There is unfortunately no medication. Most of the treatment are used to avoid snoring or sleep apnea but they are no curative. When I have suspicion that my patient might have Sleep apnea, the first thing I do is to refer him to a colleague ENT or sleep pathologist who will diagnose the severity of the pathology with an overnight sleep test called a polysomnogram, or a "sleep study. My duty is to screen and found those 4 to 8 % of the population that hads this pathology, and specially the 85% that doesn't do anything about it.
Based on the nature of the obstruction and the severity of your pathology, the team can recommend several options, including :
- Mandibular Advancement Device
- Continuous Positive Airway Pressure machine (CPAP)
- Surgical procedure
The most common treatment for sleep apnea is the use of a continuous positive airway pressure (CPAP) device, which 'splints' the patient's airway open during sleep by means of a flow of pressurized air into the throat.
A mandibular advancement device is an oral appliance that maintains the lower jaw in forward position during your sleep. This mechanical protrusion widens the pharyngeal area and reduces the obstruction phenomenon. Numerous clinical studies have proved the efficacy of custom-made mandibular advancement devices in the treatment of snoring as well as mild to moderate obstructive sleep apnoea. Significant improvement has also been shown on associated symptoms such as daytime sleepiness and fatigue.
Medical consensus also recognises mandibular advancement devices as a second line treatment for severe OSA patients who are unable to use CPAP. The dental specialist plays an important role in the treatment process.
The first step in the process is the prescription or recommendation by a sleep disorders specialist to treat the patient with the O.R.M.® type Device. Then the patient usually consults a dental specialist who will;
- Validate that the patient has no contra-indications to wear an oral appliance;
- Realize teeth impressions, since the O.R.M.® type Device is a custom made device;
- Assess maximal protrusion capacity of the patient.
Dental specialists are also in charge of fitting the splint during a second appointment. They will perform the protrusion adjustments of the splint to optimize treatment efficacy.
To finish with a funny tone, in 2005 study in the British Medical Journal found that learning and practicing the didgeridoo helped reduce snoring and sleep apnea as well as daytime sleepiness. This appears to work by strengthening muscles in the upper airway, thus reducing their tendency to collapse during sleep. Puhan MA, Suarez A, Lo Cascio C, Zahn A, Heitz M, Braendli O (February 2006). "Didgeridoo playing as alternative treatment for obstructive sleep apnoea syndrome: randomised controlled trial". BMJ 332 (7536): 266–70.
