What are benefits of oral appliance (OA) therapy for the treatment of obstructive sleep apnea (OSA)?

Updated: Sep 15, 2020
  • Author: Himanshu Wickramasinghe, MD, MBBS; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

In general, comparative studies show that CPAP is more effective than oral appliances in lowering the AHI to less than 5-10 events per hour. [190] However, many other outcomes, such as sleepiness and cognitive functioning, are not different between the 2 devices. When asked which device the participant would use at home, the responses varied; in some studies, the participants favored CPAP and in others, they favored the oral appliance.

In a trial comparing health effects after 1 month each of CPAP and mandibular advancement device (MAD) therapy in 126 patients with moderate-to-severe OSA, the 2 treatments yielded comparable improvements in neurobehavioral outcomes and disease-specific quality-of-life outcomes; neither improved blood pressure. CPAP was more effective in reducing the apnea-hypopnea index, but the difference appeared to be offset by a higher treatment compliance in the MAD group. MAD was also more effective in improving 4 general quality-of-life domains. [191]


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