CPAP & Alternatives

CPAP

A CPAP is a medical device that delivers continuous positive air pressure through a face mask or nasal tube attached to a pump. Typically the unit is placed next to the bed and it operates on normal house current. It functions by keeping the upper airway unobstructed during sleep. Proper adjustment of the CPAP is vital to achieve maximum clinical benefits and minimal side effects. Wearing a CPAP is a lifetime commitment and the mask (or tubes) must be in place whenever you sleep or nap.

So you have problems wearing your CPAP

If you are wearing a CPAP and find it intolerable and uncomfortable, there is a device that you can wear as an alternative. This device called an Oral Appliance (OA) fits in the mouth and can be placed in the mouth at bedtime. CPAP machines can be invasive and uncomfortable. This can also put a strain on your spouse and your relationship. Although the Continuous Positive Airway Pressure (CPAP) is the main treatment for Severe Sleep Apnea, it is rejected by about 50% of its users.

The CPAP unit is:

• Claustrophobic
• Can cause skin irritation
• Can be noisy
• Takes up room on the bed and needs an air compressor in the bedroom
• Can cause sinus irritation
• Is irritable for your spouse
• Difficult while travel

We can consult with you if you're suffering from snoring, mild to moderate sleep apnea or severe sleep apnea or unable or unwilling to tolerate a CPAP unit. If you have not been diagnosed with sleep apnea we will refer you to a sleep specialist for a proper diagnosis prior to treatment.

Oral Appliance Therapy-The CPAP Alternative

A viable alternative to CPAP therapy. A specially designed and adjusted oral appliance (OA) repositions the jaw and tongue during sleep The OA expands the airway by moving the tongue and jaw forward, thus creating more room for air to flow. Dentists who are trained in dental sleep medicine are qualified to fabricate an OA. They can be highly effective for those who suffer from snoring and mild to moderate sleep apnea. A quiet and restful night's sleep is important for the person who snores and the bed partner as well.

Patients who have mild to moderate occlusal spleen apnea (OSA) or cannot tolerate the CPAP should use an Oral Appliance (OA).

These Oral Appliances are worn during sleep and stops the tongue and soft tissues from collapsing in the back of the throat. The Oral Appliance Therapy will keep the airway open and promote normal and restful sleep in people who snore and / or have sleep apnea.

The oral appliances can be used in conjunction with a CPAP which may be integrated after consultation with the dentist and the sleep physician.

At your initial appointment we will discuss your particular problem and answer your questions about Oral Appliance Therapy (OAT). We will also discuss the extent to which Medical Insurance will cover the procedures. We will examine your teeth, gums, bone and entire oral environment to determine if you are healthy enough to support an oral appliance.

If you decide to proceed with Oral Appliance Therapy (OAT) we will take impressions and you can take a mobile in- home sleep study, in the comfort of your own bedroom. This will be compared to a second study done once the appliance is thought to be effective. This is usually about eight to twelve weeks after starting to use the Oralj Appliance.

After we make your Oral Appliance, you will return for a custom fitting be given instructions on use and care of the OA. You may return for two more follow up visits within three to four weeks to make any adjustments necessary.

The effectiveness of the appliance will be judged by the resolution of your symptoms which are snoring, daytime sleepiness, etc. We will give you a second take home sleep study to determine your improvement.

Eventually we will monitor you every six months for any side effects.

Surgical Procedures

Several surgical procedures are available to address snoring and sleep apnea, with the most popular today being RF (radio frequency) surgery. As with all surgeries, there is always risk of post surgical complications, but surgery may be an alternative treatment for sleep apnea. In addition to the removal of adenoids and tonsils, other surgical options include: UPPP (uvulopalatopharyngeoplasty), LAUP (laser-assisted uvulopalatoplasty), tongue reduction surgery jaw reconstruction and tracheostomy.

The UPPP and LAUP will often eliminate snoring, but may not be highly effective and predictable in treating sleep apnea.