The two most common therapies for Obstructive Sleep Apnea are continuous positive airway pressure (CPAP) and mandibular advancement splints (oral appliance). These two therapies have similar benefits to patients but differ in comfort, ease of use and compliance levels. Traditionally, CPAP has been the first choice of physicians for treatment of patients with OSA. Low CPAP compliance rates and high efficacy results for the oral appliance have physicians reconsidering this choice.
Studies show that 30 to 50% of CPAP users are noncompliant. In contrast, oral appliance users report nearly 100% compliance. Noncompliant patients are at risk of stroke, obesity, drowsy driving accidents and many other health concerns associated with OSA.
CPAP patients report machine noise, strap lines, mask discomfort, nasal dryness and claustrophobia as reasons for giving up on CPAP. Noncompliant CPAP patients also report frustrations with having too little information on how to use the equipment and knowing who to call with questions.
Compliance continues to be a primary distinction between CPAP and oral appliance therapy. It should be no surprise that physicians now involve patients in the OSA therapy decision. Patients can now choose the therapy that suits their health needs as well as their lifestyle and preferences. Recent reports show that when given a choice, patient compliance increases for both therapies with 50% of patients now choosing to start with an oral appliance.
References: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3738032/ http://www.thecpapshop.com/the-challenge-of-staying-compliant-researchers-link-stroke-sleep-apnea-and-death