How successful are Oral Devices in Managing Sleep Disordered Breathing and Sleep Apnoea?

At the Beacon Dental Clinic Dr Edward Owens, Board Certified in Dental Sleep Medicine, has been managing patients referred by Medical Consultants specialising in Respiratory Medicine and Sleep Disordered Breathing, and Ear Nose & Throat Surgeons, for over twenty years now. Device technology has evolved and is now a very acceptable alternative to CPAP (Continuous Positive Airways Pressure) therapy for both patients and referring clinicians, for patients who are prescribed device therapy.

We undertook a randomised review of patient outcomes to assess the success of oral devices therapy. Many of these patients were C.P.A.P. intolerant (unable to sleep successfully with a facemask device delivering continuous positive airways pressurised oxygen). These patients had a mandibular device (M.A.D.) scanned, designed and placed to manage their sleep disordered breathing and the results were very encouraging for these patients.

The overall number of patients included in our review was 34, all of whom had had previous overnight diagnostic pre treatment sleep study, and a further overnight study completed by their medical practioners, following device placement. The patient age range reviewed was
between 35-73.

All 34 patients in this group, had a measurable reduction in their Apnoea: Hypopnea index, that is, the number of times their oxygenation/air flow was interrupted by their sleep disordered breathing, on their repeat overnight sleep study, with their MAD (Mandibular Advancement Device) oral appliance in place.

Patients also subjectively reported feeling energised and refreshed on waking in the morning, following a much improved nights’ sleep, describing all the benefits that a quiet, quality nights’ sleep now brought to them and their sleep partner.

The results are illustrated in the two charts below:

A.H.I. = Apnoea: Hypopnea Index
The word “apnoea” literally means “without breath”. An apnoea is defined as a complete cessation of breathing that lasts 10 seconds or greater. In clinical practice, the most frequently used measurement of OSA (Obstructive Sleep Apnoea) is the Apnoea Hypopnoea Index (AHI) derived from an overnight sleep study.