Have You Been Diagnosed With Obstructive Sleep Apnea or Central Sleep Apnea?
Obstructive sleep apnea is a medical condition in which an individual’s airway collapses and becomes either partially or completely blocked by the tongue and soft tissues in the throat and neck. This obstruction can lead to reduced airflow and potentially no airflow at all. Contrastingly, in central sleep apnea either the brain fails to communicate the proper signals to the muscles that control your breathing or the respiratory muscles fail to activate. In other words, in central sleep apnea there is no effort made to breathe. Different treatment options may be recommended for obstructive and central sleep apnea.
Do I Really Need a CPAP? What Are My Options?
There are three main types of treatment for obstructive sleep apnea: CPAP therapy, oral appliance therapy, and surgical options.
- CPAP Therapy: Continuous positive airway pressure (CPAP) therapy uses a machine to push air consistently through the nose and/or mouth into the lungs in order to prevent the collapse of the airway.
- Oral Appliance Therapy: An oral appliance, also called a mandibular advancement device, is a custom-fabricated device that opens up the airway by holding the lower jaw in a forward position while you sleep. This appliance creates more space in the airway by bringing the tongue slightly forward with the lower jaw and places tension on the soft tissues to reduce airway collapse.
- Surgical Options: There are various surgical options to treat obstructive sleep apnea. Some surgeries for sleep apnea include the maxillomandibular advancement (MMA) and uvulopalatopharyngoplasty (UPPP). Inspire therapy also requires surgery with general anesthesia.
Additional options, often used in conjunction with CPAP, oral appliance therapy, or surgery, include positional sleep therapy and weight loss.
Compliance: Can You Tolerate a CPAP?
Compliance, or the ability and desire to tolerate a type of treatment, influences the overall effectiveness of a treatment option. When it comes to CPAP therapy, studies show that somewhere between 29%-83% of patients do not meet compliance criteria and either remove the device during the night or do not wear it at all (1). While CPAP is considered the “Gold Standard” of treatment, adherence challenges negatively impact the overall effectiveness of the treatment for many people. In other words, CPAP therapy often works well if you wear it.
Guidelines According to the American Academy of Sleep Medicine
The Journal of Clinical Sleep Medicine, a medical journal published by the American Academy of Sleep Medicine, indicated that oral appliance therapy may be a first-line of therapy in patients that have mild-to-moderate obstructive sleep apnea, as well as patients with severe sleep apnea that fail treatment with CPAP therapy (2). The journal further stated that CPAP has been shown to be more efficacious than oral appliance therapy; however, lower treatment adherence to CPAP has led to comparable effectiveness overtime as oral appliance therapy (2).
Are You a Candidate for Oral Appliance Therapy?
If you are considering oral appliance therapy, it is important to be examined by a qualified and well-trained sleep dentist to determine if you are a candidate.
In conclusion, while CPAP may be a great treatment option for many people, there are other options available for the treatment of obstructive sleep apnea. Like CPAP, oral appliance therapy is another non-invasive approach to treating obstructive sleep apnea. In any case, it is important to speak with your physician about your medical condition and viable treatment options for you.
- Weaver TE, Grunstein RR. Adherence to continuous positive airway pressure therapy: the challenge to effective treatment. Proc Am Thorac Soc. 2008;5(2):173-178. doi:10.1513/pats.200708-119MG
- Sutherland K; Vanderveken OM; Tsuda H; Marklund M; Gagnadoux F; Kushida CA; Cistulli PA; on behalf of the ORANGE-Registry. Oral appliance treatment for obstructive sleep apnea: an update. J Clin Sleep Med 2014;10(2):215-227.