifts to complete your kit best golf gifts.
Ten ideas to give to golf players
- If you are going to make a gift to a golfer, you will surely have a good set of clubs. But maybe he does not have good covers for them. Especially for woods, which are the woods that require more care? So, first idea to give to a golfer: covers for wood.
- Balls. If there’s a gift for a golfer that never fails, it’s the balls. At the Retamares Golf Club we like the brands of Titleist, Srixon and Callaway.
- Bags . The bag is something basic in the equipment of a golfer. It is a complement in which there is no need to skimp. So take note of what Depique offers you, the Retamares Golf Club store.
- Thermal clothing. The clothes for a golfer are something that’s always good. Both to play golf in Madrid in winter and in summer it is important that these clothes are breathable. That keeps the body safe from moisture.
- Umbrellas and plastic for the rain. Both for you and to protect your equipment on rainy days it is essential that you have a good umbrella and plastics for the equipment.
- Swiss Army knife for the golf course. Brands such as Victorinox have released special models for golfers. These have very useful tools on the field of play.
- Permanent markers to mark the balls. It is a basic gift, easy to find and very useful!
- Ones. Other gift ideas can be the tees (supports where the balls are placed), the Repair Tool, the blow counter, the markers, etc.
- Books. Although it may not seem like it, golf books can give us some useful ideas to improve our game and learn more about this sport. Some classics are Five Lessons by Ben Hogan. The modern fundamentals of golf; Golf is not the game of perfection, by Bob Rotella; o the little red golf book, by Harvey Penick.
- Finally, we propose you as an idea to give a gift to a club. In the Retamares Golf Club we have these subscriptions.
“It is sold by the owner” they say signs that surely have caught your attention if you are thinking of selling your house without using real estate agents. If that is your decision, consider the following house buyers houston.
Guide to sell your house
1. Determine when you will put your home for sale – Plan where you will live after the sale. Get ready with time, as if you were going to make the sale quickly, so that you avoid the stress of having to move quickly.
2. Know the value of your property -Don’t let yourself be carried away by rumors or feelings. Your house is not worth what the neighbor says or what you believe, it has a real value determined by the conditions in the market. If you have doubts, the best option is to request an appraisal. That valuation will make you put a fair price on your home which could make the house sell faster.
3. Establish an action plan for sale- Take into account the following:
- Type of promotion you will do.
- Evaluate how much the ads cost and where to place them-If printed newspapers work well in your place of residence, consider putting classified ads. Usually the sale of properties is not very expensive and it is easy to contract, only sending the information you want to publish.
- Internet ads are in vogue and are usually also cheap, but it limits the sales efforts to the public that you want them to arrive. Focus on the most popular properties for sale.
- Prepare signs if they are allowed in your community-In department stores you will find some almost ready, to which you only need to put your information. You must know that when you put them you will have calls to almost all hours and that you must be aware of your security when showing it.
- Let your neighbors or friends know that you are going to sell-Word-of-mouth promotion costs nothing and is sometimes very effective. If you have neighbors happy with the community they will like to know that there are properties available to notify their acquaintances.
4. Prepare your house for sale
- Some sellers hire a staging expert to make your house look as attractive as possible, but if you do not want to invest in that, make an action plan. The basic rule is to clean to perfection, repair or eliminate damaged things and accommodate furniture allowing you to see the real space that has the house, and the possibilities that new owners will have to accommodate there.
- Prepare it as neutral as possible, without religious or political allusions, and if possible begin to store personal items that only appeal to that is your home, without giving way to others imagine in it, that is inside, but not you neglect the outside. Make sure the patio is clean and the exterior (and interior) walls are painted and clean.
- Make a review or inspection of your house. Know your strengths and weaknesses. The buyers will ask you. Check what is damaged and you can repair it (sometimes investing a bit gives you great benefits) and recognize what does not work or needs fixing and you are not willing to change. Some of those things could be part of the negotiation of the sale by own will or because it is a requirement of the type of loan that the buyer will make.
5. Organize the documentation for sale
- If you have a mortgage, make sure with your bank about the debt and that you have no penalty for selling it.
- Learn about the liens that you have. To transfer the title must be free of these.
- Analyze taxes and property insurance. They will ask you how many are and the types of compulsory insurance that the house needs.
- Once there is a contract, follow up the process to ensure that the closure is achieved.
For some years, selling a house seems an impossible task. There are few buyers interested in visiting it and, even less, those who have the firm intention to buy it. But, there are some tricks that help your home sell better and faster house buyers houston.
Some details of your home can make a difference. This technique is known as ‘ home staging’ and focuses on making your home more attractive to potential buyers.
We show you ten tips , endorsed by experts, to stand out above the rest and sell your home quickly:
It seems fundamental if we want to sell any product to someone. But, you would be surprised to know how many people teach their house to potential buyers without a minimum of cleaning.
Light is essential in any home. So much to take the photos that you will hang in the network to sell your house as to give good impression to the possible buyers who come to see it.
If your house has good natural light, raise the blinds and open the curtains to make your home look more spacious and cheerful. If, on the other hand, your home is dark or the windows overlook a patio, it incorporates different clear or led spotlights at strategic points of the home.
3. Depersonalize your home
Buyers have to feel at home from the start. Remove wedding photos or pictures with family images and replace them with small details such as vases or plants and decorative items.
A broken plug, a crack in the kitchen or old tiles is small details that can decide the buyer for not buying the house. If we want to sell our home quickly and at a good price, we must invest in it.
Although at first it may seem useless to invest money in something that you are going to sell, it is not. A house can increase up to € 5,000 its value if we invest less than € 1,000 in arrangements and small details, according to the experts in ‘home staging’.
We can hire experts who know the best techniques so that our home is sold in the market or, ask for help from a relative or friend who is good at decorating.
5. Light and soft colors
Red walls or strong tones dwarf and worsen the appearance of our house. A coat of paint on time can help you sell your home. The light and soft colors such as yellow, white, cream or gray, make your home more spacious and cheerful. In addition, these tones, in general, are liked by everyone.
We cannot teach our house to anyone if we have it messy and with clutter on all sides. The atmosphere will look overloaded and will throw back the potential buyers.
7. Small details
The small details, plants or ornaments change the appearance of your home. We must get a clean, bright, pleasant house without overloading. Having too many paintings, plants or figures will overload your appearance.
The old or broken furniture will not benefit you at all. As we have said before, you must invest a minimum of money to fix those small damages in your home. In addition, they could make buyers try to lower the price of housing for those details.
9. Bad smells
Smell is one of the senses that most throws us back. For a person to feel comfortable in a place, this must have a good smell . Also do not make the mistake of abusing the air fresheners. Experts recommend cleaning the home well, making coffee or cooking something in the oven before the customers arrive so that the house gives off a pleasant smell.
Our house has to stand out among hundreds of homes that are advertised through the Internet. Therefore, the photographs of the home must attract users of these web portals from the first moment.
The images must transmit joy , have good luminosity and give the impression of spaciousness . It is not about deceiving anyone, but about showing the virtues of our home.
As we discussed with the decoration, we can go to photo experts to achieve our goal or any amateur who can get good images.
Instagram has become the social network showcase par excellence and it is not surprising, due to its great commitment to photography. This differentiates it from other social networks and makes it the second with the most users, second only to Facebook. If a picture is worth a thousand words, how could this social network not succeed? However, we must not forget that what appears on Instagram, in many cases, does not correspond to reality, but rather it is an improved version, which appeals, directly, to the field of aspirations buyiglikes buy ig likes.
But, as much as Instagram photos are riddled with filters, they get great engagement quotas . There are many brands that try to make the most of this social network. Clothing companies, makeup, technology, amusement parks, music festivals … Everyone wants to be present in the jewel in the crown of Facebook.
In fact, it has become the best ally of tourism. The city-brands take advantage of the potential and possibilities that Instagram offers to show the most beautiful places. Who has not looked for his next destination on Instagram to discover that beautiful landscape that awaits him?
Incredible as it may seem, the potential of Instagram goes further. It is the perfect tool to create a personal brand. There are more people than we can imagine with a large number of followers in that network who live, precisely, of it: to post photos on Instagram. It is what, today, is known as influencers. The brands, aware of the large audience that these people have, propose to be ambassadors of their products. It is important to keep in mind that, for the message to reach your audience, brands and their products must have some affinity with your audience.
Influencers as ambassadors of places
The influencers working in all industries, including non – -how tourism. This industry intends to benefit from the audience of these people to publicize the most beautiful corners of their cities. The tourist destinations pay these influencers for visiting their city and, in exchange, they must relate their trip by uploading the best snapshots of the place.
If you wonder how much influencer earns from traveling and documenting travel, the answer is complicated. According to Skift, the figures range between 1,000 and 3,500 dollars per day of travel. It will also depend on the type of influencer, the number of followers and the characteristics that your audience presents. There are many variables that we have to take into account, which makes it difficult to establish a specific price. However, it is a more than good figure to spend your life traveling.
Most photographed places on Instagram
Not all places have the same reception on Instagram. There are landscapes that have a special charm and succeed on the Net. Not all corners of the world are the same and neither are users. Uploading a photograph of the most famous places on Instagram does not have to involve a bath of likes. However, the same photograph taken by an influencer can reach, in just a moment, thousands of likes.
Next, the list of the most photographed places on Instagram, taking into account the use of the geolocation of snapshots by users.
- Disney The most photographed place on the Web could not be another. A magic corner where there are. In addition, this place, whether in Florida, California or Japan, takes the cake as well, in terms of the most visited places in the world.
- Universal Studios. The second place with the largest presence on Instagram is also an amusement park. Inside this park, most snapshots are taken by the part dedicated to Harry Potter.
- Central Park The lung and icon of New York could not be missing from this list. The park is a must for anyone visiting The Big Apple.
- Times Square New York, again. If Central Park is a must see, Times Square is almost a pilgrimage. In fact, in 2016 more than sixty million people visited this part of the city.
- Eiffel Tower. Although tourism in France is not going through its best, this emblem of the Parisian city is still among the most photographed.
- Louvre Museum. This other icon of the capital of France occupies a deserved 6th place on our list.
- Las Vegas Strip. Emblematic city and star of multiple films where there are, this popular avenue occupies the 7th place, in terms of Instagram geolocation labels.
- Santa Monica Pier. Known worldwide by the vigilantes of the beach, the Californian city could not be left out of this list.
- Brooklyn Bridge. Again, New York. But who can resist the charms of this city?
- Pan-Russian Exhibition Center. Finally, this great Moscow fairground, which houses a great source of historical information of the golden years of the Soviet Union.
- Tricks to succeed on Instagram
If you have also photographed these places, congratulations, but maybe you have not achieved the expected likes. That’s why maybe you’re not so happy about it. If you want to succeed on Instagram and live the dream life of most influencers, you’re still on time. Then, the 15 definitive tricks to succeed on Instagram.
- It provides quality. That everything is true is not true. If we buy quality items, we also want to see them in the photographs and the fuzzy or dark ones do not work.
- Be constant. Choose the periodicity with which you will upload photos. It is not good to upload a photo and then forget about the social network. Set yourself a minimum and try to meet them.
- Do not abuse the selfie. If you enjoy making photos, congratulations, but save them for you. It is not necessary to upload them continuously. We like to see new things and I’m sorry, but your face is not going to change from one day to the next.
- Get inspired and do not copy. The best way to know what users like is to immerse you in Instagram and see indecent amounts of photographs. This will give you ideas on what to publish or not to publish, but it does not serve to copy. A photograph takes behind it a time and work that must be valued.
- Be original. Once you are clear about what to photograph, you must take into account how to do it. Get out of the ordinary and look for different points of view to stand out among the other instagramers .
- Coherence, first of all. Do not forget that your Instagram profile is not a photo only, but a set. It is recommended that the photos follow the same pattern, that is, mark a style.
- Use the hashtags well. The hashtags can help you achieve likes and followers, but that does not mean that you can use without rhyme or reason. Do not abuse them.
- Take care of the composition. The vast majority of applications linked to photography, including Instagram, have a grid, so do not hesitate to use it. The grid corresponds to the main law of all composition, the Law of Thirds. This law states that the points of interest of the photos should be placed at the intersections, where the vertical and horizontal lines intersect. The grid will be of great help to achieve a good composition.
- The light, that great unknown. Photography is just light, so if it is well taken care of, you will get high quality photos. The smartphones , in the absence of light, generated grain in photographs, very little aesthetic element. So take generous snapshots of light and, if possible, with a diffuse light. The ideal is a slightly cloudy day.
- Vertical format Many times, we choose to shoot photographs in horizontal format for the simple fact that it covers more landscape. However, it is studied that the most successful photographs on social networks are made in vertical format. Who are we to contradict the statistics? So he will listen to them.
- Edit the photos you may like the picture as you took it. However, editing it, in its proper measure, is always a good option. The basic parameters that we must take into account when editing are: contrast, temperature, blacks, shadows and sharpness. For this, there are much more complete applications than Instagram, which can be helpful.
- Prohibited the flash. Let’s not forget that we are talking about a smartphone and not an SLR. The flash is simple, so limit you to using it when it is, absolutely, essential.
- Filters, your great ally. Do not cut yourself when using filters. If you want to succeed, the most used filters are: Myfair, Valencia, Rise, Hefe and Nashville.
- Boomerang and videos. The most important thing about Instagram is the photographs, but we must not forget other tools offered by the social network, such as boomerang or videos.
- Enjoy And, finally, whatever you do, live it.
You already know how to succeed on Instagram, what are you waiting for to become influencer? Is your moment.
Many companies are using Facebook today. It took a while for some to “get through” rather than consciously opting for it and yet, one is open to the network and the opportunities it offers. And then comes Instagram. Once again, ask yourself the question of purpose and meaning, because only stars, asterisks and other public figures use the portal. Or not?
Lots of Facebook, but little Instagram
It is striking how “Facebook-heavy” is the social media presence of most companies. Clearly, Facebook is the undisputed number one when it comes to social networks, but above all, a 8andere) platform is greatly underestimated in the business world: Instagram.
With the exception of Facebook, there is nowhere near as much potential as on Instagram. If you do not believe that, you should only look at the average figures for the exposure values (also for “business” accounts).
However, of course, here too applies: nothing comes from nothing – and even trifles can decide on victory or defeat in Instagram marketing and buy instagram comments.
Much more than an app for lunch photos
Granted, you’re not the only one who associates Instagram with photos of young people on the beach or hipsters eating their lunch snacks. And of course, this is a smartphone app, which is primarily about the presentation of photos and videos.
But who says that you cannot use these things successfully for you? Because you can, if you get it right. The following 3 tips we’d like to share with you show you how to make your Instagram account successful.
Instagram Marketing Tip # 1: Be real
Of course you do not have the obligation in every industry to look young and hip to the outside world – and that’s not what it’s all about. The goal is to present yourself as you are. If you’re not young, not hip, not cool, that does not mean the Instagram cosmos is locking you out.
However, you should try to open yourself, make you tangible, to bring yourself the sympathy – combine your knowledge in the form of visuals and let take snapshots from your daily work. That’s you and Instagrammer want to see that.
Incidentally, this is the media by nature Instagram profile – just drop by and follows us if you feel like learning more about us and our work.
Instagram Marketing Tip # 2: Use hashtags
Hashtags should not help you in terms of image, but in terms of attention. For example, if you append #Coffee to a hashtag, any user searching for that hashtag is a potential visitor (and ideally a follower) of your account.
Of course, you have to think carefully about which hashtags make sense for you and your respective contribution. Trending hashtags can be a great way to do this – as well as your very own hashtags to link rows of pictures together or track larger-scale campaigns that place value on user-generated content, among other things.
You see: #Coffee was a (consciously) bad example
Instagram Marketing Tip # 3: Unlock Ads
As you may already know from Facebook, you can also advertise on Instagram – again, it’s about getting your Instagram profile noticed, generating new followers, and expanding your reach.
The conception of the advertisements takes place via the advertisement manager or power editor of Facebook. If you have created an ad here, one click is enough to play it on Instagram.
Social media and especially Instagram offers you and your company unlikely many opportunities to be perceived as an expert within your target group – but also in this seemingly so simple area, a lot of work, know-how and, above all, patience are required. You’re very unlikely to have six-digit followers after just four weeks. But that’s fine.
We have worked with graphic designers, illustrators and various fashion-related artists to create their own brands or to repeat collections of shirts or sweatshirts personalized t shirts for kids.
The first question is: where to start? For sending us your designs and creations, and we take care of everything. In case of any doubt, we will help you choose the personalization technique that best suits your design and budget.
Quality and design
An important point to keep in mind is that the t-shirts for designers are designed to sell them and create a brand and image, so they must be medium or high quality garments. A bright design on a shirt intended for advertising is very demeaning, and it is likely that the garment will be deformed after a few washes. Nobody wants that.
In our online catalog of t-shirts we offer some brands specially designed for designers that have resulted in an incomparable quality: American Apparel, Continental Clothing, Stanley Stella, Gildan or B & C. There are them for all tastes and pockets. 😉
And if instead what you are looking for are cheap t-shirts but suitable for resale, we advise you toSols Regent t-shirt, the Gildan 150 t-shirt
or the B & C 150. They are classic and basic but they are ideal for reselling at low prices.
In addition to quality, an important part is the cut of the shirts. In our catalog you can choose the ‘ fashion filter ‘ to select the garments with the most modern and fashionable cuts.
Every time we are more aware of the environment, and in the textile world, organic t-shirts and organic cotton are getting very strong. It is evident that they are not a cheap option, but they can work very well for a specific public that values a garment made with ecological materials and with a minimum of environmental impact.
The full range of Continental Clothing or Stanley Stella are great options for your custom t-shirts . There are even T-shirts made from recycled or bamboo fabrics!
Our star techniques to create custom t-shirts for designers are three:
Silkscreen. Brilliant results at a very competitive price, but only allows you to print designs with a maximum of ⅞ colors without frames, shadows or gradients.
Digital printing. High quality printing and without any ink limit. Perfect for photographic designs or for illustrations with gradients and details in multiple colors.
Sublimation Full Print . Ideal for extra large designs that will occupy seams, collars and sides, and with no color limit. It is a fully breathable personalization technique, but only allows printing on white shirts.
Something more than shirts
To complete a collection nothing better than adding hats, sweatshirts and bags personalized with your designs.
Long tote bags, also known as tote bags, have become a flagship product for some time now. They work as textile accessories and as original packaging for your shirts. They are cheap, practical and often reused, which guarantees an extra publicity. All are advantages. : D
The last details
Any personal touch adds value to your shirts, so customizing labels is important to create your own brand.
In our personalized label service we offer several options, but our favorites are the labels printed directly on the neck of the shirt. The icing on the cake!
In addition, we offer bagging to ensure a protected storage and care of your clothes.
What is a stair lift chair?
The stairlifts are chairs or moving platforms anchored by a stair rail. They can be installed on any staircase, they are safe and easy to use, they do not hinder the passage to other users of the stairs and they have a great variety of customization options (MONTASCALE PER DISABILI).
Stairlifts can be used to raise and lower a person, but also small objects, by pressing a button.
A stair lift, in broad strokes, is a swivel seat that moves along a rail located on the stairs to access other floors.
How to correctly choose a stairlift?
When, for various reasons, you have little mobility and climbing the stairs is an impediment, sometimes you can choose to move to another floor and even move.
It is a solution, but is it going to change your habits, the distribution of your home or even move to be able to access your bedroom without problems?
Sometimes you can discard the possibility of a mobility solution because, in general, we think it is very expensive, expensive and expensive but there are solutions to improve accessibility without having to make all these changes in habits and distribution.
Installing a stairlift in your home is an investment that will provide quality of life, you can go back up the stairs without any difficulty, regaining your independence.
A stairlift no longer has to be a horrible and annoying device on the stairs. Our stair lift chairs have been specially designed to blend discreetly with the furniture of your home.
Before choosing the stairlift best suited for your needs, you should take the time to consider the following interesting aspects that can help you answer the questions that may arise when purchasing a stair lift chair
What space do I need to be able to install a stairlift?
The minimum width for straight stairs is 680 mm (without counting what the user’s knees need to bend) and for the curves about 750 mm (which can be reduced to 605 mm by installing options such as automatic turn-off or overtravel to disembark in the upper landing instead of flush with the last step) and depending on the inclination of the staircase.
Thanks to the stylized design of the range of stair lift chairs, most of the staircase space will be cleared for the transit of other members of your home when the chair is folded in its storage position.
How safe are the stair lift chairs?
All the stair lift chairs have been designed and manufactured strictly following the latest European regulations to ensure maximum safety for all users.
During the ride the safety belt and the optional curved arms keep you safe in the stair lift.
If the lift encounters an obstacle it will stop safely, thanks to special safety edges on the drive unit.
The stair lift operates on batteries, which means it can be used during an electrical outage.
Is any type of preparation work necessary for the stair to install the stairlift?
In principle it is not necessary to carry out works. In any case, during the visit we will advise you and analyze the best route.
All our stair lift chairs are fixed to the rungs and not to the wall.
Stairlifts can be installed in less than a day, which is the minimum disruption to the home.
Can the Stairlift be customized?
Indeed, our Stairlift Chairs are equipped with a variety of upholstery and rail colors for which the Chair adapts to your home as much as possible.
As well as the lifestyle changes mentioned above, people with moderate to severe OSA usually need to use a continuous positive airway pressure (CPAP) device.
This is a small pump that delivers a continuous supply of compressed air through a mask that either covers your nose or your nose and mouth. The compressed air prevents your throat closing.
CPAP machine can feel peculiar to start with and you may be tempted to stop using it. But people who persevere usually soon get used to it and their symptoms improve significantly.
Buy cpap machine is available on the NHS and is the most effective therapy for treating severe cases of OSA.
As well as reducing symptoms such as snoring and tiredness, it can also reduce the risk of complications of OSA, such as high blood pressure.
- mask discomfort
- nasal congestion, runny nose or irritation
- difficulty breathing through your nose
- headaches and ear pain
- stomach pain and flatulence (wind)
Earlier versions of CPAP also often caused problems such as nasal dryness and a sore throat. However, modern versions tend to include humidifiers, a device that increases moisture, which helps reduce these side effects.
If CPAP causes you discomfort, inform your treatment staff as the device can be modified to make it more comfortable. For example, you can try using a CPAP machine that starts with a low air pressure and gradually builds up to a higher air pressure as you fall asleep.
Mandibular advancement device (MAD)
A mandibular advancement device (MAD) is a dental appliance, similar to a gum shield, sometimes used to treat mild OSA.
They’re not generally recommended for more severe OSA, although they may be an option if you’re unable to tolerate using a CPAP device.
An MAD is worn over your teeth when you’re asleep. It’s designed to hold your jaw and tongue forward to increase the space at the back of your throat and reduce the narrowing of your airway that causes snoring.
Off-the-shelf MADs are available from specialist websites, but most experts don’t recommend them, as poor-fitting MADs can make symptoms worse.
It’s recommended you have an MAD made for you by a dentist with training and experience in treating sleep apnoea. MADs aren’t always available on the NHS, so you may need to pay for the device privately through a dentist or orthodontist.
An MAD may not be suitable treatment for you if you don’t have many – or any – teeth. If you have dental caps, crowns or bridgework, consult your dentist to ensure they won’t be stressed or damaged by an MAD.
Surgery for OSA
Surgery to treat OSA isn’t routinely recommended because evidence shows it’s not as effective as CPAP at controlling the symptoms of the condition. It also carries the risk of more serious complications.
Surgery is usually only considered as a last resort when all other treatment options have failed, and also if the condition is severely affecting your quality of life.
A range of surgical treatments have been used to treat OSA. These include:
- tonsillectomy – where the tonsils are removed if they’re enlarged and blocking your airway when you sleep
- adenoidectomy – where the adenoids, small lumps of tissue at the back of the throat above the tonsils, are removed if they’re enlarged and are blocking the airway during sleep
- tracheostomy – where a tube is inserted directly into your neck to allow you to breathe freely, even if the airways in your upper throat are blocked
- weight loss (bariatric) surgery – where the size of the stomach is reduced if you’re severely obese and this is making your sleep apnoea worse
Surgery to remove excess tissue in the throat to widen your airway (uvulopalatopharyngoplasty) used to be a common surgical treatment for OSA, but it’s performed less often nowadays.
This is because more effective treatments are available, such as CPAP. This type of surgery can mean you’re unable to use a CPAP device properly in the future if you need to.
Soft palate implants
Soft palate implants make the soft palate, part of the roof of the mouth, stiffer and less likely to vibrate and cause an obstruction. The implants are inserted into the soft palate under local anaesthetic.
The National Institute for Health and Care Excellence (NICE) has said soft palate implants are safe, but they’re not currently recommended for treating OSA as there’s a lack of evidence about their effectiveness.
However, this form of treatment is recommended for treating snoring associated with OSA in exceptional cases.