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To the Editor: Dr Shamsuzzaman and colleagues¹ only briefly addressed approaches to treatment of OSA, including continuous positive airway pressure (CPAP) and surgery. Although uvulopalatoplasty is a commonly performed procedure in these patients, it is irreversible and may be followed by relapse in nearly half of all patients.² Mandibular advancement devices, which move the tongue forward and thus prevent it from falling into the airway during recumbency, are another option.^3-5

Mortimer Lorber, DMD, MD
Department of Physiology and Biophysics
Georgetown University School of Medicine
Washington, DC

1. Shamsuzzaman ASM, Gersh BJ, Somers VK. Obstructive sleep apnea: implications for cardiac and vascular disease. JAMA. 2003;290:1906-1914. FREE FULL TEXT 2. Sharp HR, Mitchell DB. Long-term results of laser-assisted uvulopalatoplasty for snoring. J Laryngol Otol. 2001;115:897-900. PUBMED 3. Pancer J, Al-Faifi S, Al-Faifi M, Hoffstein V. Evaluation of variable mandibular advancement appliances for treatment of snoring and sleep apnea. Chest. 1999;116:1511-1518. FREE FULL TEXT 4. Bloch KE, Iseli A, Zhang JN, et al. A randomized, controlled crossover trial of two oral appliances for sleep apnea treatment. Am J Respir Crit Care Med. 2000;162:246-251. FREE FULL TEXT 5. Fritsch KM, Iseli A, Russi EW, et al. Side effects of mandibular advancement devices for sleep apnea treatment. Am J Respir Crit Care Med. 2001;164:813-818. FREE FULL TEXT

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291:557.

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