Do Oral Appliances to Manage Sleep Apnea Work?

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

“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…

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.

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