Is Oral Appliance Therapy Useful in Treating Sleep Apnea?

Picture this: you’re struggling with obstructive sleep apnea and have no clue what to do about it. Your sleep is mediocre at best, your partner no longer sleeps in the same bed, and your health is taking a decline. The thought of sleeping with one of those CPAP machines, plus the daunting task of upkeeping one, is definitely unappealing, but you just can’t seem to find a better solution. 

Pretty disconcerting, right? Well, you don’t have to look any further for a solution. Oral appliance therapy is a new and improved way of treating obstructive sleep apnea, with you and your comfort being the first priority. This article will discuss what oral appliance therapy is and how effective it is in treating obstructive sleep apnea and snoring. 

What is Oral Appliance Therapy?

Oral appliance therapy is a specific treatment for obstructive sleep apnea that involves wearing a removable oral appliance, similar to a night-guard or retainer, in your mouth during sleep. The fit of an oral appliance is not unfamiliar; in fact, it’s comparable to a sports mouth-guard. 

The directive of the oral appliance is to keep the airways from collapsing and preventing airway blockage by either holding the tongue in place or supporting the jaw in a forward position. With this appliance, the soft tissue in the back of the throat will no longer be required to support different regions of the mouth and air will flow through without any issues. To be effective in this way, oral appliances are custom-fit to your mouth shape. 

There are a variety of different oral appliances that the FDA has approved. There are now over 100 different appliances on the market. Most of them fall into two main categories:

1. Mandibular repositioning devices 

These oral appliances reposition your lower jaw down slightly and into a forward position. This positioning helps to keep your airways open while asleep and prevents hypopneas. These appliances are more widely used in treating obstructive sleep apnea. Somnomed is the leading manufacturer for these oral appliances and are scientifically validated as providing the best quality of oral appliances to patients. 

2. Tongue retaining devices 

Your tongue naturally gravitates towards the back of your throat during sleep and can cause blockages. These oral appliances hold your tongue in place in order to prevent this from happening and maintain open airways. 

Getting, Making, and Fitting an Oral Appliance

A full clinical evaluation with a certified sleep specialist is required to get an oral appliance. This usually includes an examination of your teeth, jaw, tongue, airway, and updated X-rays. A sleep study may also be included. At Advanced Sleep Centers of Virginia, you can meet with one of our sleep specialists to determine which oral appliance would be best for you. 

To customize your oral appliance, digital or physical impressions and models of your teeth are used. The models are sent to a dental lab where the oral appliance is made to match your mouth and teeth shapes. Once the appliance is complete, you will have to meet with your specialist again for proper fitting. Your doctor will adjust the appliance to maximize comfort and effectivity. You will also learn how to clean and maintain your oral appliance. Once this process is finished and you’ve received your appliance, you and your doctor may decide to retake a  sleep study to prove the appliance is working for you. 

So, is it Effective? 

According to an update in the Journal of Thoracic Disease, treatment objectives for obstructive sleep apnea are split into two categories: physiological and symptomatic treatments. Physiological aspects of the disease that need to be treated are obstructive events, sleep fragmentation, and oxygen desaturation. Symptomatic aspects are the snoring and sleepiness that treatment works to minimize. Studies use the apnea-hypopnea index (AHI), which shows the number of apnea and hypopnea events per hour of sleep, to define treatment success. Usually, anything less than or equal to 5 events an hour on the AHI is considered successful. 

While continuous positive airway pressure machines, known as CPAPs, have long been thought of as the most efficient treatment for obstructive sleep apnea, the CPAP’s difficult upkeep and high intolerance rates undermine its efficacy. Alternatives are necessary, and oral appliance therapy takes the cake in terms of efficient CPAP alternatives! In recent years, there has been a strong body of evidence supporting oral appliances in the treatment of obstructive sleep apnea. Thus, oral appliances have become the leading alternative to the pesty, old-fashioned CPAP that has plagued obstructive sleep apnea users for years. 

The most commonly used oral appliance for obstructive sleep apnea treatment, as stated above, is the mandibular repositioning device. This device now has a plethora of evidence supporting its use in treatment programs. Both video endoscopy and MRI-guided research have confirmed that these appliances increase the volume of the airway and prevent blockage and hypopneas. These devices have reported AHI reductions of between 30 to 72%. Other studies have also shown these appliances improving the arousal index and oxygen saturation parameters, as well as increasing the amount of REM sleep. Lastly, these appliances have shown a drastic reduction in snoring, which means better sleep for not just you but your partner too! 

It is important to remember that maximizing effectiveness requires adjusting oral appliances over periods of time, so follow-up visits are significant to the treatment process and long-term success. 

The CPAP vs. Oral Appliance Therapy 

For years the CPAP has been considered the most effective treatment option for those suffering from obstructive sleep apnea. Unfortunately, the CPAP and its effectiveness have been limited due to lack of patient adherence and intolerance. New research shows that despite previously thought, the CPAP is not as effective in achieving better health outcomes. In fact, mandibular repositioning appliances have achieved comparable health outcomes with a higher compliance rate than CPAPs, meaning that patients use the oral appliance more frequently than the CPAP.

It has been concluded that most patients prefer oral appliances to CPAP machines for a few reasons. The appliances are usually more comfortable, portable, and cost-effective. These factors have shown that a person is more likely to stick with oral appliances for long-term use rather than CPAP machines. 

Is it Right for You?

It is clear that oral appliance therapy is an effective treatment option for obstructive sleep apnea and snoring and should be considered by those needing treatment. Oral appliance therapy is cost-effective and in most cases tremendously beneficial to obstructive sleep apnea sufferers. Of course, as with any treatment option, you should consult a professional to make sure oral appliance therapy is the best fit for you and your circumstances. A sleep professional will be able to conclude if you are a good candidate for oral appliance therapy and fit you with the best oral appliance so you get the best treatment possible. 

Advanced Sleep Centers of Virginia and our team of highly-trained sleep professionals can help you determine if oral appliance therapy is right for you. Our specialists make the process of diagnosing and treating obstructive sleep apnea simple with at-home sleep tests, online scheduling, and a secure telemedicine portal where you can communicate with sleep professionals privately and quickly.

Living with an Oral Appliance 

If oral appliance therapy is right for you, this treatment can make you feel brand new! Not only will your symptoms be reduced, but your quality of life will improve as well. You might even find that your bed partner sleeps easier, too. Being committed to your treatment plan and keeping in touch with your doctor will maximize the benefits received from this treatment and help you to be a better version of you! 

Interested in oral appliance therapy? Advanced Sleep Solutions of Virginia will find the right oral sleep appliance for you and get you on the right track for improving your sleep. You can schedule an appointment online or call us today at (703) 689-2480.

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