Oral Appliance Therapy for the Management of Sleep-Disordered Breathing

Abstract

Oral appliances are a newer noninvasive treatment for snoring and obstructive sleep apnea (OSA). They are effective in relieving apnea in 20 to 75% of patients with OSA (depending on the definition of treatment success and the appliance studied) and generally are well tolerated by patients with few serious side effects. They are reported to improve snoring in 80 to 100% of patients and eliminate snoring in 15 to 64% of patients. Although less effective than nasal continuous positive airway pressure (CPAP) in the relief of apnea and snoring, they represent a useful alternative to CPAP in patients with less severe OSA and in patients who have failed other treatment modalities. Large, randomized clinical trials are needed to define the effects of oral appliances on excessive daytime sleepiness and performance and to determine long-term rates of effectiveness, complications, and compliance. The precise indications, complication rates, and reasons for treatment failure need to be determined for each oral appliance. On-going refinements of appliance design may eventually lead to improved treatment outcomes.

Key Words:

sleep apnea syndromes - oral appliance therapy - obstructive sleep apnea