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August 12, 2019

Research finds oral appliances may aid in sleep apnea therapy

A new study by US researchers has shown that treatment with oral appliances can be effective for a type of obstructive sleep apnea (OSA) in adults.

A new study by US researchers has shown that treatment with oral appliances can be effective for a type of obstructive sleep apnea (OSA) in adults.

According to the publication in the Annals of the American Thoracic Society, OSA is characterised by abnormal airflow into the lungs. The airflow obstruction is caused by the collapse of soft tissues in the back of the throat or tongue.

Commonly, continuous positive airway pressure (CPAP) is used to blow air via a mask into the nose and throat in order to prevent the obstruction.

For patients who face challenges with CPAP, oral appliances such as mandibular advancement devices (MAD), mandibular repositioning appliances (MRA), tongue retaining devices (TRD) and mandibular advancement splints (MAS) are offered as an alternative.

An oral appliance prevents the obstructed airflow by moving the lower jaw forward and keeping the tongue in place.

The latest research pinpoints five traits that could indicate the effectiveness of an oral appliance in OSA treatment.

The researchers used new technology to analyse the traits causing sleep apnea via a diagnostic test called polysomnography. They leveraged polysomnographic data from 93 adults with moderate to severe OSA.

Findings revealed that patients without severe collapsibility and those with weaker lower throat muscle compensation would benefit more from an oral appliance.

The researchers also observed that a higher loop gain, lower sleep arousal threshold and higher ventilatory response to sleep arousal also aid in predicting response to an oral appliance.

Depending on these five traits, the team was able to predict the effectiveness of oral appliances in 61% of participants.

Research senior author and Harvard Medical School medicine assistant professor Scott Sands said: “While CPAP is great for some, there remains a large group of patients who really struggle with it.

“For these folks, this study highlights the potential benefit of measuring the underlying causes of their sleep apnea to estimate whether an oral appliance might be an equivalent or better choice over CPAP for the treatment of their sleep apnea.”

The researchers believe that the most useful predictive measures could be used with routine sleep recording systems.

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