Doctors solve high abandonment of CPAP by prescribing mouthpieces

Lots of people who think they are getting enough sleep, may actually have sleep apnoea, and some adults have the classic signs of loud snoring and broken sleep for years without knowing their airways have been obstructed.

In the past decade there has been a big jump in the number of people being diagnosed with night-time respiratory problems and sleeping disorders, but It is estimated that Obstructive Sleep Apnoea (OSA) affects about 5 per cent of adults in the UK, with the condition being more common in males.

Man wearing a mask for treating sleep apnea. Mildly obese man suffering from sleep apnea and having a CPAP treatment

Man wearing a mask for treating sleep apnea. Mildly obese man suffering from sleep apnea and having a CPAP treatment

Obstructive Sleep Apnoea, or OSA, is characterized by seriously disrupted breathing when sleeping, which cuts off oxygen to the brain as often as 100 times per hour in the most severe cases. The consequences of the disease are becoming more and more apparent, with links to heart disease, cancer, strokes and diabetes.

However, patients with OSA face a huge issue: 50% of them abandon the main form of treatment within three months of starting it.

The continuous positive airway pressure (CPAP) machine is the first line of therapy for severe cases of OSA in patients, but it has serious downsides too. In most cases, CPAP has a mask that users wear over their mouth and nose. It has historically been a loud and invasive treatment, forcing patients into particular sleep positions. The airflow created by the bedside pump can be cold, and feel dehydrating too, and it causes claustrophobia for some.

A recent news article quoted a patient who said that his inability to use the machine wasn’t even a conscious one.

“I would just rip it off, within 5 minutes of me falling asleep,” he said.

His apnoea worsened. He suffered night terrors when his breathing became obstructed, extreme exhaustion during the day from repeated wake-ups, drowsiness while driving and his blood pressure spiked. Finally he started to use a custom-made mouthpiece to help support his jaw and to keep his airway open. He says he still wakes up two or three times per night, but for the first time in 20 years he’s waking up refreshed.

“I really started to get some really noticeable relief,” he said.

Numerous research studies have said that the current rise in obesity rates was also driving up the figures. Over the last 25 years we’ve seen a significant expansion in the waistlines of the general community, and that’s led to increased fat deposits within the upper airway and to increased incidents of sleep apnoea as a result.

Researchers stated that there certainly is a link between ageing and the propensity of the airway to collapse. Certainly all the structures within the body start to get a bit floppy as we get older, and the same occurs for the upper airways.

The realization that the CPAP machine has such a high abandonment rate has fuelled research into identifying OSA’s causes more directly and tailoring therapies for each individual patient. So for patients who’ve tried CPAP machines in the past and can’t tolerate them, it’s worth looking at the innovation in treating OSA that has evolved over the past few years.

Mouthpieces – the approved solution for those who dislike CPAP

Mouthpieces are technically called mandibular repositioning devices (MRD’s), or mandibular adjustment devices (MAD’s) because they move the jaw forward which opens the throat and keeps the airway open.  A big added benefit of the mouthpiece is ease of use for travel, unlike CPAP.

There is a wide range of medically approved oral appliances available from companies such as SleepPro, who are Britain’s leading provider of snoring solutions. SleepPro products are accredited by the British National Health service (NHS) and have been exhaustively tested in UK Hospitals where they are supplied to patients for both snoring and OSA.

SleepPro offers a choice of several starter appliances, including the market leading Starter appliance, Easifit, which after being immersed in hot water will shape to your mouth for an excellent and comfortable fit – a system they term ‘Boil’n’Bite’ that has revolutionised the fitting of mouthpieces. A similar appliance exists specially for women.

To this they have added micro-adjustable devices such as Contour that will improve the effectiveness and give added comfort, and additionally, they supply fully tailor-made appliances such as the SleepPro Custom.

All of these oral appliances have excellent pricing points and have money back guarantees. Those appliances that are custom moulded have very high effectiveness rates, and are much cheaper than similar appliances supplied by dentists. They are the next recommended line of therapy for patients who can’t tolerate CPAP machines.

All SleepPro products are British made in their own dental laboratories and are available for online purchase without prescription.

John Redfern