CPAP + Oral Appliance (All-In-One) Device for OSA

A dentist colleague of mine informed me of a new device that combines CPAP mask with an oral appliance for patients with obstructive sleep apnea (CPAP Pro + Mandibular Advancement).

The unique benefits of this combo device are several-fold:

• No straps
• Keeps mouth closed
• Addresses tongue collapse that obstruct the airway by bringing jaw forward
• Can sleep in any position

This device does need to be fitted by a dentist. (For Virginia residents, Dr. Jason Woodside is familiar with this product.)

Of course, it is relatively new and we'll see if patients love this combo CPAP mask more than the traditional masks that have been on the market.

For those patients who do NOT have a problem with tongue collapse, but prefer the no-straps solution of the oral appliance, the company does make a mouthguard that fits only the upper teeth.

Singulair May Help Cure Mild Sleep Apnea in Children

Singulair (generic montelukast as of Aug 2012) is a medication often prescribed for asthma as well as allergies and works by blocking the leukotriene receptor. This mechanism is different than that found in common allergy medications like claritin and benadryl which work by blocking the histamine receptor (anti-histamine).

Singulair has also incidentally been found to possibly help reduce the size of tonsils and adenoids. Given this beneficial affect, singulair may be a helpful intervention in those kids with mild obstructive sleep apnea or nasal obstruction due to adenoid hypertrophy avoid surgical intervention (tonsillectomy and adenoidectomy).

The most recent research published in Sept 2012 suggests that singulair may lessen symptoms in children with non-severe apnea and potentially allow them to skip the surgery.

In the study, 46 children with non-severe sleep apnea received singulair or a placebo for 12 weeks. The kids who received the drug showed improvements in their sleep apnea, their sleep-related symptoms, and the size of their adenoids compared to the placebo group. There were no side effects seen among kids who took the study drug.

Beyond singulair, steroid nasal sprays have also been found helpful to reduce adenoid size.

Singulair can be given from the age of 1 year old.

References:
Leukotriene modifier therapy for mild sleep-disordered breathing in children. Am J Respir Crit Care Med. 2005 Aug 1;172(3):364-70. Epub 2005 May 5.

Leukotriene pathways and in vitro adenotonsillar cell proliferation in children with obstructive sleep apnea. Chest. 2009 May;135(5):1142-9. Epub 2008 Dec 31.

The role of mometasone furoate aqueous nasal spray in the treatment of adenoidal hypertrophy in the pediatric age group: preliminary results of a prospective, randomized study. Pediatrics. 2007 Jun;119(6):e1392-7. Epub 2007 May 28.

Intranasal corticosteroids for nasal airway obstruction in children with moderate to severe adenoidal hypertrophy. Cochrane Database Syst Rev. 2008 Jul 16;(3):CD006286.

New Oral Appliance for OSA (Only Needs Heat to Fit)

A new sleep apnea oral appliance can be fitted and used at home without going to a dentist called ApneaRx!

Oral appliances to treat obstructive sleep apnea (OSA) have an upper and lower component that fit into the upper and lower jaws. A mechanism within the device than allows for the lower jaw to be thrust forward to some degree which pulls the tongue and anterior airway forward thereby enlarging the airway and preventing obstructive apneas during sleep. It can also help with snoring.

Typically, such OSA oral appliances must be fit by a dentist and cost upwards of $300 or more.

Most patients or loathe to spend that kind of money if they are not sure if:

1) It will actually help
2) It will be something they can actually tolerate or use

That's where this new OSA oral appliance called ApneaRx comes in which is considered a "transition" device to try and see if oral appliances will work for a given patient before going with an expensive dentist-fit customized oral appliance.

In essence, the device is heated and bitten into for fitting. The device can than be adjusted in 1mm increments by squeezing from the sides.

If this device "works" for a patient, they can either continue to use this device, or now take the time and expense of getting a customized device from a dentist.

Best of all, you can get it on Amazon!

However, please be aware that there's only one size currently available which may be too large for 20% of patients, especially women. There will soon be a smaller version for those with a smaller mouth by the end of 2012.

Read brochure.