Oral devices recommended for milder sleep apnea
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Mouth devices that aid breathing during sleep can be used as the first-line treatment for people with chronic snoring or milder cases of obstructive sleep apnea, according to new treatment guidelines.
The guidelines, published this week by the American Academy of Sleep Medicine, recommend that oral appliances - similar to mouth guards used in sports - be offered as an initial treatment to people with mild to moderate OSA.
People with more severe cases, however, are advised to first try a therapy called continuous positive airway pressure (CPAP), which has been shown more effective than oral devices.
Obstructive sleep apnea occurs when the soft tissues at the back of the throat temporarily collapse during sleep, blocking the airways. The result is numerous stops and starts in breathing during the night, with chronic, loud snoring being one of the signs of the condition.
Daytime sleepiness is another, as the repeated breathing interruptions disrupt the deep sleep phases at night.
CPAP is considered the most effective treatment for OSA, but many people find it difficult to stick with. The therapy involves wearing a facemask through which the CPAP device delivers pressurized air to keep the airways open during sleep.
For their part, oral devices help keep the throat open by repositioning the lower jaw and tongue. This less cumbersome option might be preferable for people who do not want CPAP or who fail to improve with the therapy, according to the new guidelines, published in the journal Sleep.
Oral devices are also recommended for people without OSA who snore chronically and do not improve with tactics like weight loss and changing their sleeping position.
The academy also suggests that after patients have had an oral device fitted by a dentist, they undergo a sleep study while wearing the device to ensure that they’re getting a benefit.
Controlling OSA is important because the condition can have consequences far more serious than snoring. Daytime sleepiness, for instance, can raise the risk of traffic accidents, or blunt mental sharpness in general. And over time, oxygen deprivation during the night can harm the cardiovascular system, raising the odds of high blood pressure, stroke and heart disease.
It’s estimated that half of all Americans with OSA have high blood pressure.
SOURCE: Sleep, February 2006.
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