WHAT IS CPAP INTOLERANCE?
If you have been diagnosed with Obstructive Sleep Apnea (OSA), you are probably familiar with the term “CPAP,” which is the acronym for “Continuous Positive Airway Pressure.”
A CPAP unit is a machine that delivers lightly pressurized air through a hose that is hooked to a mask that you wear while you sleep. The flow of air acts like a "splint," keeping your upper airway open and preventing apnea.
While it is considered the “gold standard” for the treatment of OSA, studies show that only 23%-45% of patients for whom CPAP is prescribed actually use the machine on a regular basis.
Additionally, CPAP use averages only 4-5 hours per night vs. the 7-9 hours of recuperative sleep recommended by organizations such as the National Sleep Foundation.
Reasons for CPAP intolerance frequently cited by patients include:
- Mask leaks (and/or an inability to get a make to fit properly)
- Uncomfortable straps and headgear
- Latex allergies
- Noise from the CPAP machine that disturbs sleep of the patient (or his/her bed partner)
- Restricted movement during sleep because of the CPAP apparatus
CPAP equipment has undergone many improvements since the first one was invented in 1980 Collin Sullivan, MBBS, PhD, FRACP, using a vacuum cleaner and a length of hose. There are always improvements being made to CPAP masks, too. However, if you have tried CPAP and found that it simply does not work for you, an oral appliance may be your next best option.
For some patients, including those with mild-to-moderate OSA, an oral sleep appliance may eliminate the need for CPAP or surgery. For patients with more severe sleep-disordered breathing problems, an oral sleep appliance may be a convenient adjunct therapy. This recommendation is consistent with the American Academy of Sleep Medicine’s practice parameters, which state:
“…oral appliances are indicated for use in patients with mild to moderate OSA who prefer OAs to CPAP, or who do not respond to CPAP, are not appropriate candidates for CPAP, or who fail attempts with CPAP or treatment with behavioral methods such as weight loss or sleep-position change.”Kushida CA, et. al. Practice parameters for the treatment of snoring and obstructive sleep apnea with oral appliances: An update for 2005. SLEEP 2006 29(2): 242.
If you are CPAP intolerant and would like to explore the benefits of an oral sleep appliance, you should know that one size does not fit all. To be effective, an oral sleep appliance must be properly fit and calibrated to each, individual patient by a dentist who has the appropriate training and experience in dental sleep medicine. “Training and experience” is defined by the American Academy of Sleep Medicine as follows:
“Oral appliances should be fitted by qualified dental personnel who are trained and experienced in the overall care of oral health, the temporomandibular joint, dental occlusion and associated oral structures.”Kushida CA, et. al. Practice parameters for the treatment of snoring and obstructive sleep apnea with oral appliances: An update for 2005. SLEEP 2006 29(2): 240.
To find out if an oral sleep appliance is right for you, please contact our office to schedule an appointment for a consultation. We have the capability of offering home sleep testing, which we can use to: a) determine if you are a candidate for oral appliance therapy, b) calibrate your appliance, and c) quantitatively measure how well your oral sleep appliance is addressing your sleep-disordered breathing problem.
Payment & Insurance
We strive to make treatment easy and affordable. We accept:
· Credit Card: VISA, MasterCard, American Express or Discover
A significant reduction in our usual fee is available when payment is received before services are provided. We also offer CareCredit™ for the convenience of patients who prefer to finance their treatment.
Insurance reimbursement for covered benefits is paid directly to the patient. If you have a CPAP machine that has been prescribed for you, we can assist you in qualifying for medical insurance benefits by working with your physician to obtain a prescription for an oral sleep appliance and by providing you with a CPAP Intolerance affidavit to submit to your insurer.
For glossary of terms that may be helpful when communicating with your health insurance provider, click here