Why do we snore? Do I have OSA?	Type of Treaments Mandibular Advancement Device (MAD)

Currently, there are 4 types of snoring treatments

1. Surgical Treatments

Unfortunately it is difficult to determine with much certainty which procedure is required from the onset, therefore frequently a serial approach to surgery is taken. These procedures have a relatively low success rate in comparison to other treatment options. They are often highly invasive procedures and can be very expensive. All surgical procedures are invasive, non reversible and carry some degree of risk.

Uvulopalatopharyngoplasty (UPPP): The uvula and portions of the soft palate are removed to widen the airway to help prevent collapse. Since the UPPP only treats the throat walls and has a modest success rate, many surgeons will also perform a procedure to pull the tongue forward at the same time as the UPPP. This includes procedures called Genioglossus Advancement and Hyoid Suspension.

Laser assisted UPPP (LAUP): This is a variation of the UPPP that can be done in the office over several visits. The pain of this procedure and the need for up to five treatments has limited this technique's popularity. Over the last few years, a number of new methods of palatal treatment have been created, all of which are invasive.

Somnoplasty: Radio frequency waves are used to cause contraction of the excessive tissues and open the upper airway. This is similar to a LAUP.

Maxillo-Mandibular Osteotomy (MMO): In cases where UPPP and combined procedures have failed, more aggressive surgical approaches have been used. Maxillo-mandibular Advancement Surgery requires cutting the upper and lower jawbones free from their attachments to the skull, pulling them forward and reattaching them in place with metal plates and screws. The teeth remain in good alignment and the net effect is to pull the tongue and its related structures forward, increasing the room in the back of the throat.

Ref: http://www.somnomed.com/index.php?id=110

2. Pillar Procedure

Injecting the pillar into the soft palate to tighten the muscle to reduce snoring

Continuous positive airway pressure (CPAP) is a device that treats OSA by providing a stream of air pressure, through a tube acting as a splint, to hold the upper airway open and prevent collapse. Use of this device requires a sleep study to determine the proper pressure to use. In this way, when a person sleeps, even if his throat muscles relax, the breathing passage stays open.

Figure 4 BreatheX Battery Powered CPAP Machine

4. Oral Appliance Therapy

An oral appliances maintain an opened, unobstructive airway to alleviate snoring and OSA. There are two basic types of oral appliances.

Tongue Retaining Devices
Tongue retainers maintain a forward positioning of the tongue

Mandibular Advancement Devices
Mandibular Advancement Devices (MAD) work by repositioning and maintaining the lower jaw (mandible) in a protruded position during sleep.

MAD is one of the best options to treat snoring, which is the easiest treatment to have and result almost the same as Other Treatments.
FDA granted approval for SomnoMed to market and sell their device, indicated for the treatment of snoring and sleep apnea, in the US.

Ref: US Food and Drug Administration (FDA) 510(k) granted for SomnoMed MADTM