An Alternative To CPAP Continued…


Since my last column, I have been flooded with inquiries about the process involved to obtain an Oral Sleep Appliance. Sleep Apnea is a medical diagnosis. When a patient cannot tolerate or will not wear their CPAP machine and requests that I fit them for an Oral Sleep Appliance, the following is the sequence of events that transpire:

  1. Preliminary consultation and screening in my dental office wherein I confirm that the patient is a candidate for an Oral Sleep Appliance.
  2. Insurance and other pertinent health information is gathered.
  3. Contact is made with the sleep physician’s office informing them of the CPAP failure condition of the patient, requesting an order to fabricate an Oral Sleep Appliance.
  4. Patient reports to my office for impressions and a bite registration for the proper positioning for the fabrication of the Oral Sleep Appliance.
  5. 2-3 weeks after impressions, the patient returns to my office for fitting of the Oral Sleep Appliance and instructions on its use and care.
  6. The patient is given 2-3 weeks for a trial use period during which any alterations, adjustments, etc. are made if needed. (seldom needed)
  7. Patient returns to my office with report of wear compliance, general sleep experience including bed partner report. Also report of the patient’s general well-being and diminished daytime sleepiness, if this was a problem in the past.
  8. Based on symptomatic findings to this point in time, a referral is then made returning the patient to the Sleep Physician’s office.
  9. The Physician obtains objective information through a follow-up sleep study confirming the effectiveness of the Oral Sleep Appliance.

CPAP users who want a back-up for power outages or travel, camping, etc. follow the same scenario. Medical insurance and Medicare cover most, if not all, costs for the above treatment.