Tuesday, March 29, 2011

Which CPAP mask is the best?

CPAP (continuous positive airway pressure) has been around as a treatment for sleep apnea and other respiratory diseases since the mid 1970's.  When they first came into commercial use there was a very limited choice in the type of mask you could use.  Most of the masks were modified from the masks used for general anesthesia in the operating room.  As the use of CPAPs became more prevalent it was apparent that the concept of "one size fits all" does not work and was (and still is) a major problem with compliance.  The manufacturers of the masks and equipment have been very innovative in introducing new and much more comfortable masks to the market.
The masks in use currently are generally divided into 3 main types:

Nasal masks- usually a soft gel that just covers the nose
Nasal pillows-soft plastic inserts that fit just into the nose
Full face masks- gel or plastic that covers the nose and the mouth for persons that breath through their mouth or have sinus problems that keep them from breathing through their nose.

The best mask is the one that fits your face and breathing pattern and will not be the same for every person.  Frequently patients will have to try two or three masks at home to find the one that fits them the best.   If you are currently a CPAP patient and are having trouble with your mask please contact your sleep professional or CPAP equipment provider to help you get fitted with the right mask for you.

Wednesday, March 23, 2011

Dental Appliances for Sleep Apnea

The oral appliance for the treatment of sleep apnea has been around for > 20 years but has gained popularity recently due to advertising and enhanced insurance payments.  The device is worn at night and works by pulling the lower jaw out to open the airway and hopefully eliminate snoring and the associated apnea and hypopnea (complete and partial blockage of airflow).  The devices can be ordered from the internet and have a "boil and bite" fit similar to a mouth guard athletes use.  The most effective devices are manufactured from impressions made by a dentist and fitted and adjusted by the dental professional.  The  success rate of the device fitted by the dental professional is about 65-70% for persons with mild to moderate sleep apnea.  Complications from the device include jaw pain and TMJ discomfort, minor shifts in occlusion and drooling.  The oral appliance requires most of your natural teeth to be present for proper fitting.
The oral appliance is a reasonable alternative for patients with sleep apnea who cannot tolerate the CPAP or need to be in areas where electricity is scarce.