What is Sleep Apnea?
Sleep apnea affects a staggering number of Americans: 1 in 5 adults has mild OSA and 1 in 15 has moderate to severe OSA1. As many as 60 million Americans could be living with undiagnosed OSA and not even know it. For those with sleep apnea, collapsed tissue within the throat obstructs the airway resulting in interrupted breathing during sleep.
- Pauses in breathing typically last 10 seconds
- Severe cases may last up to 30 seconds
- Loud snoring may be a sign of sleep apnea
- Pauses can recur throughout the sleep cycle
- May result in frequent awakenings & sleep fragmentation
There are currently three ways to treat OSA with varying degrees of invasiveness and effect. Choosing the correct method for your condition should be done after appropriate testing and with the advice of a trained professional.
Surgical treatment options correspond with the severity of the sleep apnea and address specific anatomic issues. Surgery is typically a last resort for several reasons:
- Prohibitive cost
- Any surgery carries risk & can lead to a painful recovery lasting 2-3 weeks
- May require time off of work
- Not guaranteed to cure sleep apnea
Continuous Positive Airway Pressure (CPAP) involves wearing a mask placed over the nose and mouth while sleeping. CPAP treatment can be an expensive and is generally not well tolerated – in fact it’s estimated that only 17% of CPAP users wear the devices more than 4 hours per night2.
- Expense of cumbersome mask & machine
- Ongoing CPAP maintenance & parts
- Low compliance rate
- Often more intensive treatment than required
Custom oral appliances prescribed by a physician and created by a trained dentist are an FDA approved treatment for mild to moderate OSA and an alternate treatment for CPAP-intolerant or non-compliant cases. Many find that oral appliances are preferable compared to CPAP, with use rates objectively measured at 83%3. Oral appliances have been shown to be as effective as CPAP on many real-world measures like daytime sleepiness, cognitive performance and high blood pressure4.
- In-home sleep testing
- Lower cost than CPAP & Surgery
- High compliance rate
- Ongoing treatment can be provided with regular cleanings
Access to qualified dentists providing Oral Appliance Therapy is inconsistent.
That’s why it is critical that more Dentists and Physicians receive high quality training in treatment of OSA, sleep disordered breathing, TMJ and related conditions. Expanding access to qualified care is one of the primary missions of the Academy. Our pioneering educational program combines dental and medical content into a comprehensive program suitable for both Dentists and Physicians who wish to understand the fundamentals of dental sleep medicine.
- Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM., Am J Epidemiol. 2013 May 1;177(9):1006-14. doi: 10.1093/aje/kws342. Epub 2013 Apr 14
- When adherence is defined as greater than 4 hours of nightly use, 46 to 83% of patients with obstructive sleep apnea have been reported to be non adherent to treatment. Weaver TE, Grunstein RR. Adherence to continuous positive airway pressure therapy: the challenge to effective treatment. Proc Am Thorac Soc 2008; 5:173.
- The objective mean use rate was 6.4 +- 1.7 h/night at 1 year follow-up in continuing users, with a regular use rate of 83%. Dieltjens M, et al. Chest. 2013 Nov;144(5):1495-1502. doi: 10.1378/Chest.13-0613.
- Comparable effectiveness of OAm and CPAP has been attributed to higher reported nightly use of OAm. Sutherland K, et al., Oral Appliance Treatment for Obstructive Sleep Apnea: An Update. J Clin Sleep Med. 2014 Feb 15; 10(2): 215–227.
