Biomimetic Oral Appliance Therapy in Adults with Mild to Moderate Obstructive Sleep Apnea

Introduction: For the management of obstructive sleep apnea (OSA) in adults, some professionals prescribe continuous positive airway pressure (CPAP) while others prefer mandibular advancement devices (MADs). However, both CPAP and MADs represent life-long therapy. In this study, we investigated the use of a biomimetic oral appliance system (the DNA appliance® system) to test the hypothesis that the upper airway can be improved in adults that have been diagnosed with OSA. Methods and Sample: We recruited 10 consecutive adults for this study who underwent an overnight sleep study, which was interpreted by a sleep physician. Subjects diagnosed with mild to moderate OSA were treated using biomimetic oral appliance therapy (BOAT). Each subject had monthly follow-up visits, including examinations for progress and adjustments of the devices. The mean AHI of the sample was calculated prior to and after BOAT with no appliance in the mouth. The findings were subjected to statistical analysis. Results: The mean treatment time was 8.7 mos. ± 5.8. Prior to treatment the mean AHI was 13.2 ± 7.2. The mean AHI fell by 65.9% to 4.5 ± 3.6 (p = 0.021) after BOAT with nothing in the mouth when the final overnight sleep study was performed. Conclusion: This preliminary study suggests that BOAT may be able to reduce the AHI to within normal limits perhaps to the extent that life-long therapy may not potentially be necessary. However, long-term follow up is needed to determine whether these subjects need a maintenance program to retain their initial upper airway improvements.