Dear Medical Colleague,
Patients with a diagnosis of mild or moderate OSA are often excellent candidates for oral appliance therapy. The AASM has recommended this as a first treatment option for these patients since 2006.
As you well know, there is a large number of people who should be using a PAP device but are simply unable or unwilling to do so. Since these patients have “fallen off the wagon”, they remain at risk of serious co-morbid issues like a CVA or MI. Many of them would be willing and able to use an oral appliance if it was offered to them as an option. Even if this approach did not result in a return to a normal AHI, any significant reduction would certainly lower their overall co-morbid health risks.
Of course, PAP therapy remains the Gold Standard for patients in the severe category, and every attempt should be made to get them and keep them on PAP therapy. However, for patients who simply can’t or won’t, an oral appliance may be of significant help.