Tuesday, October 27, 2009

Money Doesn’t Sleep, but You Should

How much is a good night’s sleep worth?

For people with obstructive sleep apnea (OSA), it’s worth the cost of treatment.

Twenty-five to 50 percent of the 18 million Americans who have OSA do not tolerate or comply with
CPAP, the standard treatment therapy.

These people face an important question. “Should I leave my apnea untreated or try an alternative therapy?”

Untreated OSA can lead to excessive daytime sleepiness, driving accidents, heart attack, stroke, diabetes, and obesity.

According to a recent
study in the journal Sleep and Breathing, 99 percent of OSA patients are better off receiving some form of treatment.

The researchers examined the benefits of wearing a CPAP mask verses an
oral appliance (OA) in patients with moderate to severe apnea. They looked at quality of life, driving accidents, and cardiovascular health.

They found that after five years, undergoing oral appliance therapy (OAT) is more cost-effective than not getting treated.

OAT costs range from a couple hundred dollars to a couple thousand dollars. But medical fees due to untreated OSA can cost tens of thousands of dollars if not more.

OSA patients can
Find-a-Dentist near them who practices OAT. Qualified dentists are trained to fit and adjust OAs to treat this disease.

OAs look like mouth guards and are non-intrusive.

In fact, a 2007
study found that many patients who respond to both CPAP and OAs prefer the latter.

Patients can work with their dentist, doctor, and medical insurance company to try and receive coverage for an OA.

Read more about insurance coverage

1 comment:

  1. As a sleep professional who works very closely with a sleep physician and a CPAP user myself, it must be said that treatment with positive airway pressure is still the "gold standard" for obstructive sleep apnea(OSA). Dental appliances work primarily for people with mild OSA, or an apnea/hypopnea index(AHI)of less than 15, and people with OSA who are not overweight. Dental appliances work by holding the lower jaw (mandible) forwrard. This holds the back of the tongue away from the back of the throat and at the same time pulls the palate forward. However, because people who are overweight/obese may have a lot more tissue in the airway, a dental appliance may be less likely to be effective. The American Academy of Sleep Medicine recognizes the use of dental appliances in patients with mild OSA, or an AHI of 5-15.

    The percentage of tolerance of positive airway pressure in the United States is closer to 60%, rather than the 50-75% mentioned above. The physician I work with has done a study of his own patients and found that his patients have a compliance rate of 80-85% for an AHI of greater than 15. A lot of that compliance rate corresponds to the amount of time he and his staff spends with his patients troubleshooting problems and supporting them through the initial adjustment period.

    While the study in the journal of "Sleep and Breathing" mentioned above does state that patients are better off receiving some form of treatment for OSA than none at all, it also concludes that "OAs are less econonmically attractive than CPAP...". In my work, I have seen many patients who have spent a few thousand dollars on a dental appliance only to start positive airway pressure therapy again because the dental appliance was not effective. All in all, in really comes down to what is best for each patient. And, unfortunately, at this time we have not developed a reliable method of determining which patients will benefit best from which therapy.



The Official Blog of the American Academy of Dental Sleep Medicine (AADSM) is intended as an information source only. Content of this blog should not be used for self-diagnosis or treatment, and it is not a substitute for medical care, which should be provided by the appropriate health care professional. If you suspect you have a sleep-related breathing disorder, such as obstructive sleep apnea (OSA), you should consult your personal physician or visit an AASM-accredited sleep disorders center. The AADSM, and the American Academy of Sleep Medicine, as the managing agent of the AADSM, assume no liability for the information contained on the Official Blog of the AADSM or for its use.