title: Office management of obstructive sleep apnoea: appliances.
abstract: OBJECTIVE
  Oral appliances are becoming increasingly common in the treatment of obstructive sleep apnoea (OSA). They work by advancing the mandible and opening the pharynx. There are several types of devices available for use. Many patients intolerant to continuous positive airway pressure (CPAP) are using oral appliances for OSA.
  
  
  RESULTS
  Oral appliances have been shown to improve polysomnography, quality of life and health measures associated with OSA. There is current work to better identify patients who are ideal candidates. Development of titratable devices and monitoring are optimizing usage. They have been compared with CPAP, with both showing improvement in OSA; however, CPAP remains superior overall.
  
  
  CONCLUSIONS
  Oral appliances are becoming first-line therapy for mild and moderate OSA. They provide a meaningful alternative in severe OSA for patients unable to use CPAP. Device titration and usage monitoring are beginning to hone oral appliances as a therapeutic option.
authors.affiliation: Upstate Medical University, Department of Otolaryngology - Head & Neck Surgery, Syracuse, New York, USA.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Johnson
mesh_terms: D006801:Humans; D009817:Office Management; D009967:Orthodontic Appliances; D011788:Quality of Life; D020181:Sleep Apnea, Obstructive / Q000628:therapy*