MAD therapy for snoring and Obstructive Sleep Apnea

Some people struggle to adjust to CPAP therapy, even with a great mask and a well-designed device. For people with mild-to-moderate Obstructive Sleep Apnea (OSA) or as a second intention for severe OSA patients, there’s a proven, effective alternative to CPAP1: the Mandibular Advancement Device (MAD), Narval CC.

Is the Narval CC oral appliance for you?

Your common problems

Loud snoring
Frustration
Refusal of PAP therapy
Quitting PAP therapy after a few years

The MRD solution

Narval CC is an oral appliance that will appeal to adults who want a non-invasive solution to their chronic, loud and bothersome snoring. It’s also a proven solution for those:

1. who seek an alternative to positive airway therapy
(PAP) therapy for treating mild to moderate obstructive sleep apnoea (OSA),
2. who quit PAP therapy.
The Alaska2 study demonstrated that after 1 year, 23.1% of patient quit CPAP therapy, and 47.7% after 3 years. You might be one of them? For mild, moderate or even severe OSA if you’ve demonstrated that you are unable to use CPAP devices, the MRD is a proven alternative that can treat your sleep apnea.3,4,5,6

Your sleep physician will guide you to make the right therapy choice.

What if…

You could have a proven alternative to CPAP?

What are the benefits of effective MRD therapy?

ResMed’s Narval appliance is clinically proven to be an effective treatment for snoring and mild-to-moderate obstructive sleep apnoea (OSA). Here are three key facts about Narval:

  • Snoring disappears : Loud snoring disappears in almost 90% of people who use Narval. Having a reliable way to avoid snoring could help you enjoy better sleep, have a positive impact on your relationship and help you feel more confident.
  • OSA symptoms are reduced : Narval also significantly reduces OSA symptoms: two thirds of OSA patients stop feeling tired during the day when they start using Narval.1
  • Quality of life improves : With effective MRD treatment for your sleep apnoea, you should also enjoy other benefits including better health, a healthier weight, a more positive mood, more daytime energy, happier relationships and a lower risk of accidents.

How does MRD therapy work

A mandibular repositioning device (MRD) is an oral device that’s custom made for you to wear when you sleep. It holds the lower jaw in a forward position to widen the space behind the tongue. This reduces vibration and stops your airway from becoming obstructed.

Snoring-pharynx-collapsed-airflow-blocked

Without Narval:
pharynx is collapsed and airflow is blocked

stop-snoring-with-narval

With Narval:
pharynx is open and air flows freely

What to expect when you choose Narval CC

If you’ve chosen to use Narval CC to help you fight your snoring and reduce the severity of the apnoeas that leave you tired and listless – congratulations! You’re on the journey to better health.  Here’s a short checklist of the key milestones along your journey:

Make sure you’ve been screened for sleep apnoea, and that you know what your AHI is. Getting an optimal solution depends on having the right diagnosis. Plus, it’s the only way to monitor progress.

Find a dentist with experience in dental sleep therapy.  You can ask your sleep physician for a referral, consult the European Dental Sleep Foundation registry, or contact us for help.

In general, you’ll need to see your dentist for a mouth examination and teeth imprints; then you’ll need fitting and adjustment.

Once you have an optimally-fitted Narval CC, wear it as regularly as possible if you want optimal results.

Have a check up with your dentist after 3 to 6 months to ensure your Narval is fitting well and providing the optimal balance between treatment efficacy and comfort. After that, have yearly check-ups just as you do with other healthcare providers.

Make sure you’ve been screened for sleep apnoea, and that you know what your AHI is. Getting an optimal solution depends on having the right diagnosis. Plus, it’s the only way to monitor progress.

Find a dentist with experience in dental sleep therapy.  You can ask your sleep physician for a referral, consult the European Dental Sleep Foundation registry, or contact us for help.

In general, you’ll need to see your dentist for a mouth examination and teeth imprints; then you’ll need fitting and adjustment.

Once you have an optimally-fitted Narval CC, wear it as regularly as possible if you want optimal results.

Have a check up with your dentist after 3 to 6 months to ensure your Narval is fitting well and providing the optimal balance between treatment efficacy and comfort. After that, have yearly check-ups just as you do with other healthcare providers.

Why should I choose a Narval appliance?

There are two types of MRD on the market: custom-made ones like Narval CC, and thermo-plastic MRD that patients need to fit themselves. A recent comparative study demonstrated that a custom-made oral appliance is twice as effective in reducing snoring as a non-custom, thermo-plastic MRDs.2 It has a higher compliance rate – 94% over 69%2– and patients are more likely to prefer the custom-made device (82%).2

Narval is a clinically proven, non-invasive therapy for chronic, loud and bothersome snoring. It’s custom-made to fit precisely in your mouth using advanced CAD/CAM technology. It’s small, discreet and easy to use (including on holiday). You can talk, drink and open your mouth naturally when you wear it. It’s made of a composite material with zero metal, latex and bisphenol A to minimise the risk of allergies. And it’s extremely strong, so you can wear it even if you grind your teeth when you sleep.

starting-mandibular-repositioning-device-treatment-narval

References:

1. Vecchierini MF & al. A custom-made mandibular repositioning device for obstructive sleep apnoea-hypopnoea syndrome: the ORCADES study. Sleep Med. 2016 Mar;19:131-40. doi: 10.1016.
2. Pépin, J.-L.; Bailly, S.; Rinder, P.; Adler, D.; Szeftel, D.; Malhotra, A.; Cistulli, P.A.; Benjafield, A.; Lavergne, F.; Josseran, A.; et al. CPAP Therapy Termination Rates by OSA Phenotype: A French Nationwide Database Analysis. J. Clin. Med. 2021, 10, 936. https://doi.org/10.3390/jcm10050936 Retrospective analysis on 480 000 adult patients with CPAP therapy initiated from 2015 to end of 2016, identified in the French Health insurance claims database, and followed up until end of 2019
3. Vecchierini MF & al. Late Breaking Abstract – Efficacy and tolerability of a custom-made mandibular advancement device (MAD) for the treatment of obstructive sleep apnea (OSA): ORCADES study 5-year follow-up data, European Respiratory Journal 2019; 54: Suppl. 63, OA3272
Étude prospective multicentrique observationnelle sur 331 patients sur 5 ans. Résultats de suivi à 5 ans. Clinical Trials.gov identifier: NCT01326143
4. Attali V & al. Efficacy and tolerability of a custom-made Narval mandibular advancement device for the treatment of obstructive sleep apnea: ORCADES study 2-year follow-up data. Sleep Med. 2019 Nov;63:64-74
Étude prospective multicentrique observationnelle sur 331 patients sur5 ans. Résultats de suivi à 2 ans. Clinical Trials.gov identifier: NCT01326143
5. Tests de compression – Rapport interne ResMed C258999, Mai 2018 – Chapitres 8 et 9: les gouttières Narval résistent à des forces de compression de 500N.
6. CADCAM : Conception Assistée par Ordinateur (CAO ou CAD en Anglais) et Fabrication Assistée par Ordinateur (FAO ou CAM en anglais).