“ We recommend that sleep physicians consider prescriptions of oral appliances , rather than no treatment , for adult patients with obstructive sleep apnea who are intolerant of CPAP therapy or prefer alternate therapy .”
-THE AMERICAN ASSOCIATION OF SLEEP MEDICINE
The finding of equivalent health outcomes with CPAP and Oral Devices in recent publications could therefore likely be explained by similar sleep adjusted AHIs with CPAP and COAT . To figure the sleep adjusted AHI , simply use the equation below :
Sleep adjusted AHI = ( AHI X number of hours on treatment ) + AHI X number of hours untreated ) / total hours of sleep
WHY ORAL DEVICES AND WHY NOW ?
Why oral devices ? The American Association of Sleep Medicine ( AASM ) issued the following statement :
“ We recommend that sleep physicians consider prescriptions of oral appliances , rather than no treatment , for adult patients with obstructive sleep apnea who are intolerant of CPAP therapy or prefer alternate therapy .”
Oral devices are appropriate now , more than ever , because more and more patients are being left untreated . The best clinical outcomes for oral device therapy are achieved when there is synergy between the sleep physician , the sleep dentist and the patient . A certified sleep dentist goes through extensive training to provide the best care , and relies on the sleep physician to prescribe the device and keeps the lines of communication open while the patient travels successfully through each step of the treatment pathway .
The ideal metric for treatment should take into account both the AHI and the compliance .
Using oral device therapy could be the treatment option that works best for patients – and it ’ s certainly better than leaving them on a treatment that they won ’ t use .
JAGDEEP BIJWADIA Chief Medical Officer at SomnoMed
As Chief Medical Officer of SomnoMed North America , Dr . Bijwadia is charged with helping to define strategy for the medical initiative , build clinical research educational programs and create collaborative bridges between physicians and dentists . In addition to his leadership of SomnoMed , Dr . Bijwadia has an active private clinical practice in Saint Paul MN . He previously served as Attending Physician at HealthPartners Medical Group ( HPMG ), where he was the Department Head and Director of the Sleep Medicine Center before stepping down to take the CMO role at SomnoMed . He holds a faculty position as Assistant Professor in the Department of Pulmonary Critical Care and Sleep Medicine at the University of Minnesota where he served as Director of the Sleep Program until 2012 .
Dr . Bijwadia earned his medical degree and did his internship and residency at Mumbai University . He then moved to the United States , where he completed his internship and residency at Nassau University Medical Centre at the State University of New York , where he was named Chief Resident of Internal Medicine in 1991 . Dr . Bijwadia completed a Fellowship in Pulmonary and Critical Medicine at the University of Southern California . He is board certified in Internal Medicine , Pulmonary Diseases , and Sleep Medicine . He completed the Executive Course at the Physician Leadership College at St . Thomas University , Opus College of Business in Minneapolis , Minnesota in 2011 and Health Insurance Executive Certification at the American Health Insurance Plans and Kellogg School of Business . He is currently enrolled in the Executive MBA Program at St . Thomas University Opus College of Business .