Sleep Apnea Management with Oral Devices and Mandibular Movement Monitoring

man sleeping with cpap machine

For the longest time, the continuous positive airway pressure or popularly known as CPAP remains to be the gold standard for treating and managing sleep apnea. Although it is effective, many patients cannot tolerate well the machine, especially the annoying sound it makes. This has paved a way for obtrusive oral appliances that move the jaw forward during sleep so as to keep the airway open.

Oral Appliance Therapy

The use of a dental appliance to treat and manage sleep apnea is called oral appliance therapy. The patient needs to see a dentist who is trained in sleep medicine. The subspecialty is called dental sleep medicine. The dentist will create a customized dental appliance which you need to wear during sleep. There are various types of an oral appliance and the one you should wear should be based on the doctor’s assessment of your condition.

sleep man with cpap device

Mandibular movement monitoring in conjunction with oral sleep apnea device

Mandibular movement monitoring can be used to check for the effectiveness of the oral appliance. Mandibular monitoring while the patient sleeps is an indicator of an increased respiratory effort in people with sleep apnea. A sleep study was made involving 56 patients with sleep apnea. They were fitted with a custom mandibular advancement splint and the movement of midsagittal mandible was tracked. During the titration procedure, various levels of advancement were checked up and down to check the right amount to control sleep apnea.

Goal of Mandibular Movement Monitoring

The goal of mandibular movement monitoring is to assess the effectiveness of oral appliance therapy. The sleep study revealed that at the end of the titration, sleep apnea symptoms reduced significantly. There is a reduction of the vertical respiratory mandibular movement and sleep respiratory effort. There is also a dramatic decrease in obstructive hypopnea. The apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) were reduced to a greater extent too.

Mandibular movement monitoring also plays an important role in detecting the presence of central apnea. A group was subjected to mandibular movement monitoring and it showed a decreased in respiratory effort and an increased in the sharp mandibular movement of high amplitude, which shows a persistent sleep fragmentation. These findings were all indicators of central apnea.

Mandibular movement monitoring is one of the best parameters for dental sleep specialist when titrating oral appliances. It helps measure indices of residual respiratory events when obstructive sleep apnea is managed using oral appliances. Mandibular movement monitoring has the ability to optimize the benefits and risk of oral appliances.

Find out more about Dr. Avi Weisfogel and his treatments for sleep apnea.

Leave a Comment