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Why are oral devices becoming the new favorite for treating sleep-disordered breathing?
With the changes in modern lifestyles, more and more people suffer from sleep breathing disorders, the most common of which include obstructive sleep apnea (OSA) and snoring. These problems not only affect sleep quality, but may also cause long-term damage to physical health. In recent years, the rise of oral devices, such as mandibular advancement devices, has provided patients with a new treatment option and has gradually become a popular method of caring for this condition.
The mandibular advancement device is a custom-made medical device that can effectively improve the symptoms of sleep apnea.
These devices work by moving the lower jaw slightly forward, which tightens the soft tissues and muscles of the upper airway and prevents airway obstruction during sleep. This design not only reduces snoring, but also effectively alleviates the symptoms of OSA. According to the American Academy of Sleep Medicine and the American Academy of Dental Sleep Medicine, oral devices are an alternative option worth considering for adults who are intolerant of CPAP therapy or prefer other therapies.
The use of oral appliances is becoming increasingly accepted and widely used in the United States, and is gradually gaining attention in the United Kingdom.
Clinical studies have shown that these devices have positive effects on multiple sleep monitoring indicators, subjective and objective measures of sleep sleepiness, blood pressure, neuropsychological function, and quality of life. According to a 2008 study, nasal resistance is strongly associated with the effectiveness of oral device therapy, so otolaryngologists need to work closely with sleep physicians to treat OSA.
Although oral devices have shown significant efficacy in moderate and mild OSA, their effectiveness in treating severe OSA is relatively weak. Studies have found that while oral devices can significantly reduce the number of sleep apnea episodes in patients, they cannot completely cure the condition. A meta-analysis of 51 randomized controlled trials also showed that oral devices were as effective as continuous positive airway pressure (CPAP) devices in lowering blood pressure in people with OSA.Although CPAP is considered more effective, recent randomized controlled evidence suggests that oral devices work just as well in patients with obstructive sleep apnea of all severities.
Due to their non-invasiveness, reversibility, noiselessness and high patient acceptance, oral devices have gradually gained attention in clinical treatment. However, these devices are not without disadvantages. Many patients report discomfort and poor results after use, or choose to switch to CPAP treatment. Common side effects include dry mouth, toothache, and jaw pain. Although long-term use will not cause temporomandibular joint disease, it may change the occlusion relationship of the upper and lower teeth and require annual maintenance and adjustment.
Although the maintenance costs of oral devices may impose a considerable financial burden on patients, many patients report that they experience better use than CPAP mask therapy.
In addition, depending on the health insurance policy, patients may have to pay about $1,900 out of pocket to get these devices, and not all plans cover them. As appetite grows, many low-cost, over-the-counter devices have emerged on the market that lack clinical validation and may even pose risks to patients' health. For patients, confidence and acceptance of oral devices are often affected by concerns, uncertainty, and discomfort about the impact on their teeth.
In summary, the rise of oral devices in the treatment of sleep apnea is undoubtedly the result of the joint promotion of nighttime demand and clinical research. Although these devices have shown promising therapeutic effects, patients still need to consider their individual circumstances and the suitability of the device when seeking a solution. In the future, with the advancement of technology and in-depth research, oral devices may be able to further improve their design to better serve the majority of patients. So, how should we balance the trade-off between effectiveness and comfort in the treatment of sleep apnea?
