Treatment Options

  • Maintains the lower jaw in the forward position during sleep, thus opening the airway.
  • Oral appliance therapy treats OSA and snoring by preventing the airway from becoming obstructed during sleep similarly to CPAP-devices. 
  • Oral appliances accomplish this by protruding the lower jaw, which leads to:
  • Increased retro lingual space
  • Increased tension on the soft palate that, when relaxed, causes snoring
  • Open the upper airway at most levels
  • Decreased collapsibility of the upper airway

Mechanism of action of Mandibular Advancement Device

MADs maintain the lower jaw in a forward position during sleep. In doing so, MADs generate the following effects:

  • Create an anterior movement of suprahyoid and genioglossus muscles
  • The suprahyoid muscle widens the esophagus during swallowing
  • The genioglossus muscle depresses and protrudes the tongue
  • Decrease the gravitational effect of the tongue
  • Stretch the soft palate
  • Stabilize the mandible to the hyoid bone

 

The hyoid bone attaches to the muscles of the floor of the mouth and the tongue above, to the larynx below, and to the epiglottis and pharynx behind. This result in an increase in lateral pharyngeal cross-sectional area upper airway muscle activity, thus preventing snoring and obstructive apneas.

How CPAP Works

  • Continues positive airway pressure (CPAP) – prevents collapse of the airway, but maintaining a positive a positive airway pressure during inspiration. 

Even though CPAP therapy is a gold standard for severe obstructive sleep apnea, it has its disadvantages.


Some of them are:

 

  • The mask can put pressure on the face.
  • An in lap sleep study must be completed to determine the needed pressure.
  • The airflow from the machine can cause drying of the airway.
  • Nasal congestion (caused by illness or allergies) may make it impossible to use.
  • Inconvenient to travel with due to weight.

 

How CPAP Works

Continues positive airway pressure (CPAP) – prevents collapse of the airway, but maintaining a positive a positive airway pressure during inspiration. 
Even though CPAP therapy is a gold standard for severe obstructive sleep apnea, it has its disadvantages.

Some of them are:
  • The mask can put pressure on the face.
  • An in lap sleep study must be completed to determine the needed pressure.
  • The airflow from the machine can cause drying of the airway.
  • Nasal congestion (caused by illness or allergies) may make it impossible to use.
  • Inconvenient to travel with due to weight.