If you have Apnoea it might be time to see a Lawyer!

[Moriarty]

I cannot see how the jaw can be forced forward under Cpap pressure, biologically I don't think this is possible?

I don't believe that the CPAP pressure would cause a problem - but I am fully prepared to believe that a badly fitted or over-tight mask or chin strap could.

Just sayin'...

[Podd]

'British?', It appears to be a 'Canadian' based study with a sample set of forty six 'Japanese' subjects, it is inconclusive as even the authors freely admit but IMHO this type of study is important as they form the 'Backbone' of further research.
Anyway, here is a summary of the facts or lack of facts, food for thought?, well thats up to you?

Craniofacial changes after 2 years of nasal continuous positive airway pressure use in patients with obstructive sleep apnea.
Tsuda H, Almeida FR, Tsuda T, Moritsuchi Y, Lowe AA.
Source
Department of Oral Health Sciences, The University of British Columbia, Vancouver, BC, Canada. htsuda@dent.kyushu-u.ac.jp
Abstract
BACKGROUND:
Many patients with obstructive sleep apnea (OSA) use nasal continuous positive airway pressure (nCPAP) as a first-line therapy. Previous studies have reported midfacial hypoplasia in children using nCPAP. The aim of this study is to assess the craniofacial changes in adult subjects with OSA after nCPAP use.
METHOD:
Forty-six Japanese subjects who used nCPAP for a minimum of 2 years had both a baseline and a follow-up cephalometric radiograph taken. These two radiographs were analyzed, and changes in craniofacial structures were assessed. The cephalometric measurements evaluated were related to face height, interarch relationship, and tooth position.
RESULTS:
Most of the patients with OSA were men (89.1%), and the mean baseline values for age, BMI, and apnea-hypopnea index (AHI) were 56.3 ± 13.4 years, 26.8 ± 5.6 kg/m(2), and 42.0 ± 18.6/h. The average duration of nCPAP use was 35.0 ± 6.7 months. After nCPAP use, cephalometric variables demonstrated a significant retrusion of the anterior maxilla, a decrease in maxillary-mandibular discrepancy, a setback of the supramentale and chin positions, a retroclination of maxillary incisors, and a decrease of convexity. However, significant correlations between the craniofacial changes, demographic variables, or the duration of nCPAP use could not be identified. None of the patients self-reported any permanent change of occlusion or facial profile.
CONCLUSION:
The use of an nCPAP machine for > 2 years MAY change craniofacial form by reducing maxillary and mandibular prominence and/or by altering the relationship between the dental arches.


There are some unwelcome 'side' effects to Cpap as I am sure you are well aware of, we tend to accept these as 'Par for the Course' as the benefits outweigh these, if this is true and Cpap can 'Alter' our appearance or cause Pain then perhaps this 'Balance' needs revising.