title: Noncontinuous positive airway pressure therapies for obstructive sleep apnea.
abstract: While continuous positive airway pressure is the first-line treatment for obstructive sleep apnea, many patients find this form of therapy undesirable leading to treatment nonadherence. Both mandibular advancement devices and surgical therapy offer alternative solutions for such patients. This article serves to compare the types of surgical interventions and mandibular advancement devices available, their mechanisms of action, and expected side effects. Emphasis is made on the limitations and challenges in the interpretation of the available literature due to the varying definitions of curative success. The effects of mandibular advancement devices and surgical therapy on the apnea-hypopnea index and oxygen saturation are reviewed. Patient-centered outcomes of sleepiness, quality of life, treatment preference, adherence, and their effects on disease-related outcomes of hypertension are summarized. When available, comparative effectiveness trials between these therapies versus continuous positive airway pressure are emphasized. Patient selection criteria, practice parameters, and treatment limitations are discussed.
authors.affiliation: Division of Pulmonary, Critical Care, and Sleep Medicine, Scott and White Healthcare, Texas A&M Health Science Center, Temple, Texas.
authors.forename: Shirley F
authors.initials: SF
authors.lastname: Jones
authors.affiliation: Division of Pulmonary, Critical Care, and Sleep Medicine, Scott and White Healthcare, Texas A&M Health Science Center, Temple, Texas.
authors.forename: Veronica
authors.initials: V
authors.lastname: Brito
mesh_terms: D045422:Continuous Positive Airway Pressure / Q000379:methods; D006801:Humans; D019186:Mandibular Advancement / Q000295:instrumentation / Q000379:methods; D010100:Oxygen / Q000097:blood; D010349:Patient Compliance; D018579:Patient Selection; D011175:Positive-Pressure Respiration / Q000379:methods*; D011788:Quality of Life; D020181:Sleep Apnea, Obstructive / Q000628:therapy*
chemical_list: D010100:Oxygen