COMMON METHODS OF OSA TREATMENT

1.Oral Appliance Therapy
2. Continuous Positive Air pressure (CPAP)
3. Surgery

Clearly, the largest number of patients suffering from obstructive sleep apnea are in the mild to moderate categories and should be treated with oral appliances. Despite the fact that treatment with the CPAP unit is extremely successful, there are a number of patients who cannot or choose not to wear the face mask with the attached air compressor. These patients are excellent candidates for oral appliances. Some patients either do not want surgery or have had surgery and the procedure has been unsuccessful in solving the problem of OSA. These patients prefer a non-surgical, non-invasive plastic intra-oral appliance that can be worn at night only to help solve their problem.

Today there are basically three types of appliances:

  1. Soft Palatal Life Appliance
  2. Tongue Retraining Device
  3. Mandibular Repositioner

 

CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP)

The current gold standard utilized by the medical profession for the treatment of OSA is continuous positive airway pressure (CPAP). The patient wears a tightly fitting nose mask which is strapped to the head and connected by a hose to an air compressor pump. The air is forced into the airway through the nasal passages in order to open up the airway.

Complaints about the use of this air blower include pump noise, voice changes, skin irritations from the mask, nose and throat dryness, headaches from the strap around the head, tinnitus, difficulty getting to sleep, sinus infections, and difficulty breathing out against the air being forced through the nose.

The patients who should use CPAP are the severe cases of obstructive sleep apnea as the device may indeed be a life saver. In cases of mild to moderate OSA, or in cases where patients refuse to wear the CPAP, perhaps oral appliances may be the treatment of choice.

MOST COMMON SURGICAL TECHNIQUES

  1. Laser Assisted Uvulaplasty (LAUP): This is a very popular form of surgery now being performed. The purpose is to surgically remove the uvula when it is excessive and deemed to be causing the problem.
  2. Uvulopalatopharyngoplasty (UPPP): This is the surgical removal of excess palatal tissue which is thought to be causing the problem.
  3. Mandibular Advancement Surgery: Performed by an oral-maxillofacial surgeon in conjunction with orthodontics, the mandible (lower jaw) is surgically moved forward. This opens the posterior airway and allow for better breathing.