ENTtoday
  • Home
  • COVID-19
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

Obstructive Sleep Apnea Options

by Mary Beth Nierengarten • December 9, 2011

  • Tweet
  • Email
Print-Friendly Version

Treatment for patients with obstructive sleep apnea (OSA) remains challenging given the low compliance rate for continuous positive airway pressure (CPAP) therapy. Oral appliances are increasingly as a primary treatment for patients with mild to moderate sleep apnea or for patients who are unable or unwilling to tolerate the CPAP mask and machine. These uses are in accordance with the American Academy of Sleep Medicine’s (AASM) 2006 practice parameters for oral appliance use (Sleep. 2006;29(2):240-243). Data show improvements in sleepiness and quality of life with these appliances, although CPAP remains superior in reducing polysomnographic indices of OSA such as reductions in apnea-hypopnea index (AHI) and oxygen saturation (Intern Med J. 2010;40(2):102-106). Some evidence suggests, however, that oral appliances may confer comparable AHI and oxygen saturation to CPAP because of their compliance rates. The growing emergence of oral appliances as an alternative to CPAP has highlighted a multidisciplinary approach to treatment for sleep apnea.

You Might Also Like

  • Mandibular Advancement Devices Improve AHI, Symptoms of Mild to Moderate OSA
  • Options for Obstructive Sleep Apnea Palate Surgery Reviewed
  • Pediatric Obstructive Sleep Apnea: Many Causes, Many Treatment Options
  • Is the Apnea/Hypopnea Index the Best Measure of Obstructive Sleep Apnea?
Explore This Issue
December 2011

“The basic issue for me is that sleep apnea is a medical disease, and although a dentist needs to be involved when using an oral appliance to maintain dental health, a physician needs to be involved in treating the airway and medical disease,” said B. Tucker Woodson, MD, professor of otolaryngology and communication sciences at Medical College of Wisconsin in Milwaukee, Wisc. “The otolaryngologist is ideally positioned because we understand the airway and we understand dental disease.”

John Remmers, MD, a pulmonologist and professor of internal medicine and physiology and biophysics at the University of Calgary in Alberta, Canada and one of the inventors of CPAP, said otolaryngologists may be the physicians most prone to recommending oral appliances.

“Most of us sleep physicians are pulmonologists and we are comfortable with pressures and air flows, so CPAP is very intuitive to us,” he said. “Surgeons are different and are more anatomically oriented, so it is understandable that they may be more open to oral appliances.”

Oral Appliances

According to Alan A. Lowe, DMD, PhD, there are two kinds of oral appliances: those that move the jaw forward and tongue-stabilizing devices that hold the tongue forward. The goal of both types of devices is to expand the upper airway to improve airflow, thereby preventing the collapse of the pharynx during sleep, said Dr. Lowe, chair of orthodontics at the University of British Columbia in Vancouver, BC.

Appliances that move the jaw forward are known as mandibular advancement devices (MADs). To date, most of the research on mandibular advancement has focused on these devices. MADs prevent the collapse of the upper airway by mechanically protruding the mandible (Intern Med J. 2010;40(2):102-106). A key issue still to be resolved, however, is the best way of titrating mandibular advancement to achieve optimal efficacy and comfort for each patient. The need for proper titration is highlighted by data that show high response rates, improvements in sleepiness and cognitive tests, and increases in health-related quality of life in patients fitted to MADs that are properly titrated (Curr Opin Pulm Med. 2009;15(6):591-596).  

Pages: 1 2 3 4 | Single Page

Filed Under: Head and Neck, Practice Management, Rhinology, Sleep Medicine, Special Reports, Tech Talk Tagged With: CPAP, MADs, mandibular advancement device, Obstructive sleep apnea, oral appliances, sleep apnea, Tongue-stabilizing device, TSDIssue: December 2011

You Might Also Like:

  • Mandibular Advancement Devices Improve AHI, Symptoms of Mild to Moderate OSA
  • Options for Obstructive Sleep Apnea Palate Surgery Reviewed
  • Pediatric Obstructive Sleep Apnea: Many Causes, Many Treatment Options
  • Is the Apnea/Hypopnea Index the Best Measure of Obstructive Sleep Apnea?

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • Experts Delve into Treatment Options for Laryngopharyngeal Reflux
    • Weaning Patients Off of PPIs
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Did You Receive COVID-19 Relief? Here Are Reporting Considerations for 2021
    • Otolaryngology Experts Share Best Practices in Five Areas
    • How Climate Change May Be Affecting Sleep Patterns for Adults and Children
    • Laryngologists Discuss Tough Tracheostomy Choices During COVID-19 Era
    • Head and Neck Cancer: Experts Discuss How to Improve Surgery Quality and Value

Polls

Did you receive funding from the CARES Act or Paycheck Protection Program?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2021 The Triological Society. All Rights Reserved.
ISSN 1559-4939

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.