CPAP or Oral appliances?

A PubMed search containing OSA, CPAP or oral appliances can produce hundreds of clinical articles.

Below are extracts from clinical articles that report on some of the topical issues being considered in sleep medicine today, including treatment of mild OSA, progression of mild OSA and the use of oral appliances or CPAP in mild OSA.

Bør man overhovedet behandle milde former for OSA?

Denne aktuelle artikel viser overlevelsesraten hos patienter med ubehandlet OSA 20 år efter deres diagnose.

Mens patienter med alvorlig OSA havde en lavere overlevelsesrate (25% efter 20 år), levede kun 50% af patienterne med mild OSA efter 20 år.

Overlevelseskurverne for hhv. mild og moderat OSA er næsten ens – så hvorfor behandle moderat OSA og ikke mild OSA?

Bliver OSA værre med tiden?

Bliver OSA værre med tiden?

I dette studie blev 160 patienter fulgt i 5 år:

  • For patienter med snorken som primært symptom og en AHI på <5 steg deres AHI fra 1,8 til 13,4 over en 5-årig periode. 
  • For patienter med mild OSA og en AHI på 5-15 steg deres AHI fra 9,1 til 21,7 over en 5-årig periode.

Patienter med mild OSA udviklede i denne periode moderat OSA, hvilket beviser vigtigheden af også at behandle mild OSA.

Hvad med CPAP-compliance hos patienter med mild OSA?

En meta-analyse udført i 2014 bestående af 12 studier og 1438 patienter leverede en entydig konklusion: patienter med mild OSA udviser ringere CPAP-compliance.
Vores resultater indikerer, at tandskinner bør være førstelinjebehandling til patienter med symptomatisk mild til moderat OSA, idet langt størsteparten af patienterne foretrækker denne behandling over for CPAP, når begge behandlingsformer har været succesfulde.
Reference: Ferguson et.al “A short-term controlled trial of an adjustable oral appliance for the treatment of mild to moderate OSA” Thorax 1997; 52;362-368
Som resultater ser AHI ud til at være en forudsigelse for PAP-overholdelse. Patienter med mild OSA er mindre tilbøjelige til at være kompatible med PAP-terapi.
Reference: American Journal of Therapeutics 21, 260-264 (2014)

Patient stories

Michael’s story 

“I have been using my Somnomed® device for about two years now. It has completely improved the quality of sleep that I get and consequently certain aspects of my life for the better.

On the rare occasion that I forget to put it in the device my sleep deteriorates immediately. It’s invaluable.” Read more

Liz’s story

“Having suffered jaw and tooth pain over several months and following several appointments with my GP and regular dentist to no avail, I asked April (dentist) if she could give me a second opinion. After careful consultation April suggested that sleep apnoea and teeth grinding might be behind the issues and recommended a Somnomed® device to wear at night. Read more

Simon’s story

“My name is Simon Wilsdon I am a general dentist in York with a special interest in dental sleep medicine. Over several years I have experienced mild sleep apnoea and, unfortunately for my wife, loud snoring. I have tried several different mandibular advancement devices over the years. These have given initial improvement but nothing long lasting and were uncomfortable over time. After investigating different options, I decided to give the new SomnoMed® Avant™ appliance a try. Read more

Mohammed’s story

Mohammed was diagnosed with Severe Sleep Apnoea in 2018.

“For the first year after my diagnosis, I had a CPAP machine in the home, but I really struggled with it, due to the anxiety of the mask being on my face all night. When I saw my Sleep Consultant, I was advised that I should not drive, and my driving license has now been revoked for more than 2 years. I have a family at home, with four children, so having no driving license has really affected our day-to-day lives. Little things like food shopping and trips out are much more difficult. Read more

Roy’s story

Like many people, l became aware that l was snoring during the night and feeling tired in the morning. This led me down the route of seeing my GP who felt l may have obstructive sleep apnoea and referred me to the hospital for further tests. There, l was given the Epworth Sleep Study questionnaire to complete which indicated l had daytime sleepiness but not severely. However further investigation was necessary and an overnight hospital stay was arranged where l had a sleep study conducted. Read more

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