Although CPAP is an effective treatment for sleep apnea, many people hate it. These people dislike the treatment so much that they would rather suffer the health consequences of sleep apnea–up to and including death–than use their CPAP. Clearly, these people need an alternative.
Oral appliance therapy is a popular alternative. People like it and are happy to use it–studies show that oral appliance usage is over 90% when using the same standards as CPAP, and over 80% of people wear their oral appliance all night every night.
The problem is that many people are simply not candidates for oral appliances. Their sleep apnea is too severe for oral appliance therapy.
However, new less-invasive surgical techniques might help bridge this gap. Ineffective on their own, these treatments can make people candidates for an oral appliance when they weren’t before.
These Treatments Don’t Stand on Their Own
One important thing to understand about these new sleep apnea surgeries: they don’t adequately treat sleep apnea on their own.
Practitioners call one of these treatments AIRLIFT. Marketing material describes this as “a facelift for your throat.” The technique uses stitches to provide additional support to your hyoid bone, which isn’t attached to any other bones in the body. The goal is to pull it outward to open up the airway enough to reduce sleep apnea.
However, in a clinical study promoted by AIRLIFT, it’s shown that the technique doesn’t actually cure sleep apnea. In this study, patients saw their AHI (apnea-hypopnea index, a measure of sleep apnea severity) from 40 to 22. This is an improvement from severe to moderate sleep apnea. However, moderate sleep apnea is still dangerous.
In another study, researchers looked at a modified version of traditional sleep apnea surgery. In this technique, throat and mouth structures like the uvula and tongue were reduced. The data for this study is preliminary, but people saw an improvement in AHI from 50 to 20. Again, a drop from severe to moderate sleep apnea.
In neither case does this meet the standard for successful treatment. However, in many cases, this might be just the right reduction in AHI to make oral appliance therapy a viable option.
Sleep Apnea Surgery Has Risks
Of course, it’s important to remember that sleep apnea surgery has risks. We’ve talked about this before.
People with sleep apnea automatically have an elevated surgical risk because of poor cardiovascular health. In fact, the study of the second technique showed these complications were not rare. Two of the people receiving the surgery (4%) had to be hospitalized for complications.
In addition, the results of sleep apnea surgery are notoriously unstable. Even when people can see true relief from sleep apnea, their apnea may return again after a number of months or years.
Because of these risks, sleep apnea surgery is not usually recommended as a frontline treatment. However, in some cases, it might be appropriate.
Are You Looking for a CPAP Alternative in Denver?
Oral appliance therapy is a true alternative to CPAP. For most people, it can reduce an AHI of around 40 to less than 10, dramatically reducing a person’s risk from the condition. And these days more people can get oral appliance therapy than ever.
To learn whether you are a candidate for oral appliance therapy, please call (303) 691-0267 today for an appointment with a sleep dentist at the TMJ Therapy & Sleep Center of Colorado.
