Greg Walters, DDS, FAGD

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Sleep Apnea

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Airway Obstruction Treatment Options

Positive Airway Pressure Devices versus Oral Appliances

Positive airway pressure machines, used with a variety of breathing masks, are the most widely used treatment for moderate and severe sleep apnea.

The mask, worn snugly over the nose, or sometimes nose and mouth, during sleep, supplies pressurized air that flows continuously or intermittently into the sleeper’s throat. The increased air pressure prevents the sleeper’s airway from collapsing.

The pressurized air is supplied through a flexible tube from one of several types of machines: CPAP (continuous positive airway pressure), BiPAP (bilevel positive airway pressure), VPAP (variable positive airway pressure), and so on. Studies of the effect of PAP therapy show that OSA patients who consistently use their machines feel better and, as a result of the reduction of apnea and hypopnea episodes during sleep, encounter fewer complications of the disease.

A variant on the PAP device is Provent. Operating on the same principal of keeping the lungs full and the upper airway open, this therapy does not require electricity to operate or the use of a humidifier.

Although PAP devices are not used to treat snoring alone, they do eliminate snoring in addition to treating obstructive sleep apnea. The drawback most patients report is that they are uncomfortable to wear or create too much sound in a room for your partner to rest comfortably.

Oral Appliances (which are most commonly done in dental offices trained in Sleep Apnea)

Oral appliances look like the mouth guards worn by football players. The oral appliances for treating sleep apnea and snoring are specially designed for that purpose.

The appliance is worn in the mouth during sleep. Most appliances work by positioning the lower jaw slightly forward of its usual rest position. This small change is, in many people, enough to keep the airway open during sleep.

You can simulate the effect of an oral appliance with a simple experiment. If you make a snoring sound right now and, in the middle of it, thrust your jaw forward, you will see that the snoring sound stops.

The American Academy of Sleep Medicine has endorsed oral appliance therapy for selected patients with sleep apnea.

TAP Sleep Apnea Appliance Video


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