Sleep Specialists: An Integral Key in the Treatment of OSA
At OASYS we firmly believe in a fully integrated multi-disciplinary approach to the management of OSA. Obstructive sleep apnea may present with a wide range of symptoms resulting in a variety of referral pathways. A multidisciplinary approach to examination and diagnosis helps to determine the most appropriate treatment plan for each individual. The patient is seen by each member of the team, appropriate investigations undertaken and a further meeting arranged at which all opinions are discussed. A reasoned treatment regime is produced, taking into consideration the patient's wishes and overall medical condition.
Although patients may be referred from a variety of sources, OASYS suggests that all patients consult a Sleep Physician to assess their suitability for the OASYS, and then to a dentist for device fitting. General Practitioners may also be involved, both in the initial diagnosis and in the referral to the Sleep Physician.
For the treatment of OSA, the OASYS is worn during sleep to maintain the patency of the upper airway by increasing its dimensions and reducing collapsibility. It is a custom made oral device that is comprised of upper and lower dental plates to maintain mandible protrusion.
Oral appliances in the treatment of OSA
For years CPAP has been the standard treatment for obstructive sleep. Previously, most respiratory physicians would prescribe nightly use of the CPAP for the treatment of OSA. However, CPAP has drawbacks, including discomfort from the mask, a dry or stuffy nose, and eye irritation. CPAP treatment for OSA is only effective if the patient is willing to use the device. Unfortunately, due to the often uncomfortable and invasive nature of this treatment method CPAP has a relatively low compliance rate ranging from 40% to 70%. Many patients find this treatment uncomfortable or intolerable and seek an alternate treatment method such as the OASYS.
The OASYS is the first dental device to address both vulnerable regions of the respiratory tract. By repositioning the mandible it holds the lower jaw forward to keep open the pharyngeal area in back of the tongue. Acting as a nasal dilator, it decreases airway resistance so it improves ease of airflow through the nasal passage.
Benefits of dental devices such as the OASYS seem to offer the following benefits:
- Significant reduction in apneas for those with mild-to-moderate apnea, particularly if patients sleep either on their backs or stomachs. They do not work as well if patients lie on their side. The devices may also improve airflow for some patients with severe apnea.
- Improvement in sleep in many patients.
- Improvement and reduction in the frequency of snoring and loudness of snoring in most (but not all) patients.
- Higher compliance rates than with CPAP.
Dental devices have also shown better long-term control of sleep apnea when compared to uvulopalatopharyngoplasty (UPPP), the standard surgical treatment. There are also few complications with a dental device.
Below you will find details about the OASYS product and how it benefits patients for the treatment of OSA.
OASYS Product Overview
The OASYS is an upper airway management system for the treatment of snoring and obstructive sleep apnea. The OASYS ORAL/NASAL AIRWAY SYSTEMTM is FDA approved as a medical device K040330 in two separate classifications (1) As a mandibular repositioner for treatment of snoring and sleep apnea and (2) as a nasal dilator for improved ease of breathing. The OASYS ORAL/NASAL AIRWAY SYSTEMTM is the first dental device to address the resistance to breathing in the entire upper airway (both the nose and the throat).
Features of the OASYS Oral/Nasal/Airway SystemTM
- Mandibular Repositioning
- Nasal Dilation
- Adjustability
- Maximal Intraoral Volume
- Reduction of Forces on Teeth
- Freedom of Movement
Mandibular Repositioning
The OASYS Oral/Nasal/Airway SystemTM repositions the mandible forward which brings the base of the tongue forward, opening the oropharynx and strengthening the upper airway. This results in greater resistance to airway collapse. By holding against the front teeth it uses the proprioceptive stimulation of the dentition to encourage the mandible to reposition in a gentle way.
Nasal Dilation
The OASYS Oral/Nasal/Airway SystemTM accomplishes dramatic nasal opening by means of the "nasal buttons" that extend off the upper shield that applies a stretch to the inner nasal structure from within the mouth. Our research shows an increase of 14% volume in the nasal valve which can represent a 48% increase in airflow and reduction in resistance of the nasal passage by one half. (See Effect of Intraoral Nasal Dilation Appliance Sleep and Breathing)
Adjustability
The OASYS Oral/Nasal/Airway SystemTM is easily adjusted to position the mandible in the most effective forward posture. Simply moving the lower base segment forward to slide the connecting wire through the tube and locking the stop collar back down to the new position, the OASYS is now ready to wear.
Maximum Intraoral Volume
The O2 OASYS ORAL/NASAL AIRWAY SYSTEMTM accomplishes dual action of mandibular repositioning and nasal dilation while maintaining maximum intraoral space for the tongue. It even has an opening between the front teeth to invite the tongue forward so that the base of the tongue is brought forward and the oropharynx is maximally opened.
Reduction of Forces on Teeth
The OASYS Oral/Nasal/Airway SystemTM comes with an upper splint that distributes the forces of repositioning throughout the entire upper arch and provides a cushion for the upper component. The OASYS Oral/Nasal/Airway SystemTM has a natural flexibility of the connecting wire that will "give" in response to retrusive movements of the mandible.
Freedom of Movement
The OASYS ORAL/NASAL AIRWAY SYSTEMTM is fixed solely to the lower arch. This creates a freedom of motion by allowing movement of the mandible in all directions without locking onto the upper arch.