PHARYNGEAL AIRWAY VOLUME FOLLOWING ...

mask discomfort, nasal dryness, and congestion, 24 which may
lead to compliance issues. Compliance rates range from
less than 50% 16 to as high as 75%, 24 leaving a large number
of patients in need of another form of therapy.
Oral Appliances
Oral appliances are an available alternative
treatment, especially in patients who find nasal CPAP too
cumbersome to tolerate. 25 These appliances cover the
dentition and position the mandible forward and/or advance
the tongue, and increase the posterior airway space in the
sagittal and lateral dimensions. 1 Although these
positioners are well-tolerated by patients, they have
undesirable effects on the dentition. Otsuka et. al 25 found
significant decreases in occlusal contact area and biting
force in patients who used oral appliances for 5 years.
Proclination of the mandibular incisors, retroclination of
the maxillary incisors, mesial movement of mandibular
molars, and a decrease in the SNB angle have been reported
with long-term usage, 26 as well as temporomandibular joint
problems. 27
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