Obstructive sleep apnea results from any condition or disease that causes partial or complete obstruction of the air way when the patient assumes a supine position and goes to sleep. Oral appliances are viable options for treating patients with sleep disordered breathing.
Oral appliances used in our series which included 19 patients were tongue retaining device (TRD), acrylic Herbst splint appliance and Karwetzky activator. Polysomnography was done on 10 cases with oral appliances. All cases were evaluated on Epworth Sleepiness Scale.
8 (80%) patients showed significant reduction in AHI in addition to reduction/cessation of snoring and improvement on Epworth Sleepiness Scale. In one of the cases AHI increased and in another case AHI remained almost same but SaO2 %decreased. In both these cases, oral appliances were withdrawn. In the other 9 cases who had not yet been subjected to PSG, after insertion of oral appliance 7 of the patients reported significant reduction/cessation of snoring and improvement on Epworth Sleepiness Scale. Karwetzky activator was found to be more patient friendly than other appliances used in the study.
Oral appliances therapy for OSA is non invasive, cost effective and beneficial to affected patients if desired efficacy is achieved. It greatly improves quality of life and cardio pulmonary health. We have observed short term therapeutic efficacy of oral appliances both clinically and by PSG studies.
