Treatment of Sleep Apnoea
CPAP (continuous positive airway pressure) is considered the first line of treatment for severe OSA and is very effective in terms of overcoming the symptoms of excessive daytime sleepiness. Patients with severe sleep apnoea respond well to this therapy. However, it is without doubt an arduous therapy, which involves wearing a mask during sleep (over the nose or nose and mouth), which is connected to a small air pump. The treatment works by blowing air into and pneumatically inflating the collapsible part of the upper airway, thus preventing vibration and blockage of the flexible upper airway breathing tube. Subsequently, sleep apnoea and snoring are prevented.
If your medical history and screening suggests there is a likelihood that you are suffering from OSA then you will be referred to a Respiratory Physician for a sleep study and diagnosis. This may involve spending a night at a hospital ‘Sleep Laboratory’ or more usually, you will be given a portable monitor so that a simpler study can be carried out in the comfort of your own home. Such monitors can record your heart rate, your blood oxygen carriage, your breathing (including any apnoeic events), snoring events and body position.
Once diagnosed by the Consultant Respiratory Physician, custom MRD therapy may be prescribed. The exact therapy depends upon the severity of your sleep apnoea and the existence of other medical problems. Oral appliances can be used to treat all severities of sleep apnoea but effective results are less certain with increasing severity of apnoea. Severe sleep apnoea, if treated with an oral appliance, requires careful patient monitoring.
Such custom made oral appliances can only be made, fitted and monitored by trained dentists.
When MRDs are used as an alternative treatment for severe OSA the trained dentist MUST be working as part of a multidisciplinary team, which would include either a Consultant ENT surgeon or Respiratory Physician.