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.
Details regarding CPAP and Oral Appliances are as follows:
If you have severe sleep apnea, you may benefit from a machine that delivers air pressure through a mask placed over your nose while you sleep. With CPAP (SEE-pap), the air pressure is somewhat greater than that of the surrounding air, and is just enough to keep your upper airway passages open, preventing apnea and snoring.
Another option is wearing an oral appliance designed to keep your throat open. They are designed to open your throat by bringing your jaw forward, which can sometimes relieve snoring and mild to moderate obstructive sleep apnea. Most dental devices are acrylic and fit inside your mouth, much like an athletic mouth guard or orthodontic appliance.
A number of devices are available from your dentist. You may need to try different devices before finding one that works for you. Once you find the right fit, you'll still need to follow up with your dentist at least every six months during the first year and then at least once a year after that to ensure that the fit is still good and to reassess your signs and symptoms.
Surgical Procedures:
The goal of surgery for sleep apnea is to remove excess tissue from your nose or throat that may be vibrating and causing you to snore, or that may be blocking your upper air passages and causing sleep apnea.
Surgical options may include:
UPPP (UVULOPALATOPHARYNGOPLASTY)
During this procedure, your doctor removes tissue from the rear of your mouth and top of your throat. Your tonsils and adenoids usually are removed as well. This type of surgery may be successful in stopping throat structures from vibrating and causing snoring. However, it may be less successful in treating sleep apnea because tissue farther down your throat may still block your air passage. UPPP usually is performed in a hospital and requires a general anesthetic.
Removing tissues in the back of your throat with a laser (laser-assisted uvulopalatoplasty) or with radio frequency energy (radio frequency ablation) are procedures that doctors sometimes use to treat snoring. However, these procedures aren't recommended for treating obstructive sleep apnea.
Other types of surgery may help reduce snoring and sleep apnea by clearing or enlarging air passages:
Nasal surgery to remove polyps or straighten a crooked partition between your nostrils (deviated nasal septum).
OR
Surgery to remove enlarged tonsils or adenoids.
