How oral appliances treat sleep apnea
By Assoc Prof Dr Daniel Lim Khim Hock, Assoc Prof Dr Lau May Nak
Sleep is vital for our health, yet millions worldwide grapple with obstructive sleep apnea (OSA), marked by repeated pauses in breathing during sleep. While continuous positive airway pressure (CPAP) therapy is the gold standard OSA treatment, oral appliance therapy offers a non-invasive option for those who find CPAP cumbersome or intolerable.
Before delving into oral appliance therapy, it’s essential to understand the basics of OSA. OSA occurs when throat muscles relax excessively during sleep, narrowing or collapsing the airway, leading to airflow reduction (hypopnea) or cessation (apnea), and fragmented sleep. Poor sleep quality leads to daytime fatigue and significantly increases the risk of motor vehicle accidents or occupational hazards that can be deadly. Left untreated, OSA can cause severe health issues like hypertension, heart disease, stroke, and diabetes.
Oral appliance therapy comes in several types, including mandibular advancement devices, tongue stabilizing devices, palatal lift appliances, and combination devices. The most popular type is mandibular advancement devices, which position the mandible and tongue forward to keep the airway open.
Mandibular advancement devices are discreet, comfortable, and easy to use. Unlike bulky CPAP machines which require a power source, oral appliances are small, portable, and do not need a power source, making them ideal for travel. This convenience allows individuals to maintain their OSA treatment regimen even when away from home, ensuring consistent therapy and better management of symptoms. Thus, compliance with mandibular advancement devices is significantly superior compared to CPAP, making its overall clinical effectiveness comparable with CPAP.
Additionally, oral appliance therapy is a non-invasive treatment option that does not involve surgery or the use of medications. As such, it carries minimal risk of complications and side effects, making it a safe and effective alternative for many individuals with OSA.
Mandibular advancement devices can be customized to suit each patient’s specific needs and preferences. Orthodontists carefully design and adjust the devices to ensure optimal fit and effectiveness, maximizing treatment outcomes and patient comfort. This comfort factor encourages regular use and long-term adherence to treatment. However, individuals with poor dental status, inadequate healthy teeth, active gum disease, and limited jaw motion range are not suitable for mandibular advancement devices.
Overall, oral appliance therapy plays a crucial role in managing OSA, offering a comfortable, convenient, and effective alternative to CPAP therapy for many individuals. By keeping the airway open during sleep, oral appliances reduce breathing disturbances and improve sleep quality. For individuals with mild to moderate OSA or those who cannot tolerate CPAP therapy, oral appliance therapy provides a valuable treatment option that promotes adherence, comfort, and convenience, significantly enhancing their quality of life and allowing them to enjoy restful and rejuvenating sleep night after night.
As the world comes together to celebrate World Sleep Day on March 14, let’s take this opportunity to recognize the vital role that quality sleep plays in our overall health and well-being. Prioritizing good sleep habits is not just a luxury but a necessity for a healthier, more productive life. Let’s start making better choices today, because our health doesn’t pause when we sleep.
Dr Lim is from the Department of Oral and Maxillofacial Clinical Sciences, while Dr Lau is from the Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universiti Malaya.
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