Australian researchers have published an exciting new paper about oral appliance therapy (OAT) for obstructive sleep apnea (OSA).
Oral appliances for sleep apnea are a less invasive, more comfortable way of reducing a person’s apneahypopnea index (AHI). They work by moving the lower jaw forward to keep the airway from collapsing and the tongue from blocking the airway. Many patients find them more comfortable than a positive airway pressure (PAP) machine. They also don’t require a mask or electricity and can be cleaned easily.
However, insurers are sometimes unwilling to cover OAT as a first-line treatment for sleep apnea. That’s because the appliances don’t work for all patients. However, for most patients, the appliances give great results, and they tend to result in higher compliance even in the less responsive patients.
A treatment that works pretty well and that you use 8 hours a night is a better treatment than one that sits on the shelf and hardly ever gets used because it’s inconvenient. More coverage for OAT would be a great help for many people who suffer from sleep apnea or upper airway resistance syndrome.
Enter the Australian team. These researchers studied the sleep labs of 45 patients and then tested them with an oral appliance. This allowed them to see which data from polysomnography predicted success with oral appliance therapy, defined as fewer than 5 AHI events an hour.
After they created the model, they tested it on 17 patients and found it was 92% accurate in predicting how a patient would respond to OAT. In fact, the model could even predict how large a reduction each patient would see with the appliance.
This is great news for sleep dentistry. If there is a reliable method for predicting success with OAT, more patients can skip the “try and fail at the PAP machine” phase of treatment and go straight to an oral appliance. Since many middle-aged patients grew up with braces and have successfully worn retainers, OAT is a familiar and non-threatening approach to sleep apnea treatments.
Are you a dental provider who does not yet have a sleep dentistry program? It’s time to get trained and start screening and treating patients. Many areas lack sleep dentists, and your patients need good, reliable sleep apnea treatments. Start your training now, and start saving lives.