Sleep apnea is a condition in which the airway becomes occluded during sleep, reducing airflow. In some patients, the blocking of the airway is partial, leading to loud snoring. In others, it can occlude entirely, activating the body’s stress response and causing the patient to startle awake to resume normal breathing.
Sleep apnea is difficult to diagnose because it occurs when a person is in an unconscious state. Often, the only sign of sleep apnea is waking up in the morning feeling groggy, as if you have not had a proper night of rest. Unfortunately, if you allow the condition to continue long-term, it can lead to several severe health issues, including problems concentrating, irregular heartbeat, headaches, and, in some extreme cases, heart attack.
Currently, CPAP (Continuous Positive Airway Pressure) is a popular treatment method that seeks to manage sleep apnea symptoms and facilitate better rest. The device uses a mask connected to a pump that maintains mild positive air pressure in the airways at all times, preventing occlusion.
Generally, the therapy is the most recommended treatment option for obstructive sleep apnea patients, but it comes with some drawbacks. The main issue is the feeling of claustrophobia that many patients get when wearing the CPAP mask. Covering the mouth and nose leads to the sensation of being enclosed – not something that patients want when trying to get a restful night’s sleep. Furthermore, CPAP can lead to nasal congestion and a runny nose – an annoying side effect for a surprisingly large number of sleep apnea patients.
Alternatives To CPAP Treatment
Fortunately, several appliances can alleviate symptoms of sleep apnea for patients who can’t tolerate CPAP machines. Many of these options are non-invasive and simply insert into the mouth at night.
Dr. Kevin F. Postol offer three devices that function as CPAP alternatives: EMA, the TAP 3, and the Herbst OA. Tap 3 is a proven treatment for patients with mild to moderate obstructive sleep apnea. The device works by attaching the top and bottom of the jaw via a small hook. The on-board key allows patients to adjust the guard’s position incrementally until they achieve the desired position.
The Tap 3 is famously non-invasive and has a compliance rate of around 95 percent. Patients can continue adjusting the key until the appliance is wholly closed inside their mouth,
The Herbst OA works on a similar principle but uses a set of pistons that slide within a tube instead. The device provides the user with a high degree of freedom, allowing them to move the jaw slightly while also protecting against teeth grinding. Durable elastic bands on the device prevent the jaw from flopping open during sleep (which could put them at risk of experiencing sleep apnea symptoms).
Oral appliances work by moving the lower jaw forward to ease the airflow and prevent the airway from becoming blocked by the tongue or soft palate. They fit very similarly to mouthguards, allowing you to insert and remove them whenever you like.
The Effectiveness Of CPAP Alternatives
While CPAP machines are the current go-to device for obstructive sleep apnea (OSA), oral appliance therapy is also highly effective and may have greater compliance. According to data from the American Academy of Sleep Medicine, devices like TAP 3 and Herbst OA have a 40 percent success rate among patients with severe OSA and a 60 to 75 rate of success for those with mild to moderate symptoms.
Thus, Dr. Postol typically recommend oral appliance therapy for patients with mild sleep apnea over and above CPAP as a first line of treatment. CPAP alternatives are much quieter and more comfortable, and they do not rely on the maintenance of positive air pressure, which can feel upsetting to some patients.
Interestingly, even those who just snore (and don’t have sleep apnea) can benefit tremendously from oral appliances. Around 85 percent of snorers who receive this type of therapy experience quieter, higher-quality sleep.
Who Are CPAP Alternatives For?
Primarily CPAP alternatives are for patients who refuse or cannot tolerate CPAP or for whom CPAP fails. It is an excellent choice for anyone with low tolerance of nasal CPAP or who primarily wants something that they can use during travel for mild to moderate OSA (or snoring).
What Are The Side Effects Or Oral Appliance Therapy?
Oral appliance therapy is a low-risk treatment. However, you may experience some transient symptoms as you adjust the device. Because the prosthetic changes the lower jaw’s position, it is not uncommon for patients to experience some tension after wearing it for a prolonged period. For the same reason, it can also lead to sore gums and teeth.
Is Oral Appliance Therapy Better Than Surgery?
Surgery is widely considered the last resort for sleep apnea treatment, even though it is often touted to cure it. However, there are some drawbacks. As patients get older, the skin at the back of the throat relaxes. This natural process can occasionally cause the tongue to collapse back into the palate, negating the procedure’s effectiveness.
Most patients benefit from a combination of oral appliance therapy plus evidence-based lifestyle modifications that may improve symptoms. Appliances are useful for considerably more than half of all patients with mild to moderate OSA. It is an excellent non-invasive option.
Get Treatment For Sleep Apnea
If you believe either you or a partner has sleep apnea; please contact us for an appointment. We have more than twenty-five years of experience helping patients take back control of their sleep and we can help you too. It takes around three weeks to fabricate oral appliances for OSA, so the sooner you get help from us for your condition, the better.