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What about the CPAP?

cpap drawing

Please do not assume Sleep Dentist Arizona rejects the use of the CPAP (continuous positive air pressure). It is considered the “gold standard” for treatment of obstructive sleep apnea (OSA). CPAP, when used as recommended by your physician or sleep therapist, will control obstructive sleep apnea 100% of the time.

Sleep Dentist Arizona strongly recommends that you do everything you can to utilize your CPAP unit as recommended. However, there are times in certain patients when, despite everyone's best efforts, you cannot tolerate the CPAP unit. In medical terms, we describe that as a problem with 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 for the recommended number of hours as recommended life-long.

CPAP Compliance

But multiple research articles have shown that CPAP compliance can be as low as 50% because of the discomfort of the mask, the inconvenience of the tubing and the necessity to find electrical outlets especially while travelling. Studies have indicated that as many as 25% to 54% of patients will discontinue their use of CPAP.

Treatments only work when used properly. 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. There are ways to improve CPAP comfort and, if a CPAP has been recommended, they should be attempted before switching to an oral appliance. But if you are still uncomfortable and cannot tolerate CPAP, oral appliances are an approved, effective alternative.

Many of the common problems that people experience with CPAP are related to CPAP mask problems:

Whatever the reason, some people just cannot tolerate CPAP.

The alternative – oral appliances

Still there is hope. Oral appliance sleep apnea mouthpiece therapy, provided by dentists specifically trained in the use of these devices ( such as Sleep Dentist Arizona), 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 state:

"Although not as efficacious as CPAP, oral appliances are indicated 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 mouthguards 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.

Even if you are successful utilizing the CPAP, an oral sleep appliance might prove an asset. An oral appliance makes travel or camping easier. Sometimes, combination therapy using both the CPAP and oral appliance together will be beneficial.