Obstructive sleep apnea otherwise known as OSA, is a condition that occurs when a person is asleep and is known to cause hypoxia, excessive sleepiness during the day, as well as sleep fragmentation. Obstructive sleep apnea is also linked to mood disorders, cognitive impairment, hypertension, ischemic heart disease, and cerebrovascular incidents.
When it comes to treatment of obstructive sleep apnea, dentists are in a unique position as they are well placed to manage and provide primary care through the prescription of intra-oral appliances in cases where the patient experiences moderate or mild obstructive sleep apnea.
On top of this they are in a position to manage dry mouth, which frequently occurs during treatment using Continuous Positive Airway Pressure also known as CPAP. CPAP is the most common and effective treatment for obstructive sleep apnea.
One of the side effects that is frequently reported by sleep apnea patients undergoing CPAP therapy is mouth dryness. This occurs when air around the mouth leaks out. This is regardless of the type of CPAP mask used. Even though study results vary, there is one study that points to the fact that mouth dryness frequently occurs when those undergoing CPAP therapy use oronasal masks compared to nasal masks.
What is Oral Dryness?
Oral dryness is such an issue with CPAP patients that many have discontinued their CPAP therapy all together. In fact, numerous studies have shown that around 29 to 83% of sleep apnea patients could not use CPAP machines specifically because of the dry mouth issue.
Non-compliance that results from mouth dryness, which occurs when the patient breathes through their mouth using nasal CPAP. This is a challenge to effective treatment. In addition, it increases the risk of related long-term comorbidity when the patient stops undergoing CPAP therapy.
One study conducted using sleep apnea patients with an age ranging between 45 to 70 years from Australia, China, and New Zealand. The patients who had a medical history of stroke, obstructive sleep apnea, coronary heart disease and ischemic attack. They were put in a CPAP arm of a wider study that was termed the SAVE trial.
Subjects in this trial reported leaking problems, mask fit, nasal symptoms as well as mouth dryness as adverse events that they experienced with mouth dryness being the most common one. Mouth dryness affected an overall 42% of patients.
The study concluded that dry mouth as a side effect was independently associated with a decrease in CPAP adherence at 12 months. They study also came to the conclusion that optimizing early use of CPAP equipment as well as interventions to reduce side effects is key to enhancing the long term use of CPAP adherence in patients that have obstructive sleep apnea that is moderate or severe.
Other studies have indicated that patients are more likely to continue with CPAP therapy if patterns of CPAP adherence are established as soon as the patients starts CPAP therapy.
Treatments for Oral Dryness
Fortunately, if a CPAP patient experiences dry mouth during the day, there are a number of over-the-counter drugs that are easily available and can help patients mitigate the effects of dry mouth.
If the patient is experiencing excessive dryness in the course of the night due to a condition such as Sjorgen’s disease, it is more challenging to manage. Thankfully, there are products that exist that have a record of being effective in managing excessive dry mouth during the night as well as dry mouth that is associated with use of CPAP equipment.
XyliMelts® is one such product. It is designed to work as an adhering disc that can be attached to the teeth or gingiva. It is shaped like a disc and works by slowly dissolving over time. On one side, the drug is coated with a vegetable gum adhesive, which makes it possible to attach it to oral surfaces.
Empirical assessment has shown that patients using these oral adhering drug wake up to an after taste of mild mint flavoring. This gustatory effect combined with mechanical stimulation that is provided by the adhering disc, was found to diminish the perception of oral dryness once the patient awoke according to this study .
You can review some of the reviews that have been posted online for XyliMelts®. Most of the people who review this drug have indicated a marked improvement in night time dry mouth that is not associated with CPAP use. Patients who undergo CPAP therapy and suffer from dry mouth have also praised the drug saying how effective it is.
As a CPAP therapy patient, we urge you to cautiously interpret the efficacy of any product that offers relief for dry mouth. Based on the research quoted above, there is a clear correlation between CPAP therapy and dry mouth. The studies also indicate that XyliMelts® is good treatment for dry mouth based on empirical evidence as well as the testimonials that many happy patients have left online.