Thursday, August 26, 2010

Patients Find Trouble Fitting Boil-and-Bite Oral Appliances

Oral appliances used to treat sleep apnea can be custom-made by dentists or home-made. Custom-made appliances are “titrated,” or adjusted, over a period of time to ensure effective treatment. At-home “boil-and-bite” devices are created like sports mouth guards.

A new study in the journal Sleep and Breathing found that the number one reason patients stop using boil-and-bite devices is that they have difficulty finding the optimal fit.

The researchers collected the data with a mail questionnaire. The questionnaire was sent to 84 patients six months after the delivery of an OA.

Feedback was given by 47 of the patients. Compared to non-responders, responders did not differ in terms of baseline age, body mass index (BMI), OSA severity or daytime sleepiness.

After six months, 25 percent of the patients had stopped using their appliance. Of the nonusers, almost 80 percent stopped using the OA in the first three months. Non-users reported that their device was “uncomfortable” and ill-fitting. Nonusers had a higher BMI and higher daytime sleepiness when compared with users.

Of the responding patients, 35 continued to use the appliance. More than 80 percent of these users felt that their symptoms improved and more than 60 percent were satisfied with the therapy. Many users complained about a dry mouth and excessive salivation.

Fifty percent of the nonusers and 75 percent of the users previously used CPAP.

The American Academy of Sleep Medicine (AASM) recommends the use of OAs for mild to moderate apnea patients if they prefer the appliance to CPAP, cannot tolerate CPAP, or cannot use positional therapy or weight loss to control their apnea. OAs are also recommended for severe patients if they are unable to tolerate CPAP.

Last November, this blog reported on a cornerstone study comparing the effectiveness of custom-made verses boil-and-bite devices.

Find-a-dentist in your area who is trained to make custom-made oral appliances for sleep apnea treatment.

Image by ex.libris

1 comment:

  1. My husband was snoring heavily and it worried me so we went to this Memphis Sleep Apnea clinic. He was diagnosed with sleep apnea. He was prescribed with a custom made oral appliance. Now I don't hear him snore. Besides, he says that he's getting more hours of good night's sleep.

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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.