A detailed diagnostic sleep studies on each patient must be done before treatment commences, to determine precisely what the nature and severity of their condition is. The results of the sleep study are then reviewed by an independent specialist sleep physician who will determine and prescribe an appropriate form of therapy.
If oral appliance therapy is prescribed, a specially trained and qualified dentist will custom-make an appliance, generally known as a mandibular repositioning device (MRD) or mandibular advancement splint (MAS). These devices are something like an orthodontic splint and are designed to sit comfortably inside the mouth while asleep. As their names suggest, MRD and MAS are designed to hold the mandible (lower jaw) and connected tissue forward and clear of the airway. Key benefits of this form of therapy is that the devices are extremely discreet, require no power to operate and are highly portable. This makes the devices an excellent choice for people who travel frequently, or who are sometimes unable to get access to mains power (for instance, when they go camping or boating.)
In more severe cases constant positive airway pressurisation (CPAP) is usually considered to be the most appropriate solution. This form of treatment works by introducing gently pressurised air into the upper airway to 'inflate' the soft tissue and stop it collapsing and blocking the airway. The pressurised air is introduced to the airway through a humidified hose and carefully fitted face mask which sits comfortably over the mouth and / or nose.
While this might not sound all that attractive, CPAP is recognised as the most consistently effective form of treatment, especially for severe cases of sleep apnoea. With a good CPAP nurse taking care of you, this form of treatment becomes surprisingly comfortable.
In really severe cases, ear, nose and throat (ENT) surgery may be necessary to remove, reduce or re-tension different parts of the soft tissue. Surgical intervention is normally considered a 'last resort', unless there is some specific malformation or growth which is crowding the nasal passage, oral cavity or upper airway.
The important point to note is that there are 'horses for courses'. No one solution will be suitable for all patients. When seeking treatment for your sleep disorder, make sure you deal with a provider who can offer the different forms of treatment, or who can at least refer you to experts who can. Beware of providers who only offer one form of treatment as they tend to have a vested interest in promoting it. And be particularly suspicious if the provider does not insist on a diagnostic sleep study (known as a polysomnogram) before commencing treatment.
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