Changes

There are a number of oral devices available to patients suffering from obstructive sleep apnea and snoring. The efficacy of these devices varies greatly, as does the quantity and quality of the research behind them. A study of the effects of oral devices on blood pressure conducted by the Department of Respiratory and Sleep Medicine, Department of Nephrology, St. George Hospital, and the University of New South Wales Australia found that oral devices were equally as effective as CPAP in lowering the blood pressure of patients suffering from OSA.[6] The MDSA (Sleepwell) was clinically proven to conclusively show in a large and complex randomized controlled study that CPAP and MAS are effective in treating sleep-disordered breathing in subjects with AHI 5-30, although CPAP appears to be superior to the oral appliance. They are both also effective in alleviating symptoms,improving daytime sleepiness, quality of life and some aspects of neurobehavioral function, with CPAP usage being less than self-reported MAS usage. Nevertheless, more subjects and their domestic partners felt that CPAP was the most effective treatment, although MAS was easier to use. Nocturnal systemic hypertension was shown to improve with MAS but not CPAP, although the changes are small. [7]

Many health plans do not cover mandibular advancement devices because they are a relatively new form of treatment. Patients often pay upwards of $2000 out of pocket to secure these devices. These devices can also be somewhat uncomfortable, although many patients find them less bothersome than CPAP mask treatment. Improperly fitted devices can cause teeth to shift over time, leading to significant dental problems. Regular dental checkups and adjustments to the oral device can prevent these problems. Morning jaw exercises can reduce pain and jaw dislocation, helping patients to retain a normal bite pattern.

1.^ http://www.somnomed.com