Diagnosis and management of obstructive sleep apnea

Collapsibility of the upper airway in obstructive sleep apnea (osa) causes repeated arousals from sleep,decreased oxygen saturation of the blood,and excessive sleepiness. patients with osa are at increased risk of cardiovascular and cerebrovascular disease,and experience occupational and vehicular accidents more frequently than the general population. nasal continuous positive airway pressure (cpap) is the current treatment of choice,but its cumbersome nature makes tolerance and compliance less than optimal. there is growing interest in the use of oral appliances to treat snoring and osa. the rationale is that advancement of the mandible and tongue impacts positively on upper airway caliber and function. there are many such types of appliances,and they have potential advantages over cpap in that they are unobtrusive,make no noise,do not need a power source,and are potentially less costly. there is a growing evidence base to support the use of oral appliances in the management of osa.