Driving With Your Eyes Open!

John Viviano DDS, discusses the findings of this previously published study in ‘Respiration 2011 2: 20’ Aarab G, Lobbezoo F, et al.

Airway Orthotics vs. nCPAP; which is better? Previous randomized controlled trials investigating this have found nasal continuous positive airway pressure (nCPAP) to be superior to Airway Orthotic therapy (AO).  However, in most of these studies, only nCPAP was titrated objectively but not the AO. In order to establish an unbiased comparison between these treatment modalities, the AO should be titrated objectively as well.

The purpose of the cited study was to compare the treatment effects of a “titrated AO” with those of “nCPAP” and an “intraoral placebo device”.  Sixty-four mild to moderate patients with OSA were randomly assigned to three groups: AO, nCPAP and placebo device. From all patients, two in-lab sleep study recordings were obtained; one before treatment and one after approximately 6 months of treatment.

The results demonstrated that the change in the apnea-hypopnea index (AHI) between the baseline and therapy evaluations differed significantly between the three groups. However, no statistical difference was found between the AO and nCPAP therapy, whereas the changes in AHI in these groups were significantly larger than those in the placebo group.

The authors concluded no clinically relevant difference between AOs and nCPAP in the treatment of mild to moderate OSA when both are titrated objectively. A number of very good, user-friendly ambulatory sleep screeners are available for Dentists to use. Consider it something like driving with your eyes open!

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