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I would encourage the CPAP tolerant patient to say on PAP therapy as it can’t be beat! If the patient wants an oral appliance for travel and is CPAP tolerant that is fine. I would still want a script from the physician (it can be the primary care physician or sleep physician) for oral appliance therapy for travel purposes. Most likely the medical insurance will not cover the appliance since they are CPAP tolerant so it would be fee for service!!
It really doesn’t matter what severity the patient’s OSA is! It matters if they are CPAP intolerant!!! As long as you have a diagnosis and a script from a physician you may treat the CPAP intolerant patient if they are mild, moderate or severe.
-Dr ZYX
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I would like to clarify a question which was brought up by a staff member the other day. My understanding is that we should only make an OSA appliance if the patient is CPAP intolerant. What if the patient is tolerant but would rather have an appliance than the CPAP or would like an appliance for travel? Please clarify for us when we should or should not recommend an appliance to treat mild to moderate sleep apnea.
-Dr XYZ
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