A lot of the thin patients with sleep apnea have an overbite and physicians don t tend to note that on an exam but that is a common aspect of upper airway narrowing. Neuropsychological consequences that we consider problems with attention, deficits of working memory. Patients will often complain that Effective therapies are available for the majority of patients. Many patients with mild sleep apnea do benefit from therapy. There is what I would call an expected dissociation between symptoms and projected measurements in severity, and compliance continues to be an ongoing battle.
Effective therapies are available.
For sleep apnea we start with the appliances, sleep apnea dental appliances. Surgical therapies are done, I think too frequently, and pharmacologic therapy I think is coming along as an intervention that we use increasingly. Nasal CPAP I still consider the first line of therapy for the vast majority of patients. Many do go to mandibular positioning devices as described which are best used in patients with mild or moderate disease. I think surgery should generally be used to make another therapy, CPAP, more effective or as I call it salvage therapy.