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.
A review in New Haven, Connecticut examined the role of oral appliances in treating obstructive sleep apnea (OSA). Although continuous positive airway pressure (CPAP) is the most widely used treatment, oral appliances have been known to reduce OSA by about 60 percent. When used in conjunction, CPAP and an oral appliance can further increase the acceptance rate. This review focuses on the diagnosis and treatment of obstructive sleep apnea and, specifically, on the utility of oral appliances in the management of this disorder. Dr. 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.az-tmj.com.
Mohsenin N, Mostofi MT, Mohsenin V.
Source: John B. Pierce Laboratory, New Haven, Conn., USA.
BACKGROUND: Sleep-related breathing disorders are common and often are associated with vascular complications such as arterial hypertension, coronary heart disease and stroke. The most widely studied form of these disorders is obstructive sleep apnea. Patients usually are diagnosed with obstructive sleep apnea years after the onset of symptoms, which generally are nonspecific and include excessive daytime sleepiness, chronic fatigue and habitual snoring. The risk factors for sleep apnea are obesity, advancing age, male sex and maxillofacial abnormalities. This review focuses on the diagnosis and treatment of obstructive sleep apnea and, specifically, on the utility of oral appliances in the management of this disorder.
METHODS: The review is based on a MEDLINE search for articles in English on this topic. The article discusses results of randomized studies and prospective case series.
CLINICAL IMPLICATIONS: Several treatment options are quite effective. Nasal continuous positive airway pressure, with an overall acceptance rate of 70 percent, is the most widely used treatment modality. Maxillofacial surgery, although effective, is reserved for patients who have not responded to the more conventional therapies. Newer methods include application of oral appliances. Oral appliances have been shown to alleviate the severity of respiratory disturbances during sleep by about 60 percent, with an overall acceptance rate of 75 percent. The long-term complications generally are minor and are related to occlusal changes and temporomandibular joint discomfort.
CONCLUSIONS: With the advent of oral appliances, dentists are increasingly involved in managing the care of patients with sleep-related breathing disorders. Further studies are needed to determine the long-term complications of this type of intervention for the treatment of sleep-related breathing disorders.