About Obstructive Sleep Apnea
Obstructive Sleep Apnea (OSA) is a condition caused by repeated episodes of upper airway collapse and obstruction during sleep. The oropharynx in the back of the throat collapses during OSA events, causing oxygen desaturation and fragmented sleep. Of middle-aged adults in the US, 10% have mild OSA, 3.8% have moderate OSA, and 6.5% have severe OSA. Those with mild OSA have about 5-15 apnea events per hour, moderate OSA has 15-30 per hour, and severe OSA has over 30 apnea events per hour. 56% of patients with OSA have positional-dependent OSA, or position sleep apnea, where they experience an increase in apnea events due to the effect gravity has on the repetitive collapse of the upper airway.
Current Devices
The continuous positive airway pressure (CPAP) machine is the gold standard for obstructive sleep apnea, for it has a success rate of 75% and it is the most efficacious used treatment for OSA. Oral appliances (OA) are offered to those who refuse or cannot tolerate the CPAP due to the CPAP being bulky, loud, and not practical for a good nights sleep. Although most patients prefer treatment with an OA over a CPAP, the CPAP has better outcomes in reducing the apnea-hypopnea index (AHI), which is the number of apneas that occur per hour during sleep. OAs improve the upper airway by modifying the position of the tongue and associated upper airway. These devices, however, can be uncomfortable to sleep with and cause jaw pain or sore teeth. Specifically with positional sleep apnea, laying on the back leads to an increase in AHI, for gravity contributes to the repetitive collapse of the upper airway. There are training devices that aim to prevent those with this type of OSA from sleeping on their back to reduce their AHI. An example of this is a device that vibrates when the patient turns to lay on their back during sleep, alerting the user of their position and forcing them to turn to stop the vibration, leading to lack of sleep due to the repetitive vibration throughout the night.