The NIH is frequently funding studies on CPAP effectiveness but has a history of grossly unerfunding studies on oral appliance therapy. This is extremely important because the majority of patients reject CPAP and prefer oral appliances. The NIH should consider pushing researchers to compare CPAP treatment results not only to untreated patients and healthy controls but also to patients treated with oral appliances.
Oral Appliances are the Gold Standard for compliance when compare with CPAP. While CPAP is the gold standard for treatment, it is a gol standard that fails the majority of patients completely. 60% abandon therapy completely. Medicare has recognized poor CPAP compliance and now requires 70% usage for four hours.
The dirty secret of sleep medicine is that 4 hurs a night is not goo treatment. It is better than no treatment. Oral Appliances are typically used all night but objective measurement is lacking.
The NIH should direct the bulk of research into sleep apnea into always having an oral appliance group, especially for mil to moderate sleep apnea where oral appliances are considered a first line treatment along with CPAP
The NIH should actively fund research comparing Oral Appliance results to average CPAP use results.