Objectively measured health outcomes in oral appliances vs. CPAP

When considering objective (i.e., measurable) health outcomes, Oral appliances and CPAP have similar outcomes.

References: 1. (Gotsopoulos et al.,2002), (Engleman et al., 2002), (Barnes et al., 2004), (Gagnadoux et al,, 2009), 2. (Naismith et al., 2005), 3. (Hoekema et al., 2007), 4. (Gotsopoulos, Kelly and Cistulli, 2004), (Barnes et al., 2004), 5. (Philips et al., 2013), 6. (Itzhaki et al, 2007), 7. (Marin et al., 2005), 8. (Anandam et al., 2013)

Sleep & cardiology effects

  • In a 2013 study following 667 patients for 96 months (or 6.5 years), Anandam and colleagues found no difference in cardiovascular mortality between patients using CPAP and oral appliances.
  • This was despite the residual AHI being higher in the patients with oral appliances than CPAP (16 ± 5.1 vs. 4.5 ± 2.3).
  • This was offset by greater use of the oral appliance per night – CPAP use for 5.8 ± 1.6 hours vs oral appliance use for 6.5 ± 1.2 hours.
  • Not treating OSA increased the risk of cardiovascular mortality by 6.5 times.

CPAP and Oral appliances in blood pressure control.

  • A network meta-analysis published by Bratton and colleagues in 2015 did not show a difference between CPAP and oral appliances in blood pressure outcomes.

  • There was no difference in either systolic or diastolic pressure (data not shown)
References: 1. (Schmidt-Nowara et al.,1995) 2. (Engleman et al.,2004), (Naismith et al., 2005), 3. (Gagnadoux et al., 2009)

Functional measured outcomes – oral appliances vs. CPAP

  • In measures that are important to patients and their partners, CPAP performs better in controlling snoring (by promoting nasal breathing), but oral appliance therapy performs better on quality-of-life measures (as patients generally don’t like wearing CPAP masks).
  • “Oral appliance therapy was very effective at reducing AHI and was associated with a higher reported compliance that that observed on CPAP. Both treatments improved functional outcomes in a similar way” Gagnandoux et al., 2009.

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

Find out what our patients faced

Stories of how sleep apnoea affected their lives.