A New Therapeutic Approach is Now Available — Physicians Urge Symptomatic Patients to Seek Prompt Evaluation at Affiliated Dental Clinics

Frequent Nighttime Awakenings Without Nightmares?
Obstructive Sleep Apnea (OSA) is often caused by the relaxation of the pharyngeal and tongue muscles during sleep, which leads to partial or complete airway obstruction in the supine position. As a result, many patients experience frequent arousals due to intermittent hypoxia over the years.Despite this, fewer than 122,000 individuals in Taiwan have been clinically diagnosed and treated. In contrast, U.S. studies estimate that approximately 20% of adults suffer from this condition. Extrapolating from Taiwan’s adult population, over 3 million people may remain undiagnosed and untreated, facing prolonged cerebral hypoxia that significantly increases the risk of myocardial infarction and stroke.Due to frequent disruptions in sleep, continuous positive airway pressure (CPAP) therapy is widely recommended as a first-line treatment to maintain airway patency during sleep. However, CPAP devices can themselves negatively impact sleep quality due to discomfort, noise, or poor compliance.

Ms. Lee, a patient suffering from Obstructive Sleep Apnea, endured the condition for over a decade before receiving proper treatment. She frequently woke up 4 to 5 times per night due to apneic episodes, and the resulting daytime fatigue severely impacted her ability to engage socially—even preventing her from enjoying quality time with her grandchildren on weekends.She initially hoped that continuous positive airway pressure (CPAP) therapy would provide relief. However, her heightened sensitivity to the presence of headgear and the operational noise of the machine made it difficult for her to adapt, resulting in little to no improvement in sleep quality.Following a referral to a dental specialist, she began a new oral appliance therapy. As a result, she experienced her most restful and uninterrupted sleep in nearly ten years.According to Dr. Ta-Yuan Wang, former Dean of the School of Dentistry at Taipei Medical University, patients who experience discomfort or reduced sleep quality with CPAP therapy may benefit from a new dental treatment involving a patented mandibular advancement device specifically designed for sleep apnea management.

Physician: Patients Frequently Report Three Major Challenges with CPAP Use — Potential Impacts on Physical and Psychological Well-Being

There are various treatment options for Obstructive Sleep Apnea (OSA). According to the clinical guidelines of the American Academy of Sleep Medicine, Continuous Positive Airway Pressure (CPAP) therapy is generally recommended as the first-line treatment⁵.
Dr. D.Y. Wang notes that although CPAP therapy is the standard first-line treatment, patients often report several common challenges associated with its use.
The first concern involves disruptions to daily life. The machine is bulky and comes with numerous components, making it difficult to transport—particularly while traveling. During the COVID-19 pandemic, if patients contracted the virus, it was nearly impossible to properly sanitize the equipment, often requiring full replacement.
The second issue occurs during sleep. Patients often struggle to wear the mask correctly; improper fit can cause air leakage that blasts directly onto the face, leading to discomfort. Additionally, the sensation of a foreign object strapped to the head can prevent full relaxation. Over time, mechanical noise from the device may also develop, further compromising sleep quality.
The third concern is psychological. Realizing that OSA is a chronic condition requiring lifelong dependence on a CPAP device can lead to significant emotional and mental stress for many patients.

A New Hope for Obstructive Sleep Apnea: A Three-Step Treatment Available at Partner Dental Clinics

Dr. Wen Shizheng, Director of Shihua Dental Clinic, explains that the cause of obstructive sleep apnea (OSA) is the relaxation of the tongue muscles. For severe cases, patients may not be able to breathe properly even when using a continuous positive airway pressure (CPAP) device. Ms. Chen, a patient suffering from asthma and severe obstructive sleep apnea, frequently relies on the CPAP machine. However, due to the severity of her condition, she can only lie back at a 15-degree angle to breathe properly while sleeping. She needs to stack up to 7 pillows before sleep, spending a significant amount of time setting up. Due to the severity of her condition, the CPAP device often fails to effectively clear her airway during sleep, leading to an emergency room visit about once a month. Both she and her family are afraid at night, not knowing if she will wake up after falling asleep. Dr. Wen Shizheng states that as long as the airway is effectively maintained open and the optimal angle is achieved to avoid discomfort affecting sleep, combined with self-healing training to strengthen muscle ability, obstructive sleep apnea may improve through three steps.

Ms. Chen, after using the new treatment, successfully improved her obstructive sleep apnea. She can now lie at a better angle each night and no longer needs to frequently visit the emergency room. She can now sleep peacefully without worry.

The treatment eliminates the burden of using a breathing machine, offering the potential to improve the patient's quality of life.

Dr. Wang Dayuan stated that patient Mr. Wu had previously tried using a breathing machine for treatment. However, due to his work requirements, which often involved traveling between the United States, Taiwan, and Mainland China, he was unable to bring the bulky device, including the tubing and mask, on business trips. As a result, he often felt mentally exhausted while working abroad and would frequently lose focus during conversations, significantly affecting his work efficiency. After undergoing the treatment, his sleep quality improved, and he felt more energized at work. Now, with the convenient and easy-to-clean oral appliance, discomfort from wearing it has been reduced, allowing him to maintain good sleep quality even when staying away from home. After three months of treatment, his condition has successfully improved, and he reported a noticeable enhancement in his sleep quality.

Dr. Liu Nanyou, Director of the Evergreen Dental Alliance, stated that in recent years, the number of patients with obstructive sleep apnea seeking treatment at dental clinics has gradually increased. Introducing this new treatment can help many patients who are not accustomed to using CPAP machines. Numerous clinics across Taiwan have already started incorporating this technology, including: Taipei Hongcheng Dental Clinic, Banqiao Xin'an Dental Clinic, Xindian Licheng Aesthetic Dental Clinic, Yonghe Shihua Dental Clinic, Taoyuan Jingdian/Jingzhi Dental Clinics, Hsinchu Chong'an Dental Clinic, Taichung Yatis Dental Clinic, Taichung Jingdian Aesthetic Dental Clinic, Lugang Hebu Dental Clinic, Kaohsiung Changqing Dental Clinic, Kaohsiung Jipin Dental Clinic, and others.

The main symptoms of obstructive sleep apnea include snoring, waking up suddenly, fatigue, excessive sleepiness, and irritability. This condition is most common in middle-aged and older males with obesity and a larger neck circumference. If you or your family members experience any of these symptoms, it is recommended to seek medical examination and treatment as soon as possible.

資料來源

1. Burden of Sleep Apnea: Rationale, Design, and Major Findings of the Wisconsin Sleep Cohort Study。Terry Young。AHI>5 男24%、女9%。AHI>15 男9%、女4%。
2. 鐘威昇、侯承伯。阻塞性睡眠呼吸中止症候群。家庭醫學與基層治療，2013。台灣家庭醫學醫學會，筆者統計健保資料庫統計約0.49%診斷率
3. 同上資料，筆者統計約有20%成年人罹病
4. 同上資料，研究指出約有20%成年人罹病，因此以台灣2021成年人口數進行推估
5. Marin JM, Carrizo SJ, Vicente E, Agusti AG. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure : an observational,2005
6. Treatment of Adult Obstructive Sleep Apnea with Positive Airway Pressure: An American Academy of Sleep Medicine Clinical Practice Guideline,2019