A patient under your care for pulmonary issues has recently been diagnosed with OSA. Following the primary care provider’s recommendation, the patient has completed a home sleep test, which revealed an AHI of 20 events per hour and significant oxygen desaturations. The patient has also reported symptoms of daytime fatigue and sleepiness, refractory hypertension, and loud snoring, as noted by their bed partner.
Additional physical characteristics include: A patient has a BMI of 35 kg/m2 and has experienced worsening and unmanageable hypertension over the past year, despite trying various antihypertensive medications alone and in combination. The patient’s tonsils and adenoids are normal-sized, but they have an enlarged tongue with a Mallampati score of class III. There are no abnormalities in their facial features or jaw positioning, but they have a history of significant temporomandibular joint (TMJ) pain.
As a clinician, the patient is seeking your guidance for treating their newly diagnosed obstructive sleep apnea (OSA). Your responsibility is to research four possible treatment options: continuous positive airway pressure (CPAP), oral appliance, maxillomandibular advancement surgery, and hypoglossal nerve stimulation therapy.
After conducting your research, the goal is to construct an easy-to-read treatment recommendation for this patient.
Lastly, explain why this is the best treatment for the patient and you must take into consideration the patient’s physiologic factors. support the decision by referencing at least one peer-reviewed journal article. Please use legit reference material that is not ChatGPT created and can be found using website or DOI