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What is CPAP?

Author: Donald Tanenbaum DDS MPH - Board-Certified Orofacial Pain Specialist at New York TMJ & Orofacial Pain

Date: August 22, 2011

CPAP, or Continuous Positive Airway Pressure, is the primary therapy used to manage a condition called Obstructive Sleep Apnea (OSA). As the airway narrows during sleep in individuals with OSA, the CPAP device is designed to provide a constant flow of compressed air under pressure to keep the airway open.

Often called the most effective nonsurgical treatment for obstructive sleep apnea, wearing a CPAP mask at night can improve the quality of sleep. Nightly use of the CPAP machine can also reduce high blood pressure, daytime sleepiness and snoring.

Though the CPAP machine can provide great results, it is NOT the right solution for everyone. As a matter of fact, many people find CPAP to be uncomfortable, preventing them from falling or staying asleep. As a result, according to the American Sleep Apnea Association, 60% of CPAP users discontinue use within one year because of discomfort or side effects.

Drawbacks of CPAP include:

• Can cause excessive dreaming and nightmares
• The mask often causes skin irritation
• The mask or nasal attachments often slip out of position while sleeping, diminishing the effectiveness of the device
• The airway hoses can wrap themselves around the wearers head
• The mask creates a sense of claustrophobia
• The machine is loud and can disrupt you or your sleep partner

Alternative to CPAP

An alternative to a CPAP machine is a custom fitted oral appliance which can be used to prevent snoring and to treat mild to moderate sleep apnea. Scientific studies have shown that properly constructed and adjusted oral appliances have the capacity to consistently facilitate nighttime air flow into the lungs thereby reducing the risk of stroke and high blood pressure developing in individuals with this medical condition.

An oral appliance works one of two ways. The first and most commonly utilized type of oral appliance repositions the jaw forward, carrying the tongue out of the airway . This type of appliance attaches directly to the teeth of the upper and lower dental arches. With the tongue forward the patency of the airway increases. The second type which is infrequently used is called a tongue retaining device. This appliance attaches only to the tongue and via a suction mechanism, the tongue is pulled forward out of the mouth. The end result is typically a sore tongue and a restless nights sleep.

The Perfect Marriage

As any one treatment over the course of many years can become monotonous we continue to advocate the use of both oral appliances and CPAP in patients that seek our advice. Whether a fixed schedule of alternating between the oral appliance and the CPAP is established or whether the oral appliance is just worn when traveling for work or on vacation, many of our patients have benefitted from this scenario. As over the long term oral appliances have been shown to have a better than 70% compliance they have therefore become an important component of managing OSA and socially disruptive snoring.

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Dr. Donald Tanenbaum has been practicing in New York City and Long Island for over 20 years. He is uniquely qualified to diagnose and treat Sleep Apnea, facial pain, TMJ and TMD problems, muscle pain disorders, nerve pain disorders, tension headaches, and snoring. Learn more here

DISCLAIMER: The advice offered in response to your questions is intended to be informational only and generic in nature. Namely, we in no way offer a definitive diagnosis or specific treatment recommendation for your particular situation. Our intent is solely educational and our responses to your actual questions serve as a springboard to discussion of a variety of dental topics that come up in a day-to-day dental practice. Any advice offered is no substitute for proper evaluation and care by a qualified professional.

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