New practice parameters published today by the American Academy of Sleep Medicine in the medical journal Sleep recommend oral appliances as a first-line treatment for snoring and mild-moderate obstructive sleep apnea (OSA).
This is good news for the estimated 18 million OSA sufferers in the U.S., since it enables them to avoid the risks associated with surgery and the discomfort that can accompany other treatment methods.
Signs and Symptoms
OSA causes snoring, airway blockage and sleep disruption. It occurs when the tongue and soft tissues in the back of the throat collapse to block the airway during sleep, producing pauses in breathing that can occur a few times or several hundred times a night, disrupting sleep.
OSA can cause:
- Excessive daytime sleepiness
- An increased risk of high blood pressure
- Higher rates of stroke, arrhythmias, heart attack and even death.
In fact, OSA reportedly contributed to the 2004 death of football great Reggie White. Experts also believe that it may be responsible for a high percentage of on-the-job injuries and motor vehicle accidents, as well.
OSA Can be Life Threatening: Treating It Is Important
“Oral appliances may help people who have tried other OSA treatments and been unsuccessful or who have not complied with their treatment,” added Lawrence Epstein, M.D., president, American Academy of Sleep Medicine.
“OSA is a serious, life-threatening condition — but for many patients, alleviating its effects can be as easy as utilizing an oral appliance at night,” explained ADSM president, Kent Moore, M.D., D.D.S. “Oral appliances, which resemble sports mouth guards, may control mild to moderate OSA with minimal discomfort or disruption.”
This practice parameter is based on an accompanying review of extensive evidence found in the scientific literature that was performed by an expert task force.
While continuous positive airway pressure (CPAP) is still considered the most efficacious treatment for OSA, many patients find this form of treatment uncomfortable or intolerable, making an oral appliance often a more appropriate option.
The new practice parameters (and accompanying review paper) validate the effectiveness of oral appliances as a viable treatment alternative for those patients with mild to moderate OSA who either prefer it to CPAP, or are unable to successfully comply with CPAP treatment.
Until there is higher quality evidence to suggest efficacy, CPAP is indicated whenever possible for patients with severe OSA before considering oral appliances.
According to Dr. Moore, oral appliances offer a safe, effective and non-invasive treatment option for the millions of Americans suffering from OSA and severe, chronic snoring. When utilized during sleep, they help maintain an open and unobstructed airway in the throat by repositioning or stabilizing the lower jaw, tongue, soft palate or uvula.
There are many types of oral appliances, with some designed specifically for snoring and others intended to treat both snoring and sleep apnea.
What To Do If You Think You’re Experiencing Symptoms Of OSA
Those who think they may suffer from a sleep-related breathing disorder should seek help from a qualified medical professional. A sleep clinician can assess the severity of the problem and, if appropriate, refer the patient to a dentist trained in the treatment of snoring and sleep apnea.
The dentist will properly fit and adjust an oral appliance to meet the individual patient’s needs. Follow-up visits to the sleep clinician and dentist will help monitor the patient’s progress and assess the effectiveness of the treatment.
The Academy of Dental Sleep Medicine
The Academy of Dental Sleep Medicine is a professional membership organization that promotes the use and research of oral appliances and oral surgery for the treatment of sleep disordered breathing and provides training and resources for those who work directly with patients.
The American Academy of Sleep Medicine
The American Academy of Sleep Medicine is a professional organization dedicated to the advancement of sleep medicine and related research. It also serves as the national accrediting body for sleep disorder centers and laboratories.
To identify a dentist in your area who is trained in the treatment of snoring and sleep apnea, go to www.aadsm.org. For a professional assessment of a sleep-related problem, visit www.sleepcenters.org to find an accredited sleep center near you.
Sleep is the official journal of the Associated Professional Sleep Societies, LLC, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society. Go online to www.journalsleep.org
Facts about snoring and obstructive sleep apnea:
- An estimated 30 million — or one in eight — Americans snore.
- Individuals who snore have a high likelihood of having (or developing) obstructive sleep apnea
- Approximately 18 million Americans suffer from sleep apnea.
- Some 28 percent of men over the age of 65 suffer from sleep apnea
- Up to 50 percent of sleep apnea. patients have high blood pressure
- Risk for heart attack and stroke also may increase among those who have sleep apnea.
- Nearly 60 percent of Americans suffer from daytime sleepiness, a side effect of sleep apnea.
- Snoring and mild-moderate apnea is improved and often eliminated in many patients who use oral appliances.
- Each year, sleep disorders add an estimated $15.9 billion to the national healthcare bill.
Sources: American Academy of Sleep Medicine, American Sleep Apnea Association and the National Sleep Foundation