Thursday, October 10, 2013

Oral Appliances an Effective Alternative to CPAP for Sleep Apnea

Sleep apnea is a significant and underdiagnosed medical problem. It is estimated that only twenty percent of people with sleep apnea have been properly diagnosed. Obstructive  sleep apnea is when the airway in the throat closes down blocking airflow to the lungs. These episodes can last ten second or more and cause a cascade of damage to one's health. The lack of restful sleep and poor oxygen can result in sleepiness, lack of energy, and poor mood. Research has shown that many car accidents are caused by poor attentiveness or falling asleep while driving by apneic patients. The long term medical consequences of sleep apnea include high blood pressure, obesity, heart disease, stroke,and obesity. Untreated apneas can lose a decade from their lifespan, or even more if they have an accident.

CPAP machines are very effective for treating sleep apnea. Unfortunately many patients do not tolerate these masks and give up on this vital treatment. An effective alternative is known as Oral Appliance Therapy. These custom made devices pull the lower jaw forward, much like the jaw lift in CPR. The tongue is pulled from the airway since it is attached to the lower jaw. According to the American Academy of Sleep Medicine oral appliances can be used as an equivalent to CPAP in mild to moderate apnea and also should be prescribed in severe cases where the patient has failed CPAP.

In our office we offer a simple overnight screening for sleep apnea. A wristwatch sized pulse oximeter records the patients breathing with a small finger probe during sleep. The data is evaluated for signs of obstructed breathing episodes. A referral to a sleep center or primary physician is made if the screening indicates a problem.

The EMA device is easy to wear and is adjustable using different length straps

The TAP3 Elite is comfortable and durable. The jaw position can be finitely adjusted in 1/4 millimeter increments.