Oral appliances for obstructive sleep apnoea

Abstract

There is increasing evidence suggesting that OA improves subjective sleepiness and sleep disordered breathing compared with a control. CPAP appears to be more effective in improving sleep disordered breathing than OA. The difference in symptomatic response between these two treatments is not significant, although it is not possible to exclude an effect in favour of either therapy. Until there is more definitive evidence on the effectiveness of OA in relation to CPAP, with regard to symptoms and long-term complications, it would appear to be appropriate to recommend OA therapy to patients with mild symptomatic OSAH, and those patients who are unwilling or unable to tolerate CPAP therapy. Future research should recruit patients with more severe symptoms of sleepiness, to establish whether the response to therapy differs between subgroups in terms of quality of life, symptoms and persistence with usage. Long-term data on cardiovascular health are required.

Recognizing and Managing Obstructive Sleep Apnea in Primary Care

“…65 A recent Cochrane review reported that oral appliances are not as effective as CPAP at improving sleep-disordered breathing. 22,66,67 Patients may prefer oral appliances to CPAP because of their ease of use, and they may therefore yield equivalent health outcomes in some patients due to better patient adherence. 68 If a patient stipulates a preference for an oral appliance or oral surgery for his or her OSA, it may be useful to consult the American Academy of Dental Sleep Medicine Web site (www.dentalsleepmed.org) to find additional information and details of appropriate specialists.…”

“…• Current evidence suggests that oral devices can improve apnea and daytime sleepiness and may improve blood pressure 66 • Some patients experience excessive salivation, temporomandibular joint discomfort, and dental adverse events with oral devices 22,67 • Long-term adverse events are unclear 22,67 large tonsils and resection of the uvula and soft palate to enlarge the oropharynx. 71 Other surgical options include craniofacial reconstruction and tracheostomy (this corrects the condition as it bypasses the obstruction).…”

Lifestyle modifications and the resolution of obstructive sleep apnea syndrome: a case report

“…[51][52][53][54] Several Cochrane reviews are available on the management of OSAS with CPAP and other oral appliances. [55][56][57] The general use of a CPAP machine includes applying the facemask breathing apparatus with attached air hose to a bedside machine that constantly hums throughout the night. Getting in and out of bed requires attachment and reattachment of the facemask.…”

Treatment of Sleep Apnea with Herbst Mandibular Advancement Splints

“…The information obligation: Considered as "knowing", the practitioner is legally obliged to inform the patient of the disadvantages and ways to address them. The marketing of any laboratory does not absolve the practitioner's professional responsibility [41][42][43]. The Herbst has a much more effective action than the muscle relaxation device from a 50% propulsion.…”