Oral Appliances Can Treat Even Severe Sleep Apnea Effectively, Research Shows

Sleep is something we all need, essential to good oral, systemic, and mental health. (True story: Scientific evidence suggests that lack of sleep may be a risk factor for gum disease.)

Sleep is an opportunity for your body to take care of business that it can’t do when you’re up and about – to repair and restore itself. It’s when your brain consolidates memories and metabolic waste products are cleared away from it; when your immune system replenishes its defense systems.

Yet for many of us, a good night’s sleep is an elusive thing, and we all know what it feels like when we fail to get it. You’re tired, cranky, unable to think clearly. Lack of sleep has also been linked with health problems such as obesity, heart disease, and diabetes.

If you’ve got untreated obstructive sleep apnea (OSA), quality sleep is pretty much impossible. Every morning, you wake up feeling just as drained as when you went to bed.

That’s because you’ve spent all night waking repeatedly, every time you stop breathing. Your body’s defense mechanisms go into red alert mode to get you to start breathing again.

Oxygen, after all, is not optional.

CPAP machines have long been considered the gold standard treatment, using air pressure to keep the airway clear, but many people don’t like them or can’t tolerate them. As effective as they can be, they can’t do any good if they’re not being used.

Fortunately, oral appliance therapy can provide a far more tolerable solution.

Two major types of custom-fit appliances are available for treating apnea. Most common are mandibular advancement devices (MADs), which hold the lower jaw slightly forward to keep the airway clear, allowing for unobstructed breathing all night long. The other option is a tongue retention device (TRD), which holds the tongue so it’s unable to fall back and block your airway as your muscles relax.

Oral appliances are portable, quiet, and way less cumbersome than lugging around a CPAP. And more and more evidence shows that they can be just as effective as CPAP, even in severe cases of OSA.

Earlier this year, a new study in Otolaryngology – Head and Neck Surgery evaluated the cumulative evidence up to late 2022. Forty-two studies involving 2265 patients were included.

Analysis of the data showed that, overall, AHI scores – a measure of sleep apnea severity – improved considerably with oral appliance therapy. Scores improved by

  • 48% in those with mild sleep apnea.
  • 67% in those with moderate sleep apnea.
  • 62% in those with severe sleep apnea.

Did the type of appliance make a difference? Only in mild apnea, where MADs were significantly more effective than TRDs (58% to 21%). No significant differences were found in moderate and severe cases. Sleepiness and oxygen saturation scores didn’t vary significantly either. Improvements were across the board.

“Overall,” the review authors concluded, “OAs are effective treatments for moderate and severe OSA.”

Ideally, the type of device used to treat sleep apnea dentally depends upon a number of factors, from your dental and orofacial anatomy to your personal preference. A specialist like Dr. Abdulla, with extensive training in airway/apnea, as well as TMJ health, can provide just that. After conducting a comprehensive exam and gathering information from you, she will advise on the CPAP alternative that’s most likely to bring you the best results, based on your individual needs.

It’s personalized dental medicine at its finest, so you can get the good night’s sleep you deserve each and every night.

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