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SLEEP APNEA – TREATMENT OPTIONS
The continuous
positive airway pressure (CPAP) device acts as a pneumatic splint
"blowing" air down the airway and forcing oxygenated air into the lungs.
The CPAP is the gold standard of OSA treatment and is almost 100%
effective. Unfortunately because it can be uncomfortable and cumbersome it
is only 20-30% compliant. That is 70-80% of sufferers are either unable
or unwilling to wear the CPAP. For those people who can tolerate it,
it is a life saving wonder.
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Some shortcomings of the CPAP:
Cumbersome, uncomfortable (see photo above)
Dry eyes and nose
Rash from face mask
Not very sexy
Increased upper respiratory infections
Difficult to travel with
GERD
RECAP: CPAP
Effectiveness: Almost 100%
Compliance:
20-30%
Overall success rate: 20-30%
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SURGERY OPTION
Surgeries include:
UPPP - Uvolopulatopharyngoplasty,
LAUP - Laser assisted uvuloplasty,
Turbinectomy
Deviated Septum Correction,
T & A - Tonsils and adenoids
When these surgeries are otherwise indicated, it may be a good idea to have them done. However, 80% of all snoring and obstructive sleep apnea occur at the level of the tongue and throat (oropharynx and hypopharynx) and only 20% occur at the level of the nose (velopharynx). So only about 20% of recipients receive relief from their snoring and sleep apnea from these surgeries.
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Some shortcomings of Surgery
Increased upper respiratory infections
Food regurgitation into nose
Choking
Painful surgery
Tissue remodeling over time
Dangers of general anesthesia
Complications of surgery
RECAP: SURGERY
Overall success rate: 20-35%
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ORAL APPLIANCE THERAPY (OAT)
As described elsewhere, oral appliances hold the lower jaw forward, pulling with it the tongue and airway structures.
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Some shortcomings of Oral Appliance Therapy
Some people cannot adapt to sleeping with the appliance
Temporary or permanent changes in the bite
Sore jaw joints or muscle
RECAP: ORAL APPLIANCE THERAPY
Effectiveness: 80-90%
Compliance:
80-90%
Overall success rate: 80-90%
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SLEEP DISORDER DENTAL CENTER
Mark A. Mautner, DMD, FAGD
1601 N. PALM AVE, SUITE 104, PEMBROKE PINES, FL 33026 • 866-ZZSLEEP
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Copyright 2008, Sleep Disorder Dental Center
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