Combination CPAP and OAD is Here to Stay

Dr Bradley Eli DMD MS with Majel Carnell CRT

Combination CPAP and OAD is Here to Stay

High Risk Women Age 67 Poor compliance, unmonitored for 5 years

Complaint and AHI within normal limits after 4 months with Sleep Treatment Specialists (STS) treatment

Case Highlights

  • Chief Complaints:
    • OSA/EDS/Snoring
  • Diagnosed severe OSA 2009
  • CPAP non compliant/failure
  • Elevated BMI & HPTN
  • Gastric bypass /Septaplasty
  • STS treatment plan with OAD. PAP and
    • positional therapy
  • AHI dropped from 72-3.5
  • Indicates feeling well and rested
  • Follow up visits
    • Every 3 months

 

Hx: Before Sleep Treatment Specialists

Patient X had a sleep study done in 2009. Results showed she had severe obstructive sleep apnea, with an AHI of 72.5. She was prescribed a CPAP, with a set pressure of 14 cmH2O. Over the years she experienced significant complications with her CPAP use due to removal during sleep and insufficient seal. Her medical history includes OSA, TMJ, HPTN, arthritis, and breast CA. She has undergone multiple surgical procedures over the years including gastric bypass and Septoplasty. She was referred to Sleep Treatment Specialists by her PCP July 2014 by for excessive daytime time sleepiness, non CPAP compliant, elevated BMI, HPTN and TMJ. She was interested in a CPAP alternative.

Sleep Treatment Specialists Plan & Treatment

Initial New Patient Consult:

APAP Resmed

Resmed APAP

07/21/2014 For the first consult we obtained full history from the patient. Impressions were taken for an Oral Airway Device (OAD). We gave her a 5 day Auto set PAP trial. We also went over the importance of positional therapy and weight loss.

07/28/2014 Patient returned APAP. She really liked the auto set pressure and was able to tolerate it a lot better than her set pressure. Her set pressure was too high for her. We ordered her a new APAP machine.

08/18/2014 The Patient picked up her OADAfter making a few adjustments she did a home sleep test to measure the efficacy of her OAD her AHI dropped from 72 to 22!

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Herbst by Gergens Orthodontic Lab

12/17/2014 The patient brought her new CPAP in to be adjusted to her settings. She came in a few weeks later. She is compliant with combination OAD and CPAP

 

Sleep Treatment Specialists

Dr. Brad Eli is a nationally-recognized leader in sleep disorders treatment and pain management.

His expertise in sleep led him to develop a patient-centered method that offers a variety of sleep treatment options and matches each patient with the best treatment for their symptoms and lifestyle. Patients diagnosed and treated by Dr. Eli consistently achieve better compliance rates and improved outcomes. Dr. Eli is the first Medicare and Tricare approved provider for multi therapy sleep treatment in Southern California.

Dr. Eli earned a post doctoral Master’s Degree at UCLA where he received advanced training in sleep disorders. He remains the only expert with this unique skill set in the San Diego region.

He is a member of numerous professional associations including the American Academy of Sleep Medicine and the American Academy of Dental Sleep Medicine. Dr Eli holds multiple patents in the fields of both sleep and pain.