Oral appliance treatment of obstructive sleep apnea: an update.

Keywords: Continuous positive airway pressure (CPAP), CPAP, CPAP alternative, Obstructive Sleep Apnea (OSA), sleep apnea, oral appliance, apnea/hypopnea index (AHI), Dental Sleep Medicine, and Orofacial Pain.

Although treatment of obstructive sleep apnea (OSA) with continuous positive airway pressure (CPAP) is highly effective, there is a need for an alternative treatment options based on patients limited acceptance and tolerance of the CPAP. Oral appliances are an alternative and can be very effective when used with or without the CPAP. Dr. Stan Farrell, a member of the American Academy of Dental Sleep Medicine and board certified with the American Board of Orofacial Pain, has extensive training in treating sleep apnea and other sleep disorders. AZ TMJ offers one of the leading alternatives for the CPAP, which is an oral appliance that can be used in conjunction with a CPAP or as a stand-alone oral appliance depending on the severity of the individual’s OSA. If you think you might be suffering from obstructive sleep apnea, call Dr. Farrell at 480-945-3629 to set your consultation and visit AZ TMJ at www.headpaininstitute.com.

Chan AS, Cistulli PA.


PURPOSE OF REVIEW:  Oral appliances are an alternative to continuous positive airway pressure (CPAP) for the treatment of obstructive sleep apnea (OSA). Although CPAP is a highly efficacious treatment, there is a need for other treatment options because the clinical effectiveness of CPAP is often limited by poor patient acceptance and tolerance, and suboptimal compliance.

RECENT FINDINGS:  There has been an expansion of the research evidence to support the use of oral appliances in clinical practice. Recent work has focused on the following clinically relevant areas: the effect of device design on efficacy and patient compliance, the role of different modalities for assessing the upper airway in the prediction of treatment outcome, the assessment of the impact of treatment on a range of health outcomes and the evaluation of long-term adverse effects.

SUMMARY:  There is robust evidence of the efficacy of oral appliances for improving polysomnographic indices and modifying the health risk associated with OSA. The current evidence suggests a similar impact on health outcomes as CPAP. However, further research is required to address a number of unresolved issues, including the influence of device design, titration procedures, prediction of treatment outcome and the clinical effectiveness of oral appliances for modifying the adverse health consequences of OSA.