Oral Appliance as a First-Line Therapy for OSA during the COVID-19 Pandemic
It is the position of the American Academy of Dental Sleep Medicine (AADSM) that oral appliance therapy (OAT) should be prescribed as first-line therapy for the treatment of obstructive sleep apnea (OSA) during the COVID-19 pandemic. This recommendation is being made based on the following information:
• The American Academy of Sleep Medicine (AASM) has indicated that PAP therapy potentially exposes individuals, especially those in proximity to the patient, to increased risk of transmission of COVID-19.
• A number of studies have found evidence that COVID-19 can remain suspended in the air in aerosol particles.
• It is unknown whether it is possible for patients to be re-infected from re-using PAP tubing, filters, and/or masks.
• There have been reported shortages of distilled water and other supplies necessary for optimal use of PAP machines.
• Oral appliances do not generate aerosols and can be easily disinfected by patients to kill the COVID-19 virus.
According to the AADSM and AASM clinical practice guidelines, oral appliances should be prescribed for adult patients who prefer alternate therapy to PAP. During this pandemic, it is reasonable to assume that patients would prefer a therapy that both treats their OSA and does not increase the risk of COVID-19 transmission.
Oral appliance therapy is an effective treatment for OSA without increased risks for transmitting COVID-19. Patients who prefer OAT may be more likely to adhere to treatment if they are confident that their therapy is not putting those in their household at an increased risk for COVID-19 exposure.
Journal of Dental Sleep Medicine Vol 7, Nov 3, 2020