Treatment Options for Obstructive Sleep Apnea Syndrome

Oral Appliance Therapy for Obstructive Sleep Apnea Syndrome

A variety of oral appliances have been developed to mechanically enlarge and stabilize the upper airway during sleep in patients with obstructive sleep apnea syndrome (OSAS). There are two categories of oral appliances that may be used for the management of OSAS:

• Tongue retaining appliances - these devices are designed to hold the tongue in a forward position during sleep.
• Mandibular advancing appliances - these devices are designed to bring the mandible (lower jaw) forward and, by doing so, also brings the tongue forward and away from the back of the throat during sleep.

Many oral appliances used for the treatment of OSAS are available commercially or can be custom-made by a dentist. Oral appliances, particularly the ones that are custom-made, can be quite expensive and are usually not covered by insurance.

In general, oral appliance therapy may be an option for patients with mild to moderate OSAS or patients with severe OSAS who refuse or cannot tolerate continuous positive airway pressure (CPAP) therapy. Studies have shown, however, that CPAP is more effective than oral appliances for controlling snoring and reducing the apnea-hypopnea index (AHI) in patients with OSAS.

Complications associated with oral appliance therapy may include:

• Dry mouth
• Temporomandibular joint (TMJ) pain
• Increased production of saliva
• Malocclusion - improper allignment of the upper and lower teeth