Oral Appliance Therapy

Oral appliances (OA) are an accepted therapy for OSA in patients with mild to moderate disease. OA typically come in two forms—mandibular advancement devices and tongue retention devices, both of which increase posterior pharyngeal space and relieve upper airway obstruction. Most research has been performed on mandibular advancement devices. In one large prospective study, women with OSA were more likely to have treatment success with OA than men, particularly those with milder forms of OSA (93). Men with OSA treated with OA were more likely to have treatment success when they had predominantly supine-dependent OSA and were more likely to develop treatment failure with even small changes in their BMI. Patients with a higher degree of upper airway collapse (as signified by a greater apnea/hypopnea ratio), as is more commonly seen in men, have decreased treatment benefit with OA (94,95).

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