New Update on Sleep Apnea Treatment with Oral Appliances Versus CPAP

Sept. 20, 2009 - PRLog -- It is well recognized that sleep apnea is a serious medical condition with many serious adverse health risks.  While CPAP is still considered the gold standard of treatment it has been plagued by low compliance with many patients abandoning  treatment completely or with minimal compliance.  This review points to the need for alternatives to CPAP due to poor patient acceptance and tolerance.  Dr Peter Cistulli found "The current evidence suggests a similar impact on health outcomes as CPAP" a point that an  Illinois sleep dentist has been long espousing.  Ira L Shapira DDS, DABDSM has been promoting comfortable oral appliances as a patient friendly and  comfortable alternative to CPAP for many years.  His website has sparked ire among some sleep specialists due to its name http://www.ihatecpap.com  Dr Shapira emphasizes that he does not "HATE CPAP" but patients have been telling him that for years.  I HATE CPAP! LLC is dedicated to helping patients understand the dangers of sleep apnea and to promote treatment thru Oral Appliances and Dental Sleep Medicine as well as CPAP, surgery and lifestyle changes.  

"It is vitally important" according to Dr Shapira "that patients receive a treatment they can use on a long term basis"  Numerous studies have shown that a majority of patients are not compliant with CPAP therapy.  Ninety five percent of patients offered a choice between CPAP and Oral Appliances prefer appliances according to studies.  Dr Cistulli is to be applauded for his work to help patients find comfortable therapies to treat their sleep apnea.  Dr Cistulli does call for further study to determine which appliance designs are most effective for different patients.

Examples of oral appliances can be found at:  http://www.ihatecpap.com/oral_appliance.html


PubMed.gov citation on this article is included below is provided for your convenience

1: Curr Opin Pulm Med. 2009 Aug 25. [Epub ahead of print] Links
Oral appliance treatment of obstructive sleep apnea: an update.

Chan AS, Cistulli PA.
aCentre for Sleep Health and Research, Department of Respiratory Medicine, Royal North Shore Hospital, St Leonards, Australia bWoolcock Institute of Medical Research, University of Sydney, New South Wales, Australia.
PURPOSE OF REVIEW: Oral appliances are an alternative to continuous positive airway pressure (CPAP) for the treatment of obstructive sleep apnea (OSA). Although CPAP is a highly efficacious treatment, there is a need for other treatment options because the clinical effectiveness of CPAP is often limited by poor patient acceptance and tolerance, and suboptimal compliance. RECENT FINDINGS: There has been an expansion of the research evidence to support the use of oral appliances in clinical practice. Recent work has focused on the following clinically relevant areas: the effect of device design on efficacy and patient compliance, the role of different modalities for assessing the upper airway in the prediction of treatment outcome, the assessment of the impact of treatment on a range of health outcomes and the evaluation of long-term adverse effects. SUMMARY: There is robust evidence of the efficacy of oral appliances for improving polysomnographic indices and modifying the health risk associated with OSA. The current evidence suggests a similar impact on health outcomes as CPAP. However, further research is required to address a number of unresolved issues, including the influence of device design, titration procedures, prediction of treatment outcome and the clinical effectiveness of oral appliances for modifying the adverse health consequences of OSA.
PMID: 19710614 [PubMed - as supplied by publisher]

# # #

information on sleep apnea, sleep apnea treatment and cpap alternatives are available at www.ihatecpap.com This is the premiere site for the promotion of Dental Sleep Medicine and Sleep Apnea Dentisits.