Publication
Title
Oral appliance treatment for obstructive sleep apnea : an update
Author
Abstract
Oral appliances (OA) have emerged as an alternative to continuous positive airway pressure (CPAP) for Obstructive Sleep Apnoea (OSA) treatment. The most commonly used OA reduces upper airway collapse by advancing the mandible (OAm). There is a strong evidence base demonstrating OAm improve OSA in the majority of patients, including some with more severe disease. However OAm are not efficacious for all, with approximately one third of patients experiencing no therapeutic benefit. OAm are generally well tolerated, although short-term adverse effects during acclimatization are common. Long-term dental changes do occur, but these are for the most part subclinical and do not preclude continued use. Patients often prefer OAm to gold-standard Continuous Positive Airway Pressure (CPAP) treatment. Head-to-head trials confirm CPAP is superior in reducing OSA parameters on polysomnography, however this greater efficacy does not necessarily translate into better health outcomes in clinical practice. Comparable effectiveness of OAm and CPAP has been attributed to higher reported nightly use of OAm, suggesting that inferiority in reducing apneic events may be counteracted by greater treatment adherence. Recently, significant advances in commercially available OAm technologies have been made. Remotely controlled mandibular positioners have the potential to identify treatment responders and the level of therapeutic advancement required in single night titration polysomnography. Objective monitoring of OAm adherence using small embedded temperature sensing data loggers is now available and will enhance clinical practice and research. These technologies will further enhance efficacy and effectiveness of OAm treatment for OSA.
Language
English
Source (journal)
Journal of clinical sleep medicine
Publication
Westchester : Amer acad sleep medicine , 2014
ISSN
1550-9389
DOI
10.5664/JCSM.3460
Volume/pages
10 :2 (2014) , p. 215-227
ISI
000336494300015
Full text (Publisher's DOI)
UAntwerpen
Faculty/Department
Research group
Publication type
Subject
Affiliation
Publications with a UAntwerp address
External links
Web of Science
Record
Identifier
Creation 13.01.2014
Last edited 09.10.2023
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