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Oral Appliances for the Treatment of Mild and Moderate Obstructive Sleep Apnea

Introduction: Continious Positive Airway Preasure (CPAP) is considered as a golden standard for the treatment of Obstructive sleep apnea (OSA), but the low compliance and intolerance of the patients to the machine calls for alternative treatment. Oral appliances could be a viable alternative to CPAP in patients with mild or moderate forms of OSA. Method: This study consists of case series of 37 OSA patients treated with two different types of oral appliances. The diagnosis was set by using thorough examination by an otorhinolaryngologist of the upper airways by endoscopy, sleep endoscopy, polysomnography and Epworth sleepiness scale (ESS). Apnea Hypopnea Index (AHI) and ESS score were obtained before and after the treatment. Results: According to our study, the success rate of the treatment of the patients, measured as AHI reduction less than 10 events/hour, is very high (95%). The mean AHI reduction is 9.5 events/h. compared to 19.45 before the treatment and corresponds with the results of other authors. The mean Epworth Sleepiness Scale result after the treatment was 8.6, compared to 12.7 before the treatment. Conclusion: Oral appliances are high effective in the treatment of selected patients with OSA, mainly mild and moderate cases according to AHI and ESS. The precise pretreatment work out is of uppermost importance in assessment of the grade of OSA and the site of obstruction. The combined treatment with surgery and oral appliances could be a viable option for patients with multilevel obstruction of the upper airways.