By NICK GOSNELL
Hutch Post
HUTCHINSON, Kan. — Hutchinson Regional Healthcare System pulmonologist. Dr. Mohammed Al-Halawani was the lead author on an academic paper regarding treatment of sleep apnea in veterans with PTSD who could not tolerate the use of a CPAP machine.
"With sleep apnea, as we fall asleep, the muscles relax and that includes the muscles of the airway and the tongue," Dr. Al-Halawani said. "When they relax, they fall back and block the airway. If the blockage is partial, you snore. If the blockage is complete, you have a breathing pause, or an apnea."
The innovation was to use a dental appliance or Mandibular Advancement Device instead of a CPAP to keep the muscles out of the way during sleep.
"It's a custom fitted device," Dr. Al-Halawani said. "You go to a dentist who is certified in dental sleep medicine and has experience in these devices. They custom fabricate the device for you. The device protrudes your lower jaw, so the jaw is protruded forward and it pulls with it the tongue and the neck tissue behind it, or the pharynx tissue behind it and that prevents collapse at night."
The paper, that Al-Halawani collaborated with his colleagues from Yale on, was entitled Acceptance and Efficacy of Mandibular Advancement Device Treatment in Military Veterans With Obstructive Sleep Apnea: Effect on Posttraumatic Stress Disorder and published in the Journal of Dental Sleep Medicine.
"The success rate in our study was about 65%," Dr. Al-Halawani said. "The number may sound low, but these are 65% of people who would be on no treatment otherwise."
Of 75 subjects who met initial inclusion criteria, 49 completed the study protocol. Twenty one of those said they also had PTSD and 11 of those said those symptoms improved.