SlideShare une entreprise Scribd logo
1  sur  10
Q: Do Oral Appliances
for Sleep Apnea Work?

John Viviano BSc DDS D ABDSM
The simplest way to answer this
question is to compare them to the
“Gold Standard” therapy; CPAP.
•

Oral Appliance Compliance Monitor

•
•

82% used appliance Regularly
average use of 6.7±1.3 hrs/nt
Thorax doi:10.1136/thoraxjnl-2012-201900
Mean Disease Alleviation “MDA”
Using…
…actual effectiveness and…
…actual compliance,
…one can calculate…
…actual Therapeutic Effectiveness or…

…MDA
Appliance MDA: 51.1% (mild & mod OSA)
Thorax 2012;0:1–6. doi:10.1136/thoraxjnl-2012-201900

CPAP Effectiveness (“adjusted for sleep time,
actual effect and use”): 50% (mild, mod & severe OSA)
Eur Respir J 2000;16:921–7
Appliance Efficacy Similar to CPAP…
“health outcomes in patients with moderate to severe
OSA were similar after treatment with CPAP and MAD”
“likely explained by the greater efficacy of CPAP being
offset by inferior compliance relative to MAD”
Am J Respir Crit Care Med 2013; V187:8, 879–887
Appliance Efficacy Similar to CPAP…
Oral Appliance…
…inferior to CPAP in reducing AHI
…similar effectiveness due to higher compliance
J Clin Sleep Med 2011;7:447–8
Q: Do Oral Appliances
for Sleep Apnea Work?

A: Yes.
snoresolutions@aol.com
SleepDisordersDentistry.com

Contenu connexe

Similaire à Do Oral Appliances to Manage Sleep Apnea Work?

Gioia Luca. Il Ruolo dei dispositivi intraorali nella terapia dell'Osas. ASMa...
Gioia Luca. Il Ruolo dei dispositivi intraorali nella terapia dell'Osas. ASMa...Gioia Luca. Il Ruolo dei dispositivi intraorali nella terapia dell'Osas. ASMa...
Gioia Luca. Il Ruolo dei dispositivi intraorali nella terapia dell'Osas. ASMa...
Gianfranco Tammaro
 
Identifying Asynchrony and Solving the Problem - Pilbeam
Identifying Asynchrony and Solving the Problem - PilbeamIdentifying Asynchrony and Solving the Problem - Pilbeam
Identifying Asynchrony and Solving the Problem - Pilbeam
River City Symposium
 
HOW CONTROLLED IS OBSTRUCTIVE SLEEP APNEA WITH THE .docx
HOW CONTROLLED IS OBSTRUCTIVE SLEEP APNEA WITH THE .docxHOW CONTROLLED IS OBSTRUCTIVE SLEEP APNEA WITH THE .docx
HOW CONTROLLED IS OBSTRUCTIVE SLEEP APNEA WITH THE .docx
gertrudebellgrove
 

Similaire à Do Oral Appliances to Manage Sleep Apnea Work? (16)

Gioia Luca. Il Ruolo dei dispositivi intraorali nella terapia dell'Osas. ASMa...
Gioia Luca. Il Ruolo dei dispositivi intraorali nella terapia dell'Osas. ASMa...Gioia Luca. Il Ruolo dei dispositivi intraorali nella terapia dell'Osas. ASMa...
Gioia Luca. Il Ruolo dei dispositivi intraorali nella terapia dell'Osas. ASMa...
 
Role of Dentist in Sleep Therapy
Role of Dentist in Sleep TherapyRole of Dentist in Sleep Therapy
Role of Dentist in Sleep Therapy
 
Guia 4285 apnea obstructiva del sueño
Guia 4285 apnea obstructiva del sueñoGuia 4285 apnea obstructiva del sueño
Guia 4285 apnea obstructiva del sueño
 
Identifying Asynchrony and Solving the Problem - Pilbeam
Identifying Asynchrony and Solving the Problem - PilbeamIdentifying Asynchrony and Solving the Problem - Pilbeam
Identifying Asynchrony and Solving the Problem - Pilbeam
 
HOW CONTROLLED IS OBSTRUCTIVE SLEEP APNEA WITH THE .docx
HOW CONTROLLED IS OBSTRUCTIVE SLEEP APNEA WITH THE .docxHOW CONTROLLED IS OBSTRUCTIVE SLEEP APNEA WITH THE .docx
HOW CONTROLLED IS OBSTRUCTIVE SLEEP APNEA WITH THE .docx
 
The Dentist's Role in Treatment of Sleep Disordered Breathing
The Dentist's Role in Treatment of Sleep Disordered BreathingThe Dentist's Role in Treatment of Sleep Disordered Breathing
The Dentist's Role in Treatment of Sleep Disordered Breathing
 
Treating Treatment Refractory Depression With TMS
Treating Treatment Refractory Depression With TMSTreating Treatment Refractory Depression With TMS
Treating Treatment Refractory Depression With TMS
 
Precedex pp
Precedex ppPrecedex pp
Precedex pp
 
Actualización en sedación octubre 2014, WHAT´S NEW ON SEDATION IN ICU
Actualización en sedación octubre 2014, WHAT´S NEW ON SEDATION IN ICUActualización en sedación octubre 2014, WHAT´S NEW ON SEDATION IN ICU
Actualización en sedación octubre 2014, WHAT´S NEW ON SEDATION IN ICU
 
Oxygénation Nasale Humidifiée à Haut Débit - Optiflow aux urgences COMUN 2018
Oxygénation Nasale Humidifiée à Haut Débit - Optiflow aux urgences COMUN 2018Oxygénation Nasale Humidifiée à Haut Débit - Optiflow aux urgences COMUN 2018
Oxygénation Nasale Humidifiée à Haut Débit - Optiflow aux urgences COMUN 2018
 
Diabetic macular edema studies
Diabetic macular edema studiesDiabetic macular edema studies
Diabetic macular edema studies
 
ACLS 2015 Updates - The Malaysian Perspective
ACLS 2015 Updates - The Malaysian PerspectiveACLS 2015 Updates - The Malaysian Perspective
ACLS 2015 Updates - The Malaysian Perspective
 
Sleep Apnea Treatment
Sleep Apnea Treatment Sleep Apnea Treatment
Sleep Apnea Treatment
 
Post discharge use of nebulized pulmicort respules® in children after an emer...
Post discharge use of nebulized pulmicort respules® in children after an emer...Post discharge use of nebulized pulmicort respules® in children after an emer...
Post discharge use of nebulized pulmicort respules® in children after an emer...
 
Regadenoson myocardial perfusion imaging
Regadenoson myocardial perfusion imagingRegadenoson myocardial perfusion imaging
Regadenoson myocardial perfusion imaging
 
Grand round obstructive sleep apnea in adults
Grand round obstructive sleep apnea in adultsGrand round obstructive sleep apnea in adults
Grand round obstructive sleep apnea in adults
 

Dernier

Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...
chetankumar9855
 
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
mahaiklolahd
 

Dernier (20)

Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
 
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available
 
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...
 
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
 
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...
Call Girl In Pune 👉 Just CALL ME: 9352988975 💋 Call Out Call Both With High p...
 
Call Girls Tirupati Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Tirupati Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Tirupati Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Tirupati Just Call 8250077686 Top Class Call Girl Service Available
 
Top Rated Bangalore Call Girls Richmond Circle ⟟ 9332606886 ⟟ Call Me For Ge...
Top Rated Bangalore Call Girls Richmond Circle ⟟  9332606886 ⟟ Call Me For Ge...Top Rated Bangalore Call Girls Richmond Circle ⟟  9332606886 ⟟ Call Me For Ge...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 9332606886 ⟟ Call Me For Ge...
 
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
 
Call Girls Gwalior Just Call 8617370543 Top Class Call Girl Service Available
Call Girls Gwalior Just Call 8617370543 Top Class Call Girl Service AvailableCall Girls Gwalior Just Call 8617370543 Top Class Call Girl Service Available
Call Girls Gwalior Just Call 8617370543 Top Class Call Girl Service Available
 
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
 
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on WhatsappMost Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
 
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
 
Call Girls Kurnool Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kurnool Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Kurnool Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kurnool Just Call 8250077686 Top Class Call Girl Service Available
 
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
 
Call Girls Shimla Just Call 8617370543 Top Class Call Girl Service Available
Call Girls Shimla Just Call 8617370543 Top Class Call Girl Service AvailableCall Girls Shimla Just Call 8617370543 Top Class Call Girl Service Available
Call Girls Shimla Just Call 8617370543 Top Class Call Girl Service Available
 
Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟ 9332606886 ⟟ Call Me For G...
Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟  9332606886 ⟟ Call Me For G...Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟  9332606886 ⟟ Call Me For G...
Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟ 9332606886 ⟟ Call Me For G...
 
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
 
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
 
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
 
Top Rated Bangalore Call Girls Mg Road ⟟ 9332606886 ⟟ Call Me For Genuine S...
Top Rated Bangalore Call Girls Mg Road ⟟   9332606886 ⟟ Call Me For Genuine S...Top Rated Bangalore Call Girls Mg Road ⟟   9332606886 ⟟ Call Me For Genuine S...
Top Rated Bangalore Call Girls Mg Road ⟟ 9332606886 ⟟ Call Me For Genuine S...
 

Do Oral Appliances to Manage Sleep Apnea Work?

  • 1. Q: Do Oral Appliances for Sleep Apnea Work? John Viviano BSc DDS D ABDSM
  • 2. The simplest way to answer this question is to compare them to the “Gold Standard” therapy; CPAP.
  • 3. • Oral Appliance Compliance Monitor • • 82% used appliance Regularly average use of 6.7±1.3 hrs/nt Thorax doi:10.1136/thoraxjnl-2012-201900
  • 4.
  • 5. Mean Disease Alleviation “MDA” Using… …actual effectiveness and… …actual compliance, …one can calculate… …actual Therapeutic Effectiveness or… …MDA
  • 6. Appliance MDA: 51.1% (mild & mod OSA) Thorax 2012;0:1–6. doi:10.1136/thoraxjnl-2012-201900 CPAP Effectiveness (“adjusted for sleep time, actual effect and use”): 50% (mild, mod & severe OSA) Eur Respir J 2000;16:921–7
  • 7. Appliance Efficacy Similar to CPAP… “health outcomes in patients with moderate to severe OSA were similar after treatment with CPAP and MAD” “likely explained by the greater efficacy of CPAP being offset by inferior compliance relative to MAD” Am J Respir Crit Care Med 2013; V187:8, 879–887
  • 8. Appliance Efficacy Similar to CPAP… Oral Appliance… …inferior to CPAP in reducing AHI …similar effectiveness due to higher compliance J Clin Sleep Med 2011;7:447–8
  • 9. Q: Do Oral Appliances for Sleep Apnea Work? A: Yes.