Alternatives to CPAP Clinic

The Michigan Medicine Alternatives to CPAP Clinic provides comprehensive evaluation and treatment plans for patients with obstructive sleep apnea (OSA) who cannot tolerate continuous positive airway pressure (CPAP) treatment.

Who Will I Meet with During My Visit?

During your visit to the Alternatives to CPAP Clinic, you will meet with and be evaluated by members of our experienced team:

  • A sleep medicine specialist
  • An ear, nose and throat (ENT) surgeon
  • An oral and maxillofacial surgeon (OMS)
  • A dentist who specializes in sleep medicine

Here is what you can expect with each evaluation.

Sleep Medicine Specialist

You’ll meet with the sleep medicine specialist on the same day or prior to meeting with the other specialists. The goal of the sleep medicine specialist is to understand what difficulties you encounter when you use the CPAP device.

The sleep medicine specialist will review with you the results of your sleep study (which was conducted prior to your appointment) and will discuss other factors about your sleep apnea that may need to be addressed as part of the Alternatives to CPAP Clinic evaluation.

The sleep medicine specialist will also work with you to arrange a clinic follow-up regarding your OSA condition when necessary.

Ear, Nose and Throat (ENT) Surgeon  

Your evaluation with an ENT surgeon begins with a medical history and physical exam, as well as a review of the results of your previously conducted sleep study.

If you are considered a candidate for surgery, you may undergo a laryngoscopy or nasopharyngoscopy. These diagnostic procedures use an endoscope attached to a bright light to look into the nasal passages and far back into the throat. The instrument is usually passed through the nose after a nasal spray is used to shrink and numb the nasal membranes. This frequently performed exam provides a more thorough look at the nose, mouth and throat in order to diagnose problems that are otherwise difficult to observe.

Visit our Surgical Alternatives to CPAP page to learn more about specific surgeries.

Oral and Maxillofacial Surgeon (OMS)

An Oral and Maxillofacial specialist will evaluate you to assess how your unique jaw, facial bones and oral soft tissue anatomy may be contributing to airway obstruction and sleep apnea.

A maxillofacial Cone beam CT scan or CBCT, a type of low radiation 3-D scan, images the upper part of the neck, jaw, facial bones, sinuses and the upper airway to assess risk factors for obstruction.

Using 3-D airway analysis software, we compute the volume of the upper airway and locate the narrowest cross-sectional area to determine where the airway obstruction is occurring. This imaging also demonstrates any sources of nasal obstruction, and the relationship of the jawbones relative to the skull. This information is used to determine if you are a good candidate for surgical repositioning of the upper or lower jaw.

Visit our Surgical Alternatives to CPAP page to learn more about specific surgeries.

Sleep Medicine Dentist 

Sleep Medicine dentists offer a non-surgical treatment, known as a sleep apnea oral appliance, for obstructive sleep apnea. The sleep apnea oral appliance is suitable for patients with mild to moderate obstructive sleep apnea who have attempted CPAP without improvement or who could not tolerate using CPAP and do not want to pursue a surgical approach. Since some patients with OSA experience challenges with CPAP, the sleep apnea oral appliance is a secondary option that could provide improved treatment results. 

Our team begins by evaluating your eligibility for a sleep apnea oral appliance. The evaluation entails an extraoral and intaoral screening to determine if your teeth, gums, soft tissue and temporomandibular joints (the two joints connecting the jawbone to the skull) are healthy enough to wear a sleep apnea oral appliance. You may be recommended for dental treatment prior to proceeding. Once the examination has been completed, a dentist will discuss with you the benefits, limitations and consequence of using a sleep apnea oral appliance.

The most common type of appliance is the mandibular advancement device, which moves your mandible (lower jaw or jawbone) forward to determine the best position where you may gain the most benefit.

A sleep study with a trial oral appliance may be recommended to determine the effectiveness of your future sleep apnea oral appliance, which would be conducted prior to fabricating a sleep apnea oral appliance.

Visit our Non-Surgical or Dental Alternatives to CPAP page to learn more about the sleep apnea oral appliance.

Make An Appointment

To schedule an appointment at the multidisciplinary Alternatives to CPAP Clinic, please call 734-232-8259. A physician referral is required prior to your appointment date.