Sleep Apnea

Treatments for Obstructive Apneas, OPAP™: Oral Pressure Appliance

Posted on 12. Dec, 2009 by admin in Treatments for Obstructive and Mixed Apneas

Treating obstructive sleep apnea with a mouthpiece instead of a nose mask is a new idea. The OPAP (Figure 7.4) does just that. It is a small mouthpiece that can be worn either by itself or connected to CPAP tubing and a CPAP machine. By itself, the OPAP appliance can be used like a jaw retainer to hold the lower jaw in a forward position if desired. Attached to a CPAP, it holds the airway open with air pressure, just like a CPAP, but it uses the mouth instead of the nose.

The OPAP may be a new treatment choice for people with mild to severe obstructive sleep apnea who would otherwise be using a standard CPAP nose mask. It also is an option for people who have tried CPAP and had difficulty using it and for people who have had unsuccessful surgery for obstructive sleep apnea. Worn by itself, the OPAP may be an option for people who would otherwise use another of the dental appliances to treat obstructive sleep apnea. The advantage of the OPAP is that it bypasses the nose, where many people have nasal obstructions that make it difficult to use nasal CPAP. It also avoids the mask-fitting issues of CPAP and the skin irritation that some people experience from wearing the CPAP mask against the face. The OPAP does not require headgear, so it may be more comfortable, and it eliminates the “bad hair day” that can greet a person in the morning after wearing CPAP headgear all night.

OPAP is so new that very few patients have had a chance to try it. We have not heard much direct feedback from patients about their satisfaction with an OPAP. In addition, long-term clinical effects are not yet available. Questions remain about how OPAP affects the teeth and the temporomandibular joint (TMJ). People with TMJ problems should consult their dentist about using an OPAP.

At present an OPAP is custom fit like a dental appliance, which can be costly. The cost will probably be in the neighborhood of $500. A less expensive, off-the-shelf model may be available in the future. You should contact your insurance company if you are considering an OPAP and ask whether they will cover the cost.

Ask your sleep specialist whether an OPAP would be appropriate for you. If so, he or she should be able to refer you to a dentist who is trained to fit an OPAP. If not, contact the Sleep Disorders Dental Society for the name of a dentist who is trained to treat sleep disorders.

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Tags: Obstructive Apneas, OPAP, Treatments