Together is Better: Empower your sleep with the help of
Combination Therapy

CPAP and MAD are combined when CPAP or MAD alone does not work effectively to manage sleep apnea. Not all users are able to comply with the use of a CPAP machine daily for up to 4 hours, and there can be many reasons for this, such as mask leakage, discomfort from the mask, or issues with the CPAP pressure. On the other hand, some users with MAD might realize that their Apnea-Hypopnea Index (AHI) during the REM stage of sleep may still be high after a post-treatment sleep study. When we combine CPAP and MAD, we are leveraging their strengths to provide a tailored solution that helps users improve their symptoms and compliance with the CPAP machine. For example, users who can’t tolerate the high-pressure settings delivered by CPAP, or those who experience increased mask leakage, will find combined therapy useful. The additional support from MAD helps to open up the airway. For users who still have a high residual AHI with MAD alone, CPAP can give the user the push they need to open up the airway and further decreasing the residual AHI
to normal range.

In addition to MAD (Mandibular Advancement Device) and CPAP (Continuous Positive Airway Pressure) therapy, incorporating lifestyle changes can further enhance the management of sleep apnea. Depending on an individual’s lifestyle, several modifications can be made, such as weight loss, reducing alcohol intake before bed, and smoking cessation.

Weight gain is positively correlated with an increased risk of sleep apnea. Excess fat around the neck can narrow the airway, increasing the likelihood of airway collapse during sleep. Therefore, managing your diet, potentially with the help of a continuous glucose monitoring device, or incorporating regular exercise into your lifestyle can significantly improve sleep apnea management when used alongside MAD and/or CPAP therapy.

Similarly, smoking can contribute to airway narrowing due to inflammation caused by nicotine. Nicotine also acts as a stimulant, which can disrupt sleep by making it harder to initiate sleep and causing frequent awakenings throughout the night. Smoke cessation can therefore have a positive
impact on both sleep quality and apnea severity.

Alcohol consumption also contributes to sleep apnea by relaxing the muscles in the body, including the upper airway muscles. This relaxation can prolong apnea events, as the body becomes less responsive to airway obstruction, leading to a greater drop in oxygen levels or an increased hypoxic burden. For individuals who enjoy alcohol, complete abstinence may be challenging. However, it is recommended to reduce alcohol intake or avoid drinking in the hours leading up to bedtime to
minimize its impact on sleep apnea.