Oral Pressure Therapy for Treatment of Obstructive Sleep Apnoea

Many people suffer from sleep apnoea yet few people know this fact. This is because sleep apnoea remains undiagnosed within a majority of the population. Obstructive sleep apnoea is a condition wherein there is cessation or reduction of air flowing into the lungs during sleep. This results in desaturation and diminished ventilation, thus giving rise to various health problems. These health problems range from hypertension to coronary artery disease, cardiac dysrhythmia, cerebral vascular accidents, and diabetes. Therefore sleep apnoea needs to be diagnosed and treated immediately.

There are various treatment options for obstructive sleep apnoea. Continuous positive airway pressure or CPAP is a noninvasive therapy that creates pressure between the posterior oropharynx and the anterior oropharynx to move tissues anteriorly and improve air flow in the airway. While CPAP is claimed to be an effective treatment by many experts, many patients cannot tolerate this method. Other treatments for CPAP are mandibular repositioning appliances, positional therapy, and weight loss.

Oral pressure therapy (OPT) is another treatment method for sleep apnoea. This method uses a bedside console containing a pump, a soft polymer mouthpiece, and a flexible tube connecting the mouthpiece to the console. The console creates vacuum in the oral cavity intended to pull the soft palate anteriorly to decrease airway obstruction during sleep. This device was recently developed to have ten standard sizes to accommodate a range of oral dimensions in individuals without requiring a custom production process for each patient.

A recent study in the May 2013 issue of Nat Sci Sleep, aimed to examine the safety and initial effectiveness of this new noninvasive OPT system with premanufactured mouthpieces. Fifty-six men and 20 women, aged 50.8 ± 12.0 years (mean ± standard deviation [SD]) who had OSA were studied. The results showed that OPT was generally well tolerated without any serious adverse events and that it reduced apnoea–hypopnea indices (AHI). The minimum oxygen saturation increased after treatment and Stage-N1 sleep shifts, total sleep-stage shifts, and awakenings were significantly reduced with treatment. Thus the authors concluded that OPT can improve OSA in certain subjects and shows potential as a clinically useful new alternative for treatment of OSA without the need for custom manufacture of an oral device component.

However, this study was done only on a single night of treatment. Thus, durability of treatment is not evaluated and more long-term treatment studies are needed. Indeed more studies are needed to determine its true efficacy and safety in a larger population.

Reference:

Farid-Moayer M, Siegel LC, Black J. Oral pressure therapy for treatment of obstructive sleep apnoea: clinical feasibility. Nat Sci Sleep. 2013 May 14;5:53-9. Available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3666154/pdf/nss-5-053.pdf

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