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Comparison of CPAP and Oral Appliance Therapy

Comparison of CPAP and Oral Appliance Therapy

Continuous Positive Airway Pressure (CPAP) and oral appliance therapy are two common treatment options for obstructive sleep apnea (OSA). While both methods aim to address the underlying issue of airway obstruction during sleep, they differ in various respects. Let’s compare CPAP and oral appliance therapy:

1. Mechanism of Action

CPAP: CPAP involves wearing a mask connected to a machine that delivers a continuous flow of pressurized air. This air pressure keeps the airway open, preventing collapse and maintaining normal breathing patterns during sleep.

Oral Appliance Therapy: Oral appliances are custom-made devices that fit in the mouth and reposition the jaw and tongue to keep the airway open. They work by advancing the lower jaw or tongue forward, which helps maintain the airway space.

2. Effectiveness

CPAP: In terms of efficacy, CPAP is considered the gold standard in reducing the apnea-hypopnea index (AHI) by preventing airway collapse in most people as long as sufficient pressure is applied.

Oral Appliance Therapy: Oral appliances are the leading treatment alternative to CPAP and have been proven to be as or more effective in treating obstructive sleep apnea as CPAP because patients simply tend to use oral appliances more consistently. Therapeutic response to oral appliance treatment demonstrates wider intra-individual variability between patients, making oral appliances a strong first-choice option for patients with mild to moderate obstructive sleep apnea and great alternative for patients with severe obstructive sleep apnea if they have difficulty with CPAP. Studies have demonstrated that both CPAP and oral appliance therapy produce similar health benefits for the patient, such as improvement in daytime sleepiness and blood pressure.

3. Comfort and Ease of Use

CPAP: Some individuals find CPAP therapy uncomfortable, especially during the initial adjustment period. Wearing a mask and dealing with the noise from the machine can be bothersome for certain people.

Oral Appliance Therapy: Oral appliances are generally considered more comfortable and less invasive compared to CPAP. They are custom-made to fit the individual’s mouth, and many people find them easier to tolerate.

4. Treatment Compliance

CPAP: Compliance with CPAP therapy can be challenging for some individuals due to discomfort, mask-related issues, or feeling claustrophobic. However, modern CPAP machines come with features like improved mask designs, reduced noise levels, and humidity control, which can enhance compliance.

Oral Appliance Therapy: Compliance with oral appliance therapy tends to be higher compared to CPAP, mainly because of the perceived comfort and ease of use.