Although there is a growing body of evidence in the literature this question is still routinely asked. This presentation will go a long way in putting this question to rest!
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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.