Oral appliances can work for mild apnea, but no severe sleep

As a child, I was fascinated by the comic strip Blondie, which featured the adventures of the Bumstead family. Dagwood, the awkward father snored at night by emitting a loud "SKNXXX" -So that his wife, Blondie, he buried his head in the pillows. The next day, could find Blondie Dagwood nap on the couch instead of mowing the lawn, or your boss might catch him dozing on your desktop. 
 

Years later, I realized that Dagwood was not just a vague avoid its obligations. Probably he had obstructive sleep apnea - a disease that was not identified until decades after Blondie debut in the comics.

The search for an effective treatment, easy to use for sleep apnea has been going on for years. The gold standard is a breathing machine called a continuous positive airway pressure (CPAP). A report published online this week in Archives of Internal Medicine describes a mouth guard-like device that can work for people with mild sleep apnea, but it can not be useful for Dagwoods the world.

Dangers of apnea and corrections

People with obstructive sleep apnea are never completely relaxed because they receive sleep a full night. Your airways tend to shrink during sleep, and the air trying to pass. (Snoring occurs when air is forced through clogged passages.) People with this condition may breathe shallowly or stop breathing several times an hour. Whenever the level of oxygen in the blood decreases, the central nervous system that causes to take in a big breath, which may seem a gasp. Many people with obstructive sleep apnea are not aware that they briefly awaken several times during the night.Sleep apnea may increase blood pressure. It has also been linked to the development of other cardiovascular conditions. 

CPAP is the first successful approach to the treatment of obstructive sleep apnea. CPAP keeps the airway open by increasing the pressure at which air moves through them. It is effective, but requires a pump for generating an air pressure, a flow tube and a mask attached to the tube that fits over the nose. Up to 40% of people who try CPAP not stay with it. Those who leave often say that CPAP mask is claustrophobic, the tube gets in their way while they sleep, or the hum of the machine's hard to tolerate. Its bedfellows also tend to complain devices.  

18 million Americans suffer from obstructive sleep apnea are a powerful incentive for handset manufacturers, and there are countless alternatives to CPAP in the market and in development. Some of them are even seeking sponsors to raise funds on websites. New treatments approved by the FDA include Pro - nose plugs that create pressure when air is exhaled and Winx - a device that sucks the front tongue to keep the airway open. But they are expensive and can not be covered by insurance. Mandibular advancement appliances - a form of dental night guard - have been around for a while. They are the only alternative to CPAP that can be covered Medicare and other insurers. 

Can replace CPAP night guards?

Oral devices are designed to position the lower jaw slightly forward and downward. This opens the airway. These devices are simple, portable and quiet, but can be almost as expensive as CPAP. And mounting evidence suggests that they are not as effective for people with moderate to severe obstructive sleep apnea. The new study in the Archives of Internal Medicine suggests that for people with less severe obstructive sleep apnea, devices can provide some relief. But this work also shows how difficult it is to show a slight improvement of obstructive sleep apnea and how difficult it is to measure the improvement in people with a case of Benin him.

A team of Swedish researchers recruited 96 men and women with sleep apnea. Half using a bespoke mandibular advancement device as they slept. The other half a placebo used for night duty. At the end of the four month study, people who use custom device had greater improvements in obstructive sleep apnea, snoring and restless legs than those using the placebo device.  

They also had a small improvement in daytime sleepiness, but so did those on placebo. In addition, more than half of those using placebo thought the device was so effective that they wanted to continue using it."The study may say more about the power of placebos on the effectiveness of oral appliances, like many people using improved devices ineffective reported," said Dr. Lawrence Epstein, a sleep medicine specialist at Brigham and Harvard affiliate Women's Hospital.

"It was a study of a single oral appliance and many different styles, so it is difficult to draw conclusions on all devices of this study," says Dr. Epstein. There are also some limitations the study. It included a large number of people have little or no mild obstructive sleepiness sleep apnea that may be due to time that the device could not be processed. In addition, it may have been enough people in the study showing a small change in sleepiness.  

Do you think you have sleep apnea?

By some estimates, half of all people with sleep apnea do not know they have it. If you are a snorer or regularly adjust during the day, there are two things you can do on your own to counter sleep apnea - Sleep on your side and take off a few pounds if you are overweight.

If this does not work, talk to your doctor about whether it makes sense to be tested for sleep apnea. The table below can help you decide if the sleep apnea test is right for you.