New research published August 9, 2019 in the Annals of the American Thoracic Society suggests that certain kinds of obstructive sleep apnea (OSA) can effectively be treated with oral appliances. The oral appliance moves the lower jaw forward to keep the airflow open.
Continuous Positive Airway Pressure (CPAP)
While continuous positive airway pressure (CPAP) is considered to be the prime method of treatment for OSA, it is not suitable for everyone. CPAP blows air continually through a mask into the nose and throat of the person who has obstructive sleep apnea. However, many people find it difficult to sleep wearing a mask.
Obstructive Sleep Apnea (OSA)
Obstructive sleep apnea (OSA) affects more than one in five people. Those who are male and overweight or obese are at a higher risk for OSA. Aging also increases the risk for developing OSA. Obstructive Sleep Apnea (OSA) causes breathing to temporarily stop during sleep and this can occur many times. This leads to lower oxygen levels in the blood and brain. OSA can lead to choking and some research suggests that the continuous disruption of oxygen to the brain may lead to dementia, diabetes, accidents, stroke and heart disease. To read more about OSA and a way to mass screen for it see our blog post from July 24, 2019.
Five Traits Suitable for Treating OSA with Oral Appliances
The researchers led by Ahmad A. Bamagoos have identified five traits that can make using an oral appliance suitable. They are:
- People who do not experience severe collapsibility of the upper airway were found to benefit more from an oral appliance than those who did not have this trait.
- People who had a weaker reflex response of their throat muscles, the function of which is to maintain an open airway (lower muscle compensation) could benefit more than people with a stronger reflex response.
- Higher loop gain measures how vigorously the brain and lungs respond to falling levels of oxygen and rising levels of carbon dioxide in the blood.
- Lower arousal threshold which measures how easily a person can wake up from sleep
- Higher ventilatory response to arousal leads to deeper sleep and promotes better breathing.
Polysomnography Test for Diagnosing OSA
Polysomnography is the test for diagnosing obstructive sleep apnea. The researchers analyzed data previously collected by polysomnography for 93 adults with the average age of 56 who had been diagnosed with moderate to severe OSA.
Using these five traits, oral appliances were found to be effective in treating OSA in more than half (61%) of the participants. Those patients in this group experienced a 73% reduction in the Apnea-Hypopnea Index (the number of breathing pauses per hour lasting 10 seconds or longer.)
Oral appliance therapy was also very effective in some very overweight people with a severe form of OSA.
If further testing confirms the results of this research, oral appliances could be considered along with CPAP as primary therapeutic treatments for certain types of OSA.
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It will be good to have another main way to treat OSA, as not all people can sleep with a CPAP mask on their face.