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.

Should we even treat mild OSA?

This recent article shows survivorship of untreated OSA patients at 20 years after their diagnosis. While patients with severe OSA had lower survival (25% at 20 years), only 50% of patients with mild OSA survived at 20 years. The survivorship curves for mild and moderate OSA are almost exactly the same – so why treat moderate OSA and not mild OSA?

Does OSA severity progress?

In this study of 160 patients followed for 5 years:

• For primary snorers with an AHI <5 (black line) – AHI increased from 1.8 to 13.4 over 5 years.

• For mild OSA sufferers with an AHI 5-15 (grey line) – AHI increased from 9.1 to 21.7 over 5 years.

Patients with mild OSA progressed to moderate OSA over this period, demonstrating that treating mild OSA is important.

What about compliance to CPAP in mild OSA patients?

A meta-analysis conducted in 2014 of 12 studies and 1438 patients was clear – patients with mild OSA are less compliant on CPAP:
Our results suggest that oral appliances should be considered first-line treatment for patients with symptomatic mild to moderate OSA as most patients prefer this treatment to CPAP when both treatments have been shown to be effective.
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
In conclusion, the AHI seems to be a predictor for PAP compliance. Patients with mild OSA are less likely to be compliant with PAP therapy.
Reference: American Journal of Therapeutics 21, 260-264 (2014)

See what SomnoMed® patients have to say

Every patient is different and we have helped individual patients on their journey in finding a solution.

Find out what they went through and how it feels to wear a SomnoDent® oral appliance.

Patient stories

Derek’s story

“Before I found my sleep dentist I was sleeping with my CPAP device. This posed several problems for me. Most are the obvious: wearing the CPAP mask, trying to sleep with a hose attached to your face, having to travel with it, and then my allergy issues became more severe.

Maintenance is a pain as well. My SomnoDent® device has allowed me to enjoy life a bit more without the hassle of a CPAP. And, there is the added benefit of not having to make sure I have a source of power available. Which means, I can go camping again! I would recommend the SomnoDent® device to anyone with obstructive sleep apnea. It is life changing.”

- Derek

Izy’s story

For years I fought with my CPAP, I literally tried 15 masks and I will never ever go back to CPAP after discovering SomnoDent®. I love it and so does my family because they can finally sleep in peace.

I can carry it, no more lugging around that extra CPAP baggage, I just throw my SomnoDent® device and case in my backpack and keep going. I truly am a big fan and if I can encourage others to switch to SomnoMed®, I know for a fact their quality of life would improve tremendously. Here’s another thing, I had a problem with grinding my teeth at night, not anymore!

- Izy

Mandy & Al Mermelftein's story

Borris’ story

Although a bit reticent at first in the use of this tool, once I began using it and finding out how good a night’s sleep I could have after so many years of bad nights and untold other alternatives which always proved useless, I am now happy to let you know that thanks to SomnoMed® I am able to sleep very well and also that my wife can now enjoy a good night’s sleep without my racket at night.

- Borris

Susan’s story

“With a household to manage, motherhood, night school for advanced degrees, and two jobs – good sleep seemed an unattainable goal. Over the years of sleep deprivation, my health steadily declined with resultant hypertension, chronic sinusitis, and eventually atrial fibrillation.

I had a sleep study that showed moderate obstructive sleep apnea. A second study to fit a CPAP mask was a dismal failure – 14 different masks and nothing fit.

My dentist suggested a SomnoDent® and my life has turned around since I received it.  My husband is delighted that I no longer snore. I’m off my blood pressure medications. I truly feel like a new person with much more energy. I can’t thank you folks enough for my SomnoDent®. I’m convinced it has literally saved my life.”

- Susan

Shirley's, Jesus' & April's stories