The Journal Sleep recently reported a study that confirmed the beneficial effects of wearing a CPAP. This study was undertaken to confirm the effectiveness of PAP use in reducing fatigue. The study duration was 3 weeks and double blind. No comment was made regarding the wear time of the CPAP, i.e., the number of hours of wear at night and was it worn every night.
The study did validate previous studies that suggest that CPAP use does reduce fatigue and increase vigor (energy).
The Elepant in the Room is that approximately 50% of people diagnosed with Sleep Apnea (regardless of type) do not wear their CPAP or only on an irregular basis. CPAP use while effect is not for everyone.
Those paitents that do not wear their CPAP are either non-compliant or intolerant for a variety of reasons, i.e. pain, phobias, embarrassment etc.
These patients require other forms of therapy, ie. surgical or oral appliances (OAT). An oral appliance has the same benefits of a CPAP without the mask, hose and device. They are custom fitted, FDA approved and recommended by the AASM (American Academy of Sleep Medicine) as an initial (first order) treatment for snoring and mild to moderate sleep apnea. They are also a good choice for those noncompliant and intolerant CPAP patients.
As should be noted in CPAP patients as well as Oral Appliance patients, patient selection is critical. You cannot make a patient wear something they cannot tolerate or by disposition won’t tolerate.
It should also be noted that a subset of the intolerant patients can be treated with a combination of CPAP and OAT to reduce the PAP pressure and bring the patient into compliance.
Dr Don H Lowrance
Sleep Apnea Dentist
Corpus Christi, TX