CPAP machines have been the go-to treatment for Obstructive Sleep Apnea (OSA) for many years. However, there are now several alternatives available, such as mandibular advancement devices (MADs) and continuous negative external pressure therapy (cNEP). In this article, we will explore the benefits and drawbacks of these new treatments and discuss how they compare to CPAP. Mandibular advancement devices are designed to increase the width of the upper airway, improving the airway structure and reducing symptoms. The success rate of MAD therapy is between 37 and 42.6%, but it is not as effective as CPAP in severe OSA cases. There are also several barriers to the provision of MADs, such as cost, patient compliance, and device durability. Despite these limitations, MADs have been shown to reduce daytime sleepiness, arousal index, and snoring. Continuous negative external pressure therapy (cNEP) is similar to CPAP but creates negative pressure outside the airway. It is designed to expand the airway and prevent structural collapse. It is also more convenient than a CPAP machine. A pilot study found that nine out of fifteen patients had a good response to cNEP therapy. A 2011 review of nine controlled studies found that EPAP therapy positively affected snoring and reduced daytime sleepiness in people with OSA. Overall, both MADs and cNEP are viable alternatives to CPAP machines for mild to moderate OSA cases. However, more research is needed to determine their efficacy in more severe cases. It is also important to note that neither of these treatments is as effective as CPAP in reducing apnea events.
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