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Combined Therapy in Ballston Spa, NY

Oral appliance and CPAP mask resting on tableWhile CPAP therapy and oral appliance therapy are two very effective approaches to treating sleep apnea, they often cannot help a patient on their own. Thankfully, Dr. Fred Dreher and our team at Integrative Sleep Center is able to offer something called combined therapy, in which these two treatments come together to maximize their benefits. Combined therapy offers a solution to patients who feel like they’ve tried everything, and often, it’s able to finally give them the full night’s sleep they need. Before discussing how combined therapy works, let’s first talk about the two individual treatments that make it.


Sleeping man wearing CPAP nose mask

CPAP Therapy

CPAP (continuous positive airway pressure) therapy has long been seen as the gold standard of sleep apnea treatment. It works very simply: a patient wears a facemask that is connected to an air pump that forces air into the throat in order to prevent it from becoming blocked. While it has been successful in helping millions of patients, it also has present others with additional problems. Many find the mask to the uncomfortable, and some patient even describe feelings of claustrophobia. The sensation of the air being pumped into the throat prevents many people from falling asleep, and this also creates a lot of noise. Beyond these common issues, some patients simply don’t experience relief from their sleep apnea with CPAP therapy alone. In this case, they could possibly benefit from using oral appliance therapy or combined therapy.


Model of teeth with oral appliance in place

Oral Appliance Therapy

Oral appliance therapy uses a custom-made mouthguard to slightly shift the jaw forward so that it can stay open during the night, allow a patient to breathe normally and sleep peacefully. It’s often a viable alternative to CPAP therapy, and it is actually the first recommended treatment for mild to moderate Obstructive Sleep Apnea (OSA) by the American Academy of Sleep Medicine. It’s easier to use, simply to travel with, and often has a much higher patient compliance rate than CPAP therapy. However, if a person is suffering from severe OSA or Central Sleep Apnea (CSA), it may not be able to provide complete treatment. Thankfully, it has been shown to work well with CPAP therapy to form a solution called combined therapy.


Sleeping woman wearing CPAP nasal mask

How Combined Therapy Works

With combined therapy, a patient will use a CPAP machine while wearing an oral appliance. Thanks to the assistance of the oral appliance, patients will able to use a much smaller nasal mask and set the machine to a lower setting. This tends to be much more comfortable and drastically reduces the noise that can cause so many problems for people. Also, because less air is being forced into the throat, patients will experience relief from common CPAP problems like sore throats and dry mouth. This is also an ideal solution for people who travel often by plane. Often, people simply leave their CPAP machine at home because it is bulky, and luggage space is at a premium these days. With combined therapy, they can simply take their treatment with them with a small, easy to pack oral appliance. This will help them get the peaceful sleep they need wherever they are, which is a great way to reduce stress while on the road.


Person with full CPAP mask laying awake in bed

When Should a Person Consider Combined Therapy?

Combined therapy, like all sleep apnea treatments, is not right for everyone. During your free consultation, Dr. Fred Dreher and our team will evaluate you to determine which course of treatment is the best solution for you. If the following situations apply to you, combined therapy may be your sleep solution:

  • If you are CPAP intolerant or are not able to use it consistently.
  • If you are not able to get the sleep apnea relief you need using just oral appliance therapy.
  • If your sleep apnea is not successfully treated by CPAP therapy alone.

Man with CPAP nasal mask sleeping soundly

The Benefits of Combined Therapy

  • More Comfortable: Most patients find the nasal mask to be much more comfortable and less restricting than the full facemask. Plus, since they are able to set the machine to a lower setting, they don’t have to contend with the noise or the overwhelming sensation of air being forced into the throat. This reduces morning symptoms like dry mouth and sore throat, plus it makes it much easier for the patient to share a bed without disturbing their partner.
  • Easier to Use: The biggest enemy of CPAP therapy is compliance. Simply put, nearly 50% of people who are prescribed to use a CPAP machine stop within the first year because of the issues we’ve discussed above. Thanks to the increased comfort of combined therapy, patients are much more likely to consistently use it night after night, which will provide them with the long-term solution that will maximize its health benefits.
  • More Effective: Multiple studies have shown that combined therapy is able to reduce the number of apnea events (pauses in breathing) a patient experiences during the night. One such study conducted by the American Academy of Dental Sleep Medicine found that a patient using just CPAP therapy typically experienced about 4 apnea events an hour, while those using combined therapy only experienced about 2.
  • Increase Convenience: The CPAP machine is quite bulky, which is why people tend to leave it at home whenever they travel. With combined therapy, they can simply take their oral appliance with them so they can get the rest they need no matter where they are. This enables them to have more sustained treatment, which helps increase their overall health for a longer amount of time.

Smiling man on cell phone

Contact Us Today

If you haven’t been able to get the rest you need thanks to CPAP therapy or oral appliance therapy alone, combined therapy could be your answer. When you come to Integrative Sleep Center, we will evaluate your current treatment plan, sleep test results, and other diagnostic information to determine if combined therapy is the right solution for you. The first consultation is free, so you have nothing to lose. Sleep is vital part of keeping your mind and body healthy and we’re here to help with any problems. If you’re ready to sleep again, contact our office today. We are located in Ballston Spa, but we also happily accept patients from Saratoga Springs, Cohoes, Watervliet, Schenectady, Gloversville, and Glens Falls, NY.

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