CDA Essentials 2018 • Volume 5 • Issue 6

11 Issue 6 | 2018 | CDA at W ork Treatment Required for Mild OSA? The recent article 1 in CDA Essentials which summarized the Canadian Agency for Drugs and Technologies in Health (CADTH) recommendations for the treatment options of obstruc- tive sleep apnea (OSA) is timely and well-presented. However, I have a concern that the results of the report may be misinterpreted. General dentists are often consulted by their patients regarding the appro- priateness of oral appliance therapy (OAT) for the treatment of snoring and OSA. If this article, and accompanying infographic, were interpreted literally by dentists, they would be advising all patients with “Mild OSA” that active treatment is NOT recommended. The full text of the CADTH Health Technology Assessment report 2 is not so simplistic. In fact, it states that “… treatment may be considered in pa- tients with mild OSA who are sympto- matic.” In other words, those who suffer from snoring or one of the numerous comorbidities such as non-responsive hypertension, acid reflux, morning headaches, depression and excessive daytime sleepiness. Patients generally don’t undergo a diagnostic polysomnogram (sleep study) unless they have symptoms. If a patient received a diagnosis of Reader Response: Obstructive SleepApnea 201 8 • Volume 5 • Issue 4 The views expressed are those of the author and do not necessarily reflect the opinions or official policies of the Canadian Dental Association. We reserve the right to edit all letters or comments submitted to CDA Essentials. mild OSA, it is reasonable for them to expect that this condition be treated. OAT is eminently suitable for successful- ly resolving such mild degrees of OSA and it would be unfortunate if some dentists, based on this article, dissuaded their patients from proceeding with appropriate therapy. Dr. Les Priemer Diplomat, American Board of Dental Sleep Medicine Toronto, ON References 1. Treatment options for obstructive sleep apnea. CDA Essentials 2018; 5(4):32-33. 2. Interventions for the treatment of obstructive sleep apnea in adults: recommendations. Ottawa: CADTH; Mar 2017. (CADTH Optimal Use Report; vol. 6, no. 1c) ISSN: 1927-0127