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Efficacy versus Effectiveness in the Treatment of Obstructive Sleep Apnea: CPAP and Oral Appliances

January 7th, 2017   |   Posted in: Dr. Halstrom News, Education Centre, silencer-news, Uncategorized

Efficacy versus Effectiveness in the Treatment of Obstructive Sleep Apnea: CPAP and Oral Appliances


1Department of Respiratory and Sleep Medicine, Royal North Shore Hospital and Sydney Medical School, University of Sydney, Sydney, Australia; 2Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia

ABSTRACT

Obstructive sleep apnea (OSA) is a chronic disorder and effective long-term treatment is necessary to prevent associated health risks. Standard treatment remains continuous positive airway pressure which is highly efficacious but has well-recognized limitations, with suboptimal patient acceptance and adherence rates, which in turn obviates the desired health benefits. The leading alternative device treatment is oral appliances. Patients often report preferring oral appliances to CPAP treatment, with better usage rates. However, unlike CPAP, inter-individual variability in the efficacy of oral appliance therapy means that patients are often left with some residual OSA. Despite discrepancies in efficacy (apnea-hypopnea index [AHI] reduction) between CPAP and oral appliances, randomized trials show similar improvements in health outcomes between treatments, including sleepiness, quality of life, driving performance, and blood pressure. Similar results in terms of health outcomes suggests that although the two treatments have different efficacy and treatment usage profiles, these result in similar overall effectiveness. In this narrative review, we discuss efficacy versus effectiveness in relation to CPAP and oral appliance treatment of OSA.

Citation:

Sutherland K, Phillips CL, Cistulli PA. Efficacy versus effectiveness in the treatment of obstructive sleep apnea: CPAP and oral appliances. Journal of Dental Sleep Medicine 2015;2(4):175–181.

2 Responses to “Efficacy versus Effectiveness in the Treatment of Obstructive Sleep Apnea: CPAP and Oral Appliances”

  1. I am isotope my adult son needs help, while sleeping he stops breathing and after a laboured attempts to try to gasp for breath (3-5 labourous attempta) he finally gasps for air, this is his entire night of what seems to be his sleep. How much would an device cost?

    • Hello Patty:

      Our professional device fee is just under $3,000. Insurance coverage can sometimes be available under Extended Health Benefits plans such as Blue Cross / Sun Life for example.