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Difficult-to-treat OSAS: Combined continuous positive airway pressure (CPAP) and mandibular advancement devices (MADs) therapy.

August 3rd, 2018   |   Posted in: Dr. Halstrom News, Education Centre, silencer-news, Uncategorized

Dr. Halstrom’s clinical experience with patients who wear both CPAP and an Oral Appliance is consistent with this recently published case presentation.

BACKGROUND:

Obstructive sleep apnea syndrome and is characterized by recurrent episodes of partial or complete upper airway collapse during sleep with consequent oxygen desaturations and cardiovascular, neurological, and metabolic impairment.

CLINICAL PRESENTATION:

The authors report the case of a 66-year-old male presenting “metabolic syndrome” (obesity, impaired glucose tolerance, dyslipidemia, multi-drug treated arterial hypertension), atopy, mouth breathing due to turbinate hypertrophy, and pathological daytime sleepiness. As patient’s compliance to standard continuous positive airway pressure (CPAP) therapy was poor, he was treated using low-pressure CPAP combined with a mandibular advancement device (MAD).

CONCLUSION:

In selected patients, a treatment combining CPAP and MAD might be a more tolerable alternative to CPAP alone. The improved pharyngeal patency, promoted by mandibular advancement and stretching of the pharyngeal muscles, allows operating the CPAP at lower pressures when the MAD alone is not sufficient to induce a safe sleep profile.

 

Cranio. 2018 Jul 26:1-5. doi: 10.1080/08869634.2018.1496628. [Epub ahead of print]

Difficult-to-treat OSAS: Combined continuous positive airway pressure (CPAP) and mandibular advancement devices (MADs) therapy. A case report.

Luzzi V DDS, PhD1, Brunori M MD, DDS2, Terranova S MD, DDS3, Di Paolo C MD, DDS1, Ierardo G DDS, PhD1, Vozza I DDS, PhD1, Polimeni A MD, DDS1.