Take a few seconds and watch this video of a person going through a sleep apnea episode - play this for your spouse and see if there are any similarities between this video and your sleep patterns.
CPAP – the "gold standard"
While CPAP (Continuous Positive Air Pressure applied through a nasal mask) is considered the "gold standard" for treatment of Obstructive Sleep Apnea (OSA), it is not without its problems. CPAP, when used, will control obstructive sleep apnea 100% of the time but there is a problem with patient compliance. Compliance simply means that a patient is following their doctor's orders to keep their disease problem under control. In the case of sleep apnea, it means that the patient is using the CPAP machine every night as recommended life-long.
But multiple research articles have shown that CPAP compliance can be as low as 50% because of discomfort and inconvenience. Obstructive sleep apnea sufferers who do not wear their CPAP machines increase their risk of heart failure, high blood pressure and stroke and are drowsy during the day and fall asleep while driving. OSA sufferers who stop wearing CPAP often snore, gasp and choke loudly disturbing their bed partners placing a strain on relationships and marriages.
Some of the common problems that people experience with CPAP are:
- The mask is uncomfortable
- The mask is taken off at night without knowing it
- The mask is taken off at night to use the bathroom and it's too much bother to put it back on
- The mask irritates the skin and the nose
- Air in the stomach or sinuses
- The mask leaks air
- The pressure of the CPAP is bothersome
- The CPAP machine is too noisy to allow sleep
- The tubing gets in the way
- You just can't get used to the mask
- The mask gives you a feeling of claustrophobia
- Your nose can be stuffy because of a cold or allergies
- The air is too hot, too cold or too dry
Whatever the reason, some people just cannot tolerate the CPAP machine. This is what a CPAP device looks like as worn by a patient. You can see why there may be a compliance issue with many patients. When patients discontinue CPAP use they are again at risk for all of the health issues associated with sleep apnea and are right back where they started.
The alternative – oral appliances
Still there is hope. Oral appliance therapy, provided by dentists specifically trained in the use of these devices, can be an effective alternative to CPAP. A recent parameters paper published in the journal Sleep by the American Academy of Sleep Medicine stated that oral appliances can be used as first-line therapy in some patients for treating mild-to-moderate obstructive sleep apnea. The guidelines states, "Oral appliances are indicated and FDA approved for use in patients with mild-to-moderate obstructive sleep apnea who prefer oral appliances to CPAP, or who do not respond to CPAP, are not appropriate candidates for CPAP, or who fail treatment attempts with CPAP or treatment with behavioral measures such as weight loss or sleep-position change."
Oral appliances, which resemble sports mouth guards, are associated with better compliance than CPAP systems for many patients. Oral appliances can also be used as first-line treatment for primary snoring that is not associated with obstructive sleep apnea.
These appliances should be fitted by dentists specifically trained in oral appliance therapy and those experienced in treatment of temporomandibular joint and dental occlusion. Treatment with oral appliances should be followed on a regular basis and have follow up polysomnography.
The appliance shown here is a SomnoMed Mandibular Advancement Splint. This appliance is the most comfortable appliance we have used and we have experienced 100% compliance with this device to date.
For more information click on this link SOMNOMED WEBSITE
To make an appointment just call Tana at 832.413.6987 ext 108 and she can expedite your appointment.
"I just had an appliance done by Dr. Schleicher for TMJ and after one week of wearing this appliance I don't have these huge knots behind by ears and behind my head from grinding my teeth all night! The appliance took only 2 nights to get use to but I don't grind my teeth all night long anymore!!! Dr. Schleicher is so personal and even took time to email me the first day I met him and the entire staff is wonderful. He's not my regular dentist but if I lived closer to him I'm sure he would be! My husband is also seeing him for snoring and sleep apnea. Dr. Schleicher has made him an appliance as well and his snoring is so much better already. I'm sure with a few more adjustments of this appliance and he won't be snoring anymore.
So my husband and I love Dr. Schleicher!!! "
J.P Houston, Texas
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