Obstructive Sleep Apnea Treatment: Oral Appliances, Surgery or Something Else?

After a patient has been diagnosed with obstructive sleep apnea (OSA), they have a very important healthcare decision to make with the guidance of their physician: what OSA treatment is right for them? Many have the misconception that there is one ideal treatment for everyone or that a continuous positive airway pressure (CPAP) device is the only effective option. This is not the case. In truth, there are a variety of different therapies, treatments, and devices available for use and finding the right one depends on a number of factors. 4 Questions to Ask Before Choosing An OSA Treatment It is vital to review several considerations before deciding upon an OSA treatment, including the severity of the apnea, the cause of the apnea, and the personal preferences and habits of the patient. Let’s take a closer look at four questions patients should explore with their doctor before taking action:

• What is my Apnea Hypopnea Index (AHI)? Your AHI is the best way to understand the severity of your OSA. Very simply, your AHI measures how many apnea events you have each hour during sleep. Those with mild sleep apnea have fewer than fifteen apneas per hour, while those with moderate sleep apnea have an AHI between 15 and 30. Those with severe OSA have an AHI of 30 or higher. Patients with an AHI index of 15 or lower may find adequate treatment through an oral device, positional therapy, or lifestyle changes. Those with higher AHIs may consider CPAP or surgery, sometimes in tandem with an oral device.
• What are the possible root causes of my OSA? As with so many other diseases, your treatment should reflect the cause. In the case of OSA, it is important to discover what is obstructing your breathing and what could remedy the situation. For example, if your sleep apnea is caused by or made worse by a deviated septum or a high BMI, those issues should be addressed. If your sleep apnea is simply caused by a narrow airway, that issue needs to be addressed.
• Do I have other significant health concerns? Sleep apnea often exists alongside other health concerns, such as asthma, obesity, heart disease, diabetes, and arrhythmia. In many cases, sleep apnea can be made more severe by these health conditions and in many cases, sleep apnea can make these health conditions more severe, too. If you have serious health problems besides OSA, surgery may not be a possible solution for you. However, if your sleep apnea is causing other health problems, it is vital you find a working treatment that effectively treats the issue.
• Will compliance be an issue? Some sleep apnea treatments are effective, but only if the patient uses them correctly and consistently. Unfortunately, compliance with CPAP devices is very low, with a large number of users taking the device off in the middle of the night or only using it occasionally. Likewise, some patients are not able to consistently wear their dental appliances. It is key to understand that your sleep apnea symptoms will return if you do not choose a treatment that you can commit to and use correctly for the rest of your life.

An oral appliance may be the right choice if…

• You have an AHI of 15 or lower.
• You only suffer from mild OSA.
• You have health issues that prevent you from having OSA surgery.
• You have a remaining AHI between 5 and 15 after your OSA surgery.
• You are not able to use your CPAP device consistently.
• You can’t use a CPAP device due to a side effect or health issue.

Sleep apnea surgery (bimaxillary advancement surgery) may be the right choice if…

• You have an AHI higher than 15.
• You suffer from moderate to severe sleep apnea.
• You have issues with oral device compliance.
• Your have tried other interventions, such as oral devices, CPAP, and lifestyle changes.
• Your OSA is caused by a narrow or blocked airway.
• You are not able to use your CPAP device consistently.
• You can’t use a CPAP device due to a side effect or health issue.
• You are looking for a permanent, lifelong solution to your OSA.

Consulting with Doctors & Dentists The single best way to find an effective and appropriate sleep apnea treatment is to speak to sleep apnea medical professionals. A sleep apnea surgeon can help patients better understand the severity and cause of their OSA as well as the best possible treatment plans for the individual’s needs. A dentist can help patients determine whether an oral device may be helpful, either on its own or in conjunction with another treatment. A dentist can also make certain your dental appliance fits correctly. Contact Surgical Sleep Solutions with additional questions. [gravityform id="14" title="false" description="false"]