A study conducted at the University Medical Center, Groningen, The Netherlands aimed to report about the subjective and objective treatment outcome of oral appliance therapy and continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea syndrome (OSAS). 103 patients with OSAS were assessed after 1 and 2 years of treatment. Treatment was a success when the apneahypopnea index (AHI) reduction was less than 5. Regarding successful treatments, no significant difference was found between oral appliance therapy and CPAP in treating OSAS in a 2-year follow-up. However, CPAP was more effective in lowering the AHI, compared to oral appliance therapy. 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 OSAS. If you think you might be suffering from obstructive sleep apnea, call Dr. Farrell at 480-945-3629 or visit AZ TMJ at www.headpaininstitute.com.
Michiel H. J. Doff, PhD1; Aarnoud Hoekema, PhD1; Peter J. Wijkstra, PhD2; Johannes H. van der Hoeven, PhD3; James J. R. Huddleston Slater, PhD1; Lambert G. M. de Bont, PhD1; Boudewijn Stegenga, PhD1
Abstract:
Oral appliance therapy has emerged as an important alternative to continuous positive airway pressure (CPAP) in treating patients with obstructive sleep apnea syndrome (OSAS). In this study we report about the subjective and objective treatment outcome of oral appliance therapy and CPAP in patients with OSAS. Objective (polysomnography) and subjective (Epworth Sleepiness Scale, Functional Outcomes of Sleep Questionnaire, Medical Outcomes Study 36-item Short Form Health Survey [SF-36]) parameters were assessed after 1 and 2 years of treatment. Treatment was considered successful when the apneahypopnea index (AHI) was < 5 or showed substantial reduction, defined as reduction in the index of at least 50% from the baseline value to a value of < 20 in a patient without OSAS symptoms while undergoing therapy. Regarding the proportions of successful treatments, no significant difference was found between oral appliance therapy and CPAP in treating mild to severe OSAS in a 2-year follow-up. More patients (not significant) dropped out under oral appliance therapy (47%) compared with CPAP (33%). Both therapies showed substantial improvements in polysomnographic and neurobehavioral outcomes. However, CPAP was more effective in lowering the AHI and showed higher oxyhemoglobin saturation levels compared to oral appliance therapy (P < 0.05). Oral appliance therapy should be considered as a viable treatment alternative to continuous positive airway pressure (CPAP) in patients with mild to moderate obstructive sleep apnea syndrome (OSAS). In patients with severe OSAS, CPAP remains the treatment of first choice.
