Every patient is provided with the options of –
- Weight loss advice where warranted
- Sleep hygiene advice
- ENT Referral whenever there is any indication of nasal airway obstruction or tonsli enlargement
- Nasonex or other nasal sprays prescribed where appropriate
- Nasal breathing therapy – the book “The Oxygen Advantage, by Patrick McKeown” is recommended, and breathing coaching provided
- MFT – Tongue posture therapy – a referral to an Oral Myologist and/or “Mewing” videos are recommended for all patients and exercises to improve pharyngeal tone.
- Lip Taping – where nasal breathing is possible and practiced during the day, but developing the habit during sleep is troublesome.
- Nasal valve therapy – nasal cones or breathe right strips where nasal valve collapse is noted and a surgical approach is not desired
- OAT (Oral Appliance Therapy) is recommended for snoring and Mild–Moderate OSA and for those who either do not want or can not tolerate CPAP. This is preferred for those who do not choose Orthopaedic treatment.
- Orthopaedic Maxillo-Mandibular Advancement – including orthodontic treatment – This is my preferred approach and recommended to all who have the appropriate anatomical underdevelopment. This approach (in conjunction with the others listed above) has provided a cure for many of Dr Baret’s patients, and has dramatically improved the condition of all others treated this way.
- Referral for propper fitting of CPAP where appropriate
- CPAP combined with OAT for those who can gain from this approach
- Positional devices advice – where SDB is significantly influenced by sleeping posture
Referral for Maxillo-Mandibular Advancement Surgery – only for the most extreme cases of improper anatomical development. (I have never yet needed to refer for this.)
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