Alternatives to CPAP
All of my experience in sleep having come from the sleep lab, I do not have any hands-on experience with oral appliances. I have done a few sleep studies with appliances in place but that is the extent of my exposure.
I am comfortable supporting the oral appliance in theory. I think it is an excellent option and/or alternative. Thinking of the patients who just cannot tolerate CPAP -- what do we do? Do we tell them in no uncertain terms that CPAP is what they need and they need to try harder to use it? I don't think that's realistic and it's very not very user-friendly.
I think we should embrace new therapies and try to have several options to present to patients. Is a little CPAP better than no CPAP at all? Is an oral appliance better than no intervention ever? Yes!
And can we also concede that while CPAP is the gold standard of treatment for sleep apnea, it is not always practical? Why not have the appliance available for times when CPAP is not practical or convenient, such as when travelling or flying (the oral appliance fits in your pocket) and when camping (no power or water is needed). If a patient has difficulty acclimating to traditional CPAP but really needs intervention should they not be given an option? I think most practitioners would say yes. But I see very little actual implementation of alternatives. I wonder, what are other techs seeing?