Sleep Apnea Contributions by Olivia Cerf

Your doctor may refer you to a pulmonologist or an ear, nose, and throat specialist (otolaryngologist). They will give you a physical exam, and if they determine that a CPAP is right for you, they will send you to a sleep technician for a polysomnogram.

The sleep technician will determine the amount of pressure necessary for your CPAP. They will also ensure that the mask fits correctly, which will be one of the major determinants of the success of the machine.

Your dentist would be the first stop to finding the right device for you. If you don't already have a dentist that you trust, the American Academy of Dental Sleep Medicine accredits dentists to prescribe and fit dental devices for sleep apnea. They have a directory of accredited dentists here:

http://www.aadsm.org/findadentist.aspx#

To measure the effectiveness of your new device, you'll need a polysomnograph done by a sleep technician. A sleep lab near you can be found here:

http://www.sleepcenters.org/

According to the University of Maryland Medical Center, dental devices have shown better long-term control of sleep apnea when compared to uvulopalatopharyngoplasty (UPPP), which is the standard surgical treatment. There are also few complications with a dental device, and they are easier to use than CPAP devices, resulting in better long-term compliance. Dental devices are most effective as a treatment for mild to moderate sleep apnea.

Mandibular Advancement Splint

Several dental devices are available for the treatment of sleep apnea. These devices may hold the tongue down, thrust it forward, or thrust the lower jaw forward.

Some devices used to treat sleep apnea are:

Mandibular Advancement Splint Mandibular Advancement Splint (MAS)

The MAS maintains the lower jaw in a protruded position, which prevents collapse of the pharynx. It is less effective than the CPAP, but it is generally preferred for mild to moderate cases of sleep apnea due to greater ease of use and the fact that there are fewer side effects.

Tongue Retraining Device

Tongue-Retraining Device (TRD)

This device uses a slight negative pressure from air displacement to hold the tongue in place outside of the mouth, preventing it from falling back into the throat.

This device holds the tongue in place outside of the mouth to prevent it from falling back into the throat. It is recommended for patients who do not tolerate the CPAP machine. Based on polysomnograms of 36 users, the TRD was shown in one study to be 71% effective in reducing apnea events. Among the noncompliant participants, reasons for discontinuing use were discomfort or sensation of a foreign body, pain, excessive salivation, excessive mouth dryness, and aesthetic reasons.¹

¹Lazard, Diane S. et al. “The Tongue-Retaining Device: Efficacy and Side Effects in Obstructive Sleep Apnea Syndrome,” Journal of Clinical Sleep Medicine 5, no 5 (2009): 431-438

According to the University of Maryland Medical Center, dental devices have shown better long-term control of sleep apnea when compared to uvulopalatopharyngoplasty (UPPP), which is the standard surgical treatment. There are also few complications with a dental device, and they are easier to use than CPAP devices, resulting in better long-term compliance. Dental devices are most effective as a treatment for mild to moderate sleep apnea.

Mandibular Advancement Splint

Several dental devices are available for the treatment of sleep apnea. These devices may hold the tongue down, thrust it forward, or thrust the lower jaw forward. These devices are easier to use than CPAP devices, although they are only effective as a treatment for mild to moderate sleep apnea.

Some devices used to treat sleep apnea are:

Mandibular Advancement Splint (MAS)

The MAS maintains the lower jaw in a protruded position, which prevents collapse of the pharynx. It is less effective than the CPAP, but it is generally preferred for mild to moderate cases of sleep apnea due to greater ease of use and the fact that there are fewer [side effects][ side effects.

Tongue Retraining Device

Tongue-Retraining Device (TRD)

This device uses a slight negative pressure from air displacement to hold the tongue in place outside of the mouth, preventing it from falling back into the throat.

This device holds the tongue in place outside of the mouth to prevent it from falling back into the throat. It is recommended for patients who do not tolerate the CPAP machine. Based on polysomnograms of 36 users, the TRD was shown in one study to be 71% effective in reducing apnea events. Among the noncompliant participants, reasons for discontinuing use were discomfort or sensation of a foreign body, pain, excessive salivation, excessive mouth dryness, and aesthetic reasons.¹

American Academy of Dental Sleep Medicine

Address

2510 North Frontage Road Darien, IL 60561

Website

www.aadsm.org

Description of Services Provided

The AADSM promotes research on the use of oral appliances and dental surgery for the treatment of sleep disordered breathing. Their website provides a search function for dentists by zip code who are accredited by the academy, which can be found here:

http://www.aadsm.org/findadentist.aspx#

They provide the same service for finding a sleep lab, where you can get a polysomnograph to diagnose sleep apnea. It can be found here:

http://www.sleepcenters.org/

American Sleep Apnea Association (ASNA)

Address:

6856 Eastern Avenue, NW, Suite 203
Washington, DC 20012

Phone:

Internet address:

Website

http://www.sleepapnea.org/

Description of services provided:

This website provides a variety of materials discussing sleep apnea, including a brochure and many other educational materials. You can participate in the "Sleep Apnea Support Forum" and post questions about the condition and treatments.

National Heart, Lung, and Blood Institute (NHLBI)

Address:

NHLBI Health Information Center
Attn: Web Site
PO Box 30105
Bethesda, MD 20824-0105

Phone:

Internet address:

Website

http://www.nhlbi.nih.gov/

Description of services provided:

NHLBI provides fact sheets on sleep apnea and other sleep disorders, as well as heart, lung, and blood disorders. Look here for information on current areas of research, clinical trials seeking subjects, meetings and conferences, and a link to the organization's sister website, the National Center on Sleep Disorders Research (NCSDR).

National Sleep Foundation

Address:

1522 K ST, NW, Suite 500
Washington, DC 20005

Phone:

Internet address:

Website

http://www.sleepfoundation.org/

Description of services providedprovide:

The National Sleep Foundation (NSF) offers brochures, newsletters, and reports on sleep apnea and other sleep disorders. The website features a list of related links and an area called the NSF Community Sleep Awareness Partners (CSAP), where you can find sleep disorder specialists in your area.

American Academy of Otolaryngology—Head and Neck Surgery

Address:

1650 Diagonal Road
Alexandria, VA 22314-3357

Phone:

Internet address:

Website

http://www.entnet.org/

Description of services provided:

The American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) is the world's largest organization representing specialists who treat the ear, nose, throat, and related structures of the head and neck. On this website, you can find newsletters, reports about obstructive sleep apnea and other sleep disorders, and a lengthy list of links to related websites.

American Academy of Dental Sleep Medicine

Address

2510 North Frontage Road Darien, IL 60561

Website

www.aadsm.org

Description of Services Provided

The AADSM promotes research on the use of oral appliances and dental surgery for the treatment of sleep disordered breathing. Their website provides a search function for dentists by zip code who are accredited by the academy, which can be found here:

http://www.aadsm.org/findadentist.aspx#

They provide the same service for finding a sleep lab, where you can get a polysomnograph to diagnose sleep apnea. It can be found here:

http://www.sleepcenters.org/

American Sleep Apnea Association (ASNA)

Address

6856 Eastern Avenue, NW, Suite 203
Washington, DC 20012

Website

http://www.sleepapnea.org/

Description of services provided:

This website provides a variety of materials discussing sleep apnea, including a brochure and many other educational materials. You can participate in the "Sleep Apnea Support Forum" and post questions about the condition and treatments.

National Heart, Lung, and Blood Institute (NHLBI)

Address

NHLBI Health Information Center
Attn: Web Site
PO Box 30105
Bethesda, MD 20824-0105

Website

http://www.nhlbi.nih.gov/

Description of services provided

NHLBI provides fact sheets on sleep apnea and other sleep disorders, as well as heart, lung, and blood disorders. Look here for information on current areas of research, clinical trials seeking subjects, meetings and conferences, and a link to the organization's sister website, the National Center on Sleep Disorders Research (NCSDR).

National Sleep Foundation

Address

1522 K ST, NW, Suite 500
Washington, DC 20005

Website

http://www.sleepfoundation.org/

Description of services provide:

The National Sleep Foundation (NSF) offers brochures, newsletters, and reports on sleep apnea and other sleep disorders. The website features a list of related links and an area called the NSF Community Sleep Awareness Partners (CSAP), where you can find sleep disorder specialists in your area.

American Academy of Otolaryngology—Head and Neck Surgery

Address

1650 Diagonal Road
Alexandria, VA 22314-3357

Website

http://www.entnet.org/

Description of services provided

The American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) is the world's largest organization representing specialists who treat the ear, nose, throat, and related structures of the head and neck. On this website, you can find newsletters, reports about obstructive sleep apnea and other sleep disorders, and a lengthy list of links to related websites.

American Sleep Apnea Association (ASNA)

Address:

Phone:

Internet address:

Description of services provided:

National Heart, Lung, and Blood Institute (NHLBI)

Address:

Phone:

Internet address:

Description of services provided:

National Sleep Foundation

Address:

Phone:

Internet address:

Description of services provided:

American Academy of Otolaryngology—Head and Neck Surgery

Address:

Phone:

Internet address:

Description of services provided:

According to the University of Maryland Medical Center, dental devices have shown better long-term control of sleep apnea when compared to uvulopalatopharyngoplasty (UPPP), which is the standard surgical treatment. There are also few complications with a dental device, and they are easier to use than CPAP devices, resulting in better long-term compliance. Dental devices are most effective as a treatment for mild to moderate sleep apnea.

Mandibular Advancement Splint

Several dental devices are available for the treatment of sleep apnea. These devices may hold the tongue down, thrust it forward, or thrust the lower jaw forward.

Some devices used to treat sleep apnea are:

Mandibular Advancement Splint (MAS)

The MAS maintains the lower jaw in a protruded position, which prevents collapse of the pharynx. It is less effective than the CPAP, but it is generally preferred for mild to moderate cases of sleep apnea due to greater ease of use and the fact that there are fewer side effects.

Tongue Retraining Device

Tongue-Retraining Device (TRD)

This device uses a slight negative pressure from air displacement to hold the tongue in place outside of the mouth, preventing it from falling back into the throat.

This device holds the tongue in place outside of the mouth to prevent it from falling back into the throat. It is recommended for patients who do not tolerate the CPAP machine. Based on polysomnograms of 36 users, the TRD was shown in one study to be 71% effective in reducing apnea events. Among the noncompliant participants, reasons for discontinuing use were discomfort or sensation of a foreign body, pain, excessive salivation, excessive mouth dryness, and aesthetic reasons.¹

According to the University of Maryland Medical Center, dental devices have shown better long-term control of sleep apnea when compared to uvulopalatopharyngoplasty (UPPP), which is the standard surgical treatment. There are also few complications with a dental device, and they are easier to use than CPAP devices, resulting in better long-term compliance. Dental devices are most effective as a seem to be less frustratderate treatment for mild to moderate sleep apnea.

Mandibular Advancement Splint

Several dental devices are available for the treatment of sleep apnea. These devices may hold the tongue down, thrust it forward, or thrust the lower jaw forward.

Some devices used to treat sleep apnea are:

Mandibular Advancement Splint (MAS)

The MAS maintains the lower jaw in a protruded position, which prevents collapse of the pharynx. It is less effective than the CPAP, but it is generally preferred for mild to moderate cases of sleep apnea due to greater ease of use and the fact that there are fewer side effects.

Tongue Retraining Device

Tongue-Retraining Device (TRD)

This device uses a slight negative pressure from air displacement to hold the tongue in place outside of the mouth, preventing it from falling back into the throat.

This device holds the tongue in place outside of the mouth to prevent it from falling back into the throat. It is recommended for patients who do not tolerate the CPAP machine. Based on polysomnograms of 36 users, the TRD was shown in one study to be 71% effective in reducing apnea events. Among the noncompliant participants, reasons for discontinuing use were discomfort or sensation of a foreign body, pain, excessive salivation, excessive mouth dryness, and aesthetic reasons.¹

CPAP Pillow

CPAP Pillows

CPAP pillows are designed to accommodate the shape of the CPAP mask as the user moves during sleep. Using this pillow is likely to lead to higher compliance in CPAP use, leading to improved effectiveness of the machine.

SONA Pillow

SONA Pillow

The SONA Pillow® is an FDA-approved triangular pillow with space to place your arm under the head while sleeping on the side. A study on 22 people showed that respiratory disturbance index (RDI) went down in users with mild to moderate snoring and obstructive sleep apnea.¹

Medslant Pillow

Medslant Pillow

Sleeping on the back often increases the severity of sleep apnea. If it is the preferred sleeping position, however, sleeping on an incline can prevent the throat from closing during sleep. This pillow can also be used to help symptoms of gastroesophegeal reflux disease (GERD) and acid reflux.

CPAP Pillows

CPAP Pillow

CPAP Pillows

CPAP pillows are designed to accommodate the shape of the CPAP mask as the user moves during sleep. Using this pillow is likely to lead to higher compliance in CPAP use, leading to improved effectiveness of the machine.

SONA Pillow

SONA Pillow

The SONA Pillow® is an FDA-approved triangular pillow with space to place your arm under the head while sleeping on the side. A study on 22 people showed that respiratory disturbance index (RDI) went down in users with mild to moderate snoring and obstructive sleep apnea.¹

Medslant Pillow

Medslant Pillow

Sleeping on the back often increases the severity of sleep apnea. If it is the preferred sleeping position, however, sleeping on an incline can prevent the throat from closing during sleep. This pillow can also be used to help symptoms of gastroesophegeal reflux disease (GERD) and acid reflux.

Medslant Pillow

CPAP Pillow

CPAP Pillows

CPAP pillows are designed to accommodate the shape of the CPAP mask as the user moves during sleep. Using this pillow is likely to lead to higher compliance in CPAP use, leading to improved effectiveness of the machine.

SONA Pillow

SONA Pillow

The SONA Pillow® is an FDA-approved triangular pillow with space to place your arm under the head while sleeping on the side. A study on 22 people showed that respiratory disturbance index (RDI) went down in users with mild to moderate snoring and obstructive sleep apnea.¹

Medslant Pillow

Medslant Pillow

Medslant Pillow

Sleeping on the back often increases the severity of sleep apnea. If it is the preferred sleeping position, however, sleeping on an incline can prevent the throat from closing during sleep. This pillow can also be used to help symptoms of gastroesophegeal reflux disease (GERD) and acid reflux.

CPAP Pillow

CPAP Pillows

CPAP pillows are designed to accommodate the shape of the CPAP mask as the user moves during sleep. Using this pillow is likely to lead to higher compliance in CPAP use, leading to improved effectiveness of the machine.

SONA Pillow

SONA Pillow

The SONA Pillow® is an FDA-approved triangular pillow with space to place your arm under the head while sleeping on the side. A study on 22 people showed that respiratory disturbance index (RDI) went down in users with mild to moderate snoring and obstructive sleep apnea.¹

Medslant Pillow

Medslant Pillow

Sleeping on the back often increases the severity of sleep apnea. If it is the preferred sleeping position, however, sleeping on an incline can prevent the throat from closing during sleep. This pillow can also be used to help symptoms of gastroesophegeal reflux disease (GERD) and acid reflux.

Medical interventions for sleep apnea range from prescription drugs to surgery to dental devices. The gold standard medical treatment for sleep apnea is the Continuous Positive Airway Pressure (CPAP) device, which keeps air moving into either the mouth, nose, or both to prevent the airway from closing.

Other medical devices include specialized pillows, Radiofrequency Ablation, and devices such as the lingual restraint and Mandibular Advancement Splints.

In the event that these approaches do not work, surgery for sleep apnea may be considered to remove excess tissue or change the structure of the throat.

Type of intervention is determined based on severity of the condition.

If problems are identified that may be contributing to sleep apnea, and if the continuous positive airway pressure (CPAP) treatment fails, it may be beneficial to have surgery. These may include:

• Tonsillectomy (for enlarged tonsils)
• Removal of nasal polyps
• Surgery to straighten a deviated septum
• Correction of facial or jaw deformities
• Removal of tissue in the throat (uvulopalatopharyngoplasty)

There are specialized procedures that are used to treat problems that may be contributing to sleep apnea. Each has variable success rates, with the potential for surgical complications.

Because sleep apnea is caused by being overweight or obese, bariatric surgery may also be worth considering if other weight loss approaches have failed.

If problems are identified that may be contributing to sleep apnea, and if the continuous positive airway pressure (CPAP) treatment fails, it may be beneficial to have surgery. These may include:

• Tonsillectomy (for enlarged tonsils)
• Removal of nasal polyps
• Surgery to straighten a deviated septum
• Correction of facial or jaw deformities
• Removal of tissue in the throat (uvulopalatopharyngoplasty)

There are specialized procedures that are used to treat problems that may be contributing to sleep apnea. Each has variable success rates, with the potential for surgical complications.

Because sleep apnea is caused by being overweight or obese, bariatric surgery may also be worth considering if other weight loss approaches have failed.

CPAP Pillow

CPAP Pillows

CPAP pillows are designed to accommodate the shape of the CPAP mask as the user moves during sleep. Using this pillow is likely to lead to higher compliance in CPAP use, leading to improved effectiveness of the machine.

SONA Pillow

SONA Pillow

The SONA Pillow® is an FDA-approved triangular pillow with space to place your arm under the head while sleeping on the side. A study on 22 people showed that respiratory disturbance index (RDI) went down in users with mild to moderate snoring and obstructive sleep apnea.¹

Medslant Pillow

SONA Medslant Pillow

Sleeping on the back often increases the severity of sleep apnea. If it is the preferred sleeping position, however, sleeping on an incline can prevent the throat from closing during sleep. This pillow can also be used to help symptoms of gastroesophegeal reflux disease (GERD) and acid reflux.

Medslant Pillow

CPAP Pillow

CPAP Pillows

CPAP pillows are designed to accommodate the shape of the CPAP mask as the user moves during sleep. Using this pillow is likely to lead to higher compliance in CPAP use, leading to improved effectiveness of the machine.

SONA Pillow

SONA Pillow

SONA Pillow

The SONA Pillow® is an FDA-approved triangular pillow with space to place your arm under the head while sleeping on the side. A study on 22 people showed that respiratory disturbance index (RDI) went down in users with mild to moderate snoring and obstructive sleep apnea.¹

Medslant Pillow

Medslant Pillow

Sleeping on the back often increases the severity of sleep apnea. If it is the preferred sleeping position, however, sleeping on an incline can prevent the throat from closing during sleep. This pillow can also be used to help symptoms of gastroesophegeal reflux disease (GERD) and acid reflux.

CPAP Pillow

CPAP Pillows

CPAP

CPAP pillows are designed to accommodate the shape of the CPAP mask as the user moves during sleep. Using this pillow is likely to lead to higher compliance in CPAP use, leading to improved effectiveness of the machine.

SONA Pillow

SONA Pillow

The SONA Pillow® is an FDA-approved triangular pillow with space to place your arm under the head while sleeping on the side. A study on 22 people showed that respiratory disturbance index (RDI) went down in users with mild to moderate snoring and obstructive sleep apnea.¹

Medslant Pillow

Medslant Pillow

Sleeping on the back often increases the severity of sleep apnea. If it is the preferred sleeping position, however, sleeping on an incline can prevent the throat from closing during sleep. This pillow can also be used to help symptoms of gastroesophegeal reflux disease (GERD) and acid reflux.