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      Update on Oral Appliance Therapy for OSA

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          Abstract

          Purpose of Review

          The majority of the adult population is affected by obstructive sleep apnea (OSA), according to recent epidemiological research. Oral appliance (OA) therapy is increasingly recommended, particularly for patients with milder OSA. This review updates the evidence in favor of OA therapy.

          Recent Findings

          A high level of evidence shows that OA is effective in the treatment of OSA, but continuous positive airway pressure (CPAP) is more efficient. Higher adherence with OAs may compensate for this difference. Daytime sleepiness is better treated with CPAP than with OA in patients with severe OSA. In patients with milder OSA, it is unclear whether sleepiness is significantly reduced. The long-term effectiveness of OAs is uncertain because of side-effects and the risk of OSA deterioration.

          Summary

          OAs are effective, but their efficacy is more variable than that of CPAP. More research is needed about the mechanism of action of OA, subjective effects and long-term health outcomes.

          Related collections

          Most cited references93

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          Clinical Practice Guideline for the Treatment of Obstructive Sleep Apnea and Snoring with Oral Appliance Therapy: An Update for 2015.

          Since the previous parameter and review paper publication on oral appliances (OAs) in 2006, the relevant scientific literature has grown considerably, particularly in relation to clinical outcomes. The purpose of this new guideline is to replace the previous and update recommendations for the use of OAs in the treatment of obstructive sleep apnea (OSA) and snoring.
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            Sleep apnea and 20-year follow-up for all-cause mortality, stroke, and cancer incidence and mortality in the Busselton Health Study cohort.

            To ascertain whether objectively measured obstructive sleep apnea (OSA) independently increases the risk of all cause death, cardiovascular disease (CVD), coronary heart disease (CHD), stroke or cancer.
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              Health outcomes of continuous positive airway pressure versus oral appliance treatment for obstructive sleep apnea: a randomized controlled trial.

              Continuous positive airway pressure (CPAP) and mandibular advancement device (MAD) therapy are commonly used to treat obstructive sleep apnea (OSA). Differences in efficacy and compliance of these treatments are likely to influence improvements in health outcomes.
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                Author and article information

                Contributors
                +46706360729 , marie.marklund@umu.se
                Journal
                Curr Sleep Med Rep
                Curr Sleep Med Rep
                Current Sleep Medicine Reports
                Springer International Publishing (Cham )
                2198-6401
                10 July 2017
                10 July 2017
                2017
                : 3
                : 3
                : 143-151
                Affiliations
                ISNI 0000 0001 1034 3451, GRID grid.12650.30, Department of Odontology, Medical Faculty, , Umeå University, ; SE-906 87 Umeå, Sweden
                Article
                80
                10.1007/s40675-017-0080-5
                5592194
                28955651
                7afff453-8de9-4c88-963a-eaef9a43d255
                © The Author(s) 2017

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                Funding
                Funded by: Umea University
                Categories
                Sleep and Otolaryngology (H Gouveris, Section Editor)
                Custom metadata
                © Springer International Publishing AG 2017

                oral appliances,mandibular advancement devices,mandibular repositioning appliances

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