Author: Dr. Mayoor Patel, DDS, MS
Approximately 80 percent of patients with post-traumatic stress disorder (PTSD) have at least one comorbid psychiatric disorder. The most common comorbid disorders include depression, alcohol and drug abuse, and other anxiety disorders. In a study from Dove Press, the connection between PTSD and obstructive sleep apnea (OSA) was addressed.
It found that patients with PTSD and OSA experience a low adherence to continuous positive airway pressure (CPAP). This is often due to fixed, pressure-induced expiratory pressure intolerance (EPI), which is a subjective symptom and objective sign aggravated by anxiety sensitivity and somatosensory amplification.
What Does This Mean For Dentists?
While this might just look like a lot of abbreviations and long words, it is actually something we can benefit from and it might not be an area you ever thought about looking into. PTSD is a very complicated condition and the medical field continues to look for solutions. Knowing that PTSD and OSA might be connected, we need to pay closer attention to our patients and their conditions.
As dentists, we can offer another solution for their noncompliance issue with CPAP therapy. If a patient is experiencing this disruption in care, oral appliance therapy might be a better option for them. Listen closely to what they have to say about their experience and go from there. We are in the unique position to help those patients and we need to continue to provide that service to them. Knowing this is an issue for patients with PTSD, I hope you can take it back to your practice and continue to offer superior dental care.
Look Beyond CPAP Therapy
This is probably the main reason why patients should visit the dentist. While the CPAP machine is beneficial for a variety of reasons, it still might not be the best solution for everyone. Most people feel that compared to CPAP therapy, an oral appliance is very comfortable and easy to use. There are even social reasons that make oral appliances very appealing.
The Benefits of Oral Appliance Therapy
One of the leading benefits of oral appliance therapy is the increased mobility. Oral appliance therapy is extremely convenient and comfortable. Imagine traveling with a CPAP machine. Where do you store it? Do you have to pay extra for a carry-on? We understand that our patients are in need of an option that is less intrusive, which is where an oral appliance comes into the picture.
Oral appliance therapy is extremely convenient and comfortable. Overall, these devices tend to be more economical and are generally a lot easier to tolerate and use. Still, there is no one-size-fits-all scenario and oral appliances work well by themselves in combination with other therapies. Currently, the largest number of patients suffering from sleep apnea is in the mild to moderate categories and should be treated with oral appliances.
Treatment Is Important
As soon as a patient is diagnosed with sleep apnea, it is important to find out if they are a good candidate for an oral appliance. The best odds of success are for those who have mild to moderate sleep apnea—working with your patient’s sleep doctor can help your patient gain a better understanding of what type of sleep apnea they have. When patients are referred to a sleep study, it is important for them to be educated about all of the available options. There is very little downside to a properly fitted and adjusted oral appliance.
All too often many patients have said that they wish someone had told them about oral appliance therapy sooner. This is where us as dentists can help. We tend to be the ones that notice signs and symptoms of sleep apnea before the patient even recognizes there is an issue.
By attending an upcoming lecture or seminar, you can help your team better understand how to help your patients with sleep apnea and PTSD. It might just be as simple as changing treatment to an oral appliance.
We have some great upcoming educational courses to help further improve your understanding of sleep apnea treatment in the dental field. For more information, visit our Dental Sleep Medicine schedule page. If you have any further questions, please contact us through our site or by phone at 1-800-879-6468.