Sleep apnea can be mild. It can be severe. What makes the difference is something called the Apnea-Hypopnea Index, or AHI. Basically, it’s a count of the average number of times you stop breathing each hour as you sleep. If your AHI is between 5 and 15, you have mild apnea. Between 15 and 30 is moderate; more than 30 is severe.
Think about that last number for a minute. That’s an average of an episode every two minutes! That’s a lot of time to be not-breathing – especially considering that your brain requires oxygen to function. Each apneic event is actually your body going into red alert mode to get you to start breathing again.
It used to be that there was just one treatment for sleep apnea, regardless of severity: continuous positive airway pressure, or CPAP. While a literal lifesaver, CPAP has never been exactly beloved by those who need it. The mask, the hose, the noise – not exactly the stuff of peaceful slumber. Many ultimately give up on it, resigning themselves to noisy nights, groggy days, and a greater likelihood of the poor overall health that apnea brings.
Today, though, oral appliance therapy is a real alternative to CPAP – far more tolerable and just as effective, even for severe apnea. There are lots of different devices and designs available, so we can match you with one that meets your specific needs. In fact, Dr. Abdulla just added another option to our sleep apnea toolkit: the ProSomnus EVO Guided device.
Like other apnea appliances, EVO Guided is like a custom mouthguard that fits over both your upper and lower teeth, gently holding your lower jaw forward to keep the airway open. But it goes a step further, having been specially designed to dilate both the velopharynx and oropharynx – areas at the top of your throat that tend to collapse during sleep, blocking airflow. By keeping them open, EVO Guided lets you breathe freely through the night.
In fact, it’s the ONLY device currently available that addresses what new research has shown: Airway blockage mostly happens at the level of the velopharynx. It’s also free from BPA and phthalates.
EVO Guided’s design also addresses the hyo-glossal complex – a/k/a the tongue and the muscles that control it. Specifically, it does three critical things at once to help optimize the airway:
- It guides and stabilizes your jaw in an optimal therapeutic position.
- It guides your tongue into a good forward position.
- It guides your mouth closed during sleep.
This creates much more room for the tongue, while the appliance’s low vertical dimension lets your mouth close much more naturally during sleep. Morning dry mouth is much less likely because of this.
While the EVO Guided is so new that studies have yet to be published on its effectiveness, ProSomnus devices in general have good evidence backing them up. One 2022 study, for instance, in the Journal of Clinical Sleep Medicine found that ProSomnus devices had an 81% success rate. Broken down by apnea severity, the success rate was 64% for severe OSA, 87% for moderate, and 100% for mild.
Those rates put it in CPAP territory.
A slightly larger study the next year similarly found that 89% of all patients achieved an AHI below 10 using ProSomnus EVO, For those with mild or moderate apnea, the success rate was 98.5%. Where apnea was severe, 80% reached an AHI below 20 with a 50% improvement in their AHI.
And nearly all participants – 96% – “were confirmed to remain in active treatment” after at least one year – a testament not only to the results it gets but also its greater comfort compared to many older devices.
And unlike CPAP, it works with the body’s natural anatomy rather than fight against it – the perfect approach for a holistic, biological practice like ours.