Collapsibility, muscle compensation are keys
Certain traits may define a type of obstructive sleep apnea (OSA) that can be effectively treated with an oral appliance, according to new research published online in the Annals of the American Thoracic Society.
With OSA, air cannot always flow normally into the lungs during sleep. The collapse of the soft tissues in the back of the throat or tongue usually causes the airflow obstruction.
Continuous positive airway pressure, or CPAP, is considered the gold standard for preventing the obstruction by blowing air through a mask into the nose and throat. However, many patients have trouble sleeping with CPAP. For these patients, an oral appliance that moves the lower jaw forward to prevent the periods of obstructed airflow is often an alternative.
“Sleep apnea is not all the same, but we only recently developed ways to look at a sleep study and determine what traits cause the condition in different patients,” said senior author Scott Sands, PhD, assistant professor of medicine at Harvard Medical School and Brigham and Women’s Hospital in Boston. “Since oral appliances work by improving the collapsibility of the upper airway, patients without really severe collapsibility are more likely to benefit from an oral appliance, while those with sleep apnea caused by other traits, such as exaggerated reflex responses to drops in oxygen levels, are less likely to benefit.”
The authors looked at two traits related to the upper airway: collapsibility and muscle compensation. Patients without severe collapsibility benefited more from the oral appliance than those without this trait.