Alternatives to CPAP Sleep Apnea Oral Appliances

By Michael B. Rogers, DDS

Fairlington Dental

. http://www.fairlingtondental.com/

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Alternatives to CPAP Sleep Apnea Oral Appliances

Obstructive sleep apnea (OSA) is a common condition which can shorten your lifespan on average by seven years.

The condition arises when you fall asleep and your tongue and throat muscles relax, causing your airway to become so restricted that you actually stop breathing during your sleep.

Then, after your brain is deprived of oxygen for awhile, it stimulates you to wake up, gasp for breath, and then resume breathing normally until it happens again.

Most people are unaware of the condition because they don't reach full consciousness each time they gasp for breath, so they don't remember waking up every few minutes. The only symptom most people with OSA experience is daytime sleepiness.

There are severe medical consequences, however, for patients with untreated OSA.

Hardening of the arteries leading to heart attacks or stroke, high blood pressure, and falling asleep at the wheel are the most deadly. So treatment of OSA is very important.

The first line of defense is a machine known as the CPAP (continuous positive airway pressure).

It is essentially an air compressor attached to a hose and a mask which fits over your face when you sleep (think Top Gun fighter pilot).

While very effective in the lab, the actual effectiveness in real life is less than 50% because most patients can't tolerate the bulky equipment or toss it off during their sleep.

Fortunately, the dental community can offer an effective alternative to CPAP. Oral appliances have been used for many years to reduce snoring, and the same appliances can often treat OSA as well.

In fact, oral appliances have been approved by the FDA as a first line of defense in mild to moderate OSA cases.

Most oral appliances are composed of upper and lower retainers which are either hooked together or have attachments which prevent the lower jaw from falling back.

This holds the tongue off the back of the throat and keeps the airway open. Common appliances that hold the jaw forward are the Silencer, the OASYS, Herbst, TAP, and SomnoMed MAS.

Sometimes moving the jaw forward is ineffective, so other appliances such as the Full Breath Solution or the Tongue Retaining Device can be used to keep the tongue off the back of the throat without moving the jaw forward.

Finally, oral appliances can be used to prevent sleep apnea as well.

There is increasing evidence that narrow dental arches which push the tongue back or require extractions to complete orthodontic treatment can increase the likelihood of developing sleep apnea later in life.

So interceptive orthodontics at an early age (typically between the ages of 6-11) utilizing palate expanders or similar appliances can actually help prevent future cases of sleep apnea from developing in the first place.