CPAP Alternative: Mandibular Advancement Device

I can’t wear my CPAP. Now What?

CPAP, which stands for continuous positive airway pressure, is the most commonly prescribed treatment for obstructive sleep apnea (OSA) by physicians. A CPAP machine uses a special mask that covers the nose and sometimes the mouth as well.   A compressor pump is attached to the mask via a hose to keep your airway splinted open during sleep so you can breathe.  For some patients, though, the CPAP is something they simply are unable or unwilling to tolerate.  Some patients find that the CPAP solves some problems, and creates others that they weren’t experiencing before treatment for their OSA began. The term doctor’s use for the description above is called “CPAP Intolerance”.

Signs of CPAP intolerance include:

  • Nasal congestion and irritation of the lining of the nose.
  • Eye, or sinus irritations from the blowing air and mask leaks.
  • Bloating in your stomach from swallowed air.
  • Headaches from the mask and strap pressure.
  • Continued drowsiness because of an inability to wear the CPAP for more than a few hours.

Thankfully, CPAP isn’t the only treatment option for patients who struggle with OSA. Since 1996, the American Academy of Sleep Medicine has recommended that a professionally made oral appliance should be considered as a first line therapy for those with mild or moderate OSA, as well as those with severe OSA who have tried and failed CPAP therapy. .With oral appliance therapy, our patients from all over King and Pierce County are enjoying an alternative that allows them to get the full night of rest they deserve.

Oral appliance therapy uses a comfortable, custom-made two piece mouthpiece that is designed to reposition your tongue and throat muscles by advancing the lower jaw.  Not only will that help you sleep better, it will also treat your snoring, which will make your bed partner very happy!  In some cases, couples who were forced to sleep in separate bedrooms are able to sleep in the same bed again.

If you have you tried to treat your OSA with CPAP and have experienced side effects that make you unable or unwilling to use it, give us a call.   At Sleep Solutions Northwest in Auburn, Washington we have helped many patients with OSA find relief.  Your personalized treatment plan will include an exam and consultation with us, where we can explain how treatment will work and answer any questions you might have.  We serve patients from Gig Harbor and Tacoma all the way up to Seattle.  Contact us today for an appointment.  If you are a physician with patients who may benefit from oral appliance therapy, please download the physician referral form, fill it out and fax it to us.  We will take it from there, and keep you posted as to your patient’s progress, each step of the way.

Example Oral Appliances

Our office uses all of the devices shown below in the treatment of snoring and obstructive sleep apnea.  Which one is best for you depends on a number of factors.  After your examination, Dr. Rich will make the determination on which one is best for your particular needs.

This type of appliance is named for the distinctive fins that protrude upward from the lower appliance.  All surfaces are smooth acrylic against your cheeks, lips and tongue, and it is easily adjustable.

The SUAD appliance allows more lateral movement than most of the appliances, and is specially made with extra cast metal components for our patients who aggressively grind their teeth at night. The thermoflex material usually requires heating in warm water to soften it slightly before attempting to place it over your teeth.

The OASYS is the only dental device that is FDA approved as a medical device in two separate classifications (1) As a mandibular repositioner for treatment of snoring and sleep apnea and (2) As a nasal dilator for improved ease of nasal breathing.

It strengthens the throat area by pulling the lower jaw and tongue forward to prevent the tongue from blocking the airflow and strengthening the throat against collapse during sleep.

The NARVAL appliance is made of nylon, and is quite thin yet durable, which allows maximum tongue space.  The amount of mandibular advancement is adjusted by changing out the attachment arms, which are available in a wide variety of lengths.

This design allows a lot of side to side movement, and is a good choice for people who grind their teeth or simply want more ability to move.  It is also one of the approved designs for patients with Medicare and works well in a variety of patients.  As a result, it is one of the most popular devices in use today.