Summary And Conclusions

CPAP


  A continuous positive airway pressure machine (CPAP) is a new device with a mask that fits snugly over the sleeper’s nose. It sends a continuous stream of air under positive pressure that is adjusted for each person using it to hold the throat open through the night.

  Summary And Conclusions

OSA is characterized by breathing and sometimes pronounced body and arm movements. The victim may wake up suddenly with choking sensations, gasping for air, or in a sweat, other symptoms may be frequent napping during the day, especially in inappropriate places (like meetings, or while driving), memory problems, lack of concentration, high blood pressur. Many of these symptoms can also be caused by many other conditions, so diagnosis may be difficult. Orthodontic diagnosis may discover anatomic conditions that could cause this condition. Enlarged tonsils or adenoids in a lateral cephalometric radiagraph, or maxillary width deficiency and narrow nasal cavity in a P.A. radiograph, are indications for questioning the patient about other symptoms. If obstructive sleep apnea is suspected, a medical consultation is in order. It is important to distinguish between central and mixed sleep apnea.

 CENTRAL sleep apnea involves a cessation of respiratory effort, as well as reduced air flow. This condition is relatively rare. MIXED sleep apnea might involve two hundred obstructive and twenty kinds of central apneas, so some A.C. P’s group them together as mixed apneas. The belief is that the central apneas in the category are a secondary effect of the reduced air flow caused by the obstruction rather than a primary etiologic factor. OSA is simply rendered ineffective by the obstruction. It is in this condition that the orthodontist may best participate in relieving or curing the symptoms.

 Developments have been reflected in the updated practice parameters of the American Academy of Sleep Medicine, which now recommend the use of oral oppliances for mild-to-moderate OSA, or for patients with servere OSA who are unable to tolerate CPAP or refuse treatment with CPAP. With this review article we research should focus on determining the influence of the design of oral appliances on clinical outcome, the development of a clinically reliable method for identifying those patients who are most likely to achieve a favorable treatment response, and the characterization of facotors predisposing to long-term adverse effects of oral appliance treatment.

 

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