The first kind specifically protrudes the tongue. The second causes the mandible to protrude, opening the airway during sleep. Oral Devices Oral appliances require custom fitting, according to Sam Kuna, MD, chief of Pulmonary, Critical Care and Sleep Medicine at the VA Hospital in Philadelphia. The trays are designed to help move the lower jaw forward to maintain a patent opening. Oral appliances are gaining popularity among OSA patients because many feel claustrophobic wearing CPAP devices and opt out of surgery, Kuna said.
Patients find it easier to wear something in their mouth than a mask covering the face.
If the patient chooses an oral device, the patient's mandible needs to be moved forward gently and adjusted with patient comfort of foremost consideration, Kuna said. With 50 different models, the physician can usually find the right one. Md. Constant episodes of hypoxia associated with apneic episodes cause secretions of epinephrine and norepinephrine into the OSA patient's blood stream, keeping their blood pressure from normalizing. OSA patients have no drop due to constant arousals, so even patients with mild to moderate OSA are at high risk for hypertension. The Pennsylvania State College of Medicine released a study late last month supporting Hunt.