Obstructive sleep apnea affects around 20 million Americans and can lead to hypertension, heart attack, stroke, depression, muscle pain, fibromyalgia, morning headaches, and excessive daytime sleepiness.

Wednesday, January 19, 2011

What do patients feel about wearing an oral appliance vs CPAP?

I just received a e-mail from a patient who recently switched to a comfortable oral appliance from CPAP. I think he clearly stated the answer to how comfortable an oral appliance is so I copy and pasted his answer below.

Niiiiiiiiiicccceee!

Why do patients abandon CPAP? They appreciate the benefits but dislike the mask, hose and entire CPAP set-up. Give most patients an appliance and they blown away by how small and non intrusive appliances are. This is especially true for patients who feel claustrophobic when using CPAP. Some patient may feel a little claustophobic with an appliance initially but it is rare. Patients who switch from CPAP to appliance therapy tend to agree with Gene, ie Niiiiiiiiiicccceee!

BiPAP, ramping, APAP, humidification, heated CPAP hoses all increase the comfort of the patient using CPAP but none of these statistically increase compliance.

The best method of increasing compliance in non-compliant CPAP users is to offer a more comfortable treatment alternative. Oral Appliances are not perfect but the have a 90+% compliance. This is especially impressive because there is an adverse selection of patients, ie, those who have already failed another treatment.

Studies have shown the huge ajority of patients offered a choice between CPAP and Oral Appliances chose the appliance.

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posted by Dr Shapira at 10:19 AM