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Oral appliance therapy
Oral appliances were first utilized in the 1930′s to help people breathe properly during sleep. By the 1980′s, physicians and dentists began to seriously study the effectiveness of oral appliances to treat snoring and obstructive sleep apnea and found them to be effective in many, but not all cases. Recent studies show oral appliances to be most effective in treating snoring and mild to moderate obstructive sleep apnea. However, some appliances have been shown to effectively treat severe apnea in some cases. While oral appliances are often effective, it is important to know that they are not adequate for everyone and to date, it is not possible to predict the successes from the failures prior to treatment. The two categories of devices are mandibular advancement devices or tongue retained devices.
Continuous Positive Air Pressure (CPAP)
A common treatment for treating breathing disorders has incorporated the use of a specially designed mask that is strapped onto the head at bedtime. A plastic device, it completely covers the nose and mouth and is connected to a machine with an air hose. This device has become commonly referred to as a CPAP Mask.
Despite it’s popularity (the CPAP Mask is considered to be the gold standard of treatment), recent research indicates that there is only 46% compliance after the first 3 months of treatment. 37% of those still using the CPAP soon abandon it completely – Journal of Respiratory Therapy
- Lacerations to the bridge of the nose due to the mask
- Rawness of the throat due to constant airflow
- Bloating of the stomach
- Deprivation of sleep, the very reason the mask is prescribed
- Patient Embarassment
- His or Her bed partner’s lack of acceptance of the device
Medical intervention incorporating different types of surgery which range in invasiveness may or may not be successful. Some estimates indicate that surgery may be 20% to 50% effective. Examples of some irreversible breathing disorder treatment alternatives include:
- Tonsillectomy – Removal of Tonsils
- Adenoidectomy – Removal of Adenoids
- Uvulopalatopharyngoplasty (UPPP) – removal of excess throat tissue to widen the airway
- Nasal surgery
- Radiofrequency palatoplasty
- Tongue base suspension
- Maxillomandibular advancement
While tracheostomy and maxillomandibular advancement have been shown to be efficacious, they are quite invasive.
The other options are far less predictable.