Oral appliance therapy is an alternative treatment option for mild to moderate OSA patients and for the severe OSA patient who cannot tolerate CPAP.  There is a growing body of research which verifies this and the Treatment Parameters position paper put out by the AASM in 2015 outlines their recommendations in the treatment of OSA. 

Compliance Vs Efficacy 

It is well-known that the compliance rates are higher with the oral device, but equally accepted that CPAP provides greater efficacy among patients who can accept this therapy. 

Best Treatment Options 

The dilemma becomes what treatment option gives the patient the best opportunity to be successful in keeping the airway from collapsing and compliant on a daily basis.  It is my contention that any treatment modality not used as directed is not rendering the treatment outcomes we as clinicians are prescribing. 

As health care providers we should be more concerned with the therapy that can create a level of patient satisfaction and compliance that results in long-term benefits. 

Patient Centered Approach 

In future writings I will discuss what a “patient-centered” approach to the treatment of OSA looks like and how including the patient in the conversation can increase the success of OSA treatment modalities.