Oral Appliances More Effective in Positional Sleep Apnea

This finding does not suprise me. However, I consider it a very important finding that deserves much more study.

"Our data suggest that MADs are more effective in positional OSA than nonpositional OSA patients."
Article: http://www.dentistryiq.com/index/displa ... 77417.html

The findings are from a "Dentistry School of Medicine"? I would expect nothing less...there's lots of money in them there oral appliances.
On a side note, the Bakers Union completed a study showing surplus yeast consumption has provide positive results for many individuals...

Maple Leaf wrote:The findings are from a "Dentistry School of Medicine"? I would expect nothing less...there's lots of money in them there oral appliances.
On a side note, the Bakers Union completed a study showing surplus yeast consumption has provide positive results for many individuals...

I see it the opposite of what you are implying. They are discouraging a big part of their market - the part that has nonpositional sleep apnea.

ResMed has said that 40% of patients have positional sleep apnea (PSA), so that means 60% have NPSA.

I would think if their motives were purely to promote the field of dentistry at the expense of the truth and patients' health, they would have destroyed the study before publication. (I am also not so cynical as to suspect that medical schools are lying to promote their field.)

What I think can come out of the study and additional studies, is a method to predict which patients will be treated well with oral appliances and which will not be treated well. This could eliminate the thousands of cases where much money and time is spent on an oral appliance and then sleep studies show they are not suitably effective for controlling OSA in these individuals.

I think this is out of the presence of anesthesia within the dental clinic that is why it has been concluded that oral appliances are more effective than positional sleep arena.

Didn't and doesn't work for me whatsoever. Apparently I was also deemed an "ideal" candidate for an oral appliance for my "mild" OSA, which is greatly positional. I still need & benefit only from PAP therapy & I force myself to side sleep. With only a dental device, a friggin' $2600+ piece of crap at that (though it does help keep my jaw shut), I still get apneas & other events while side sleeping (even restrained side sleeping of head and body, meaning the events are NOT from a momentary supine position). Being an ideal candidate, with normal BMI, excellent jaw and teeth structure, and no other physical impairments that might cause OSA, an oral appliance "should" have worked for me as there would be little for the appliance to do. My tongue was not deemed other than normal as well.

My point is, that if the oral appliance did not work for someone like me in a side sleeping position, I can't imagine who it actually might work for? 2 wasted years of trying and waiting for it to help reduce my OSA. Maybe for a very thin person in their 20's or 30's, with a normal jaw and so before their throat? might become too soft and that a slight jaw advancement might help keep it open. However, I doubt it's true efficacy over time for such a person ESPECIALLY compared to PAP therapy.

My experience has proven to me that it is only about money and profit for dentists vs. anything of value for the patient. However, there might be a placebo effect for some people?

Mtnviewer wrote: Didn't and doesn't work for me whatsoever.

Sorry about your bad expensive experiment.

Mtnviewer wrote: Apparently I was also deemed an "ideal" candidate for an oral appliance for my "mild" OSA, which is greatly positional.

The medical field of treating OSA is a fairly new one and until lately the research into the causes and treatments has been sparse.

Dentists that believe mild OSA cases are ideal candidates for oral appliances (MAD) may be out of date in their information. If interested, look at this thread, viewtopic.php?f=1&t=44181&p=393400&hilit=+jaw#p393400 , which references some studies and discusses how evidence is now showing that mild cases may not be the most suited for MAD therapy.

You may also be interested to read about small jaws as the primary cause of OSA, viewtopic.php?f=1&t=53983&st=0&sk=t&sd=a .

Oral appliances do work for some limited amount of patients.

It can also be stated that CPAP, the gold standard of treatments, has a horrible effectiveness rate across the population of sufferers. Compliance rates of CPAP are typically stated around 50% and compliance is defined as a minimum of four hours of usage five nights per week. And that is just using the CPAP, it says nothing about effectiveness during use because the great majority of patients have no efficacy data capability.

The compliance rates of CPAP also say nothing about the legions who refuse sleep studies because they "would never be able to wear a mask".

If you could boil this all down to the essentials, I believe you would find the true effective compliance rate for CPAP is somewhere between 10 and 25%.

cpaptalk members who aggressively treat their condition with CPAP are in a rare group, so I don't begrudge anyone who gets some therapy from a dental appliance.

...and then there's the logical possibility that some degree of mandibular advancement could increase the efficacy or tolerability of PAP, e.g., allow a lower PAP pressure, and/or make a pap mask fit better. For most of us, however, these are prohibitively expensive experiments to try for oneself.

I'm not a good candidate for MAD (SA too severe), but if dental schools/MAD device makers had done studies of combined therapy, I might be more interested.

M.D.Hosehead wrote: I'm not a good candidate for MAD (SA too severe),

M.D., You either did not read the links I posted or you flat out reject their conclusions.

Very well, I conditionally withdraw that clause, conditionally because the issue does not seem to be a settled one.

Overall, though, I was agreeing with your point that there may be a greater role for MAD than is currently recognized.

Sure, anyway, despite all our jabbering, eventually it works down to whether it works for the individual.

Is this Dentistry School of Medicine is a professional school that contains a lot of knowledgeable persons? If yes I will be agree to their findings and I will give them a thumbs up. I will also congratulate them for a very nice work they done.