Obstructive sleep apnea affects millions of people in the United States. The consequences of untreated sleep apnea can be serious, including increased risk of stroke and heart attack. The problem is pretty straight forward: the tongue and soft tissues in the throat collapse during sleep and block the airway.
The treatment of choice for most people with obstructive sleep apnea is Continuous Positive Airway Pressure(CPAP). CPAP therapy comes in several different types and has many different types of masks and interfaces. Significant advances have been made, however, even with all of these advances, some people are still unable to tolerate CPAP. And for whatever reason, some people give up on CPAP therapy, but their sleep apnea just doesn’t go away!
Oral appliances, fit by a qualified dentist, are an alternative treatment for many patients who can’t use CPAP therapy. Oral appliances come in many different designs, and are custom made. A trained dentist will be familiar with several different appliances and will work with the patient to choose the appliance most likely to be effective and comfortable for them.
Like CPAP therapy, oral appliances work by helping to keep the airway open during sleep. Unlike CPAP therapy, the oral appliances do not require machines or masks. This makes them an attractive option for patients who frequently travel.
You will need a referral from your primary care physician to a dentist who is knowledgeable about sleep apnea, and how to use oral appliances. When you see the dentist, you will have an x-ray to make sure that your teeth and the bone around your teeth can support an oral appliance. If you are a good candidate for an oral appliance, the dentist will choose the best appliance for you. They will take impressions of of your teeth. These will be sent to a dental lab where your oral appliance will be custom made. A few weeks later, you will return to have the appliance fit.
Most people will take a few weeks to get used to wearing something in their mouth while they sleep. After a few weeks you will return to check on your progress and to allow the dentist to make any changes needed. Once the appliance is comfortable and seems to be working (you will have less snoring and feel more rested) the dentist will ask you to return to your physician’s office for consideration of a follow up sleep study. It is critical that you see the dentist at least once a year for as long as you wear the oral appliance for any adjustments that need to be made.
Most of the time oral appliances are covered by medical insurance, including Medicare and Medicaid, especially if you have tried CPAP therapy and it was covered by your insurance. A sleep study must be done to measure the amount of apnea and pre-authorization is usually required.
Many people have sleep apnea and are not aware of the treatment options. Oral appliance therapy can be used alone or in conjunction with CPAP therapy, depending on the severity of the sleep apnea. The bottom line is that your sleep apnea needs to be treated, and the good news is you have options.