Multilevel oral appliance and method for maintaining a pharyngeal airway

Abstract

Plural tongue gripping projections coupled to upper and lower supports grip and hold the tongue during sleep and minimize the risk of the tongue slipping back and blocking the throat. One or both of the upper and lower supports are biased together. A tongue depressor extends rearwardly and downwardly from a cross member portion of a jaw coupler. A soft palate engager extends rearwardly from the cross member. The tongue grasping device, tongue depressor and soft palate engager cooperatively resist closing of the user's pharyngeal airway. The tongue depressor and soft palate engager are desirably biased apart and supported by flexible supports to permit movement of the rear of the tongue to close the pharyngeal airway during swallowing.

1 . An apparatus for grasping and restraining a front portion of the tongue of a user, engaging a rear portion of the tongue of the user, and engaging the soft palate of a user rearwardly of the hard palate of the user so as to resist closing of the pharyngeal airway of the user, the apparatus comprising:
 a first upper support;   the first upper support comprising a first tongue gripping surface, the first tongue gripping surface comprising a plurality of tongue engaging projections that are adapted to extend toward the upper surface of the tongue of a user;   an upper jaw coupler adapted to couple the first support to the upper jaw of the user, the upper jaw coupler comprising an upper cross member portion;   a second lower support;   the second lower support comprising a second tongue gripping surface, the second tongue gripping surface comprising a plurality of tongue engaging projections that are adapted to extend toward the lower surface of the tongue of a user;   a lower jaw coupler adapted to couple the second support to the lower jaw of the user;   at least one biasing member coupled to at least one of the first and second supports and adapted to urge at least one of the first and second tongue gripping surfaces toward the other of the first and second tongue gripping surfaces with the user's tongue positioned therebetween so as to grasp and restrain the tongue of the user;   a tongue depressor coupled to the cross member portion and projecting rearwardly and downwardly relative to the cross member portion, the tongue depressor being adapted to engage a rear portion of the tongue of a user;   a soft palate engager coupled to the cross member portion and projecting rearwardly relative to the cross member portion; the soft palate engager being adapted to engage a portion of the soft palate of a user; and   wherein the tongue depressor and soft palate engager are adapted to urge the engaged rear surface of the tongue and the engaged portion of the soft palate away from one another so as to resist closing of the pharyngeal airway of the user.   
     
     
         2 . An apparatus according to  claim 1  wherein the tongue depressor comprises a first arm having a first end portion coupled to the cross member portion and a second end portion located rearwardly and downwardly from the first end portion o the first arm, the tongue depressor comprising a tongue depressing portion coupled to the second end portion of the first arm; wherein the soft palate engager comprises a second arm having a first end portion coupled to the cross member and a second end portion located rearwardly of the first end portion of the second arm, the soft palate engager comprising a soft palate engaging portion coupled to the second end portion of the second arm; and wherein the tongue depressor is below the soft palate engager. 
     
     
         3 . An apparatus according to  claim 1  wherein the tongue depressor is movable relative to the cross member portion in upward and downward directions; and wherein the soft palate engager is movable relative to the cross member portion in upward and downward directions. 
     
     
         4 . An apparatus according to  claim 1  wherein the tongue depressor comprises at least one elongated bendable tongue depressor support arm of a material that remains in a bent position following bending, the tongue depressor support arm comprising a first tongue depressor support arm end portion coupled to the cross member portion and a second distal tongue depressor support arm end portion spaced from the cross member portion, and at least one tongue engager mounted to the second distal arm end portion; and wherein the soft palate engager comprises at least one bendable soft palate engager support arm of a material that remains in a bent position following bending, the soft palate engager support arm comprising a first soft palate engager support arm end portion coupled to the cross member portion and a second distal soft palate engager support arm end portion spaced from the cross member portion, and at least one soft palate engager mounted to the second distal soft palate engager arm end portion. 
     
     
         5 . A method of resisting closure of the pharyngeal airway of an individual comprising:
 holding the tongue of the user in a protruded position;   depressing a rear portion of the user's tongue;   pushing the soft palate away from the rear portion of the user's tongue; and   wherein the above acts are simultaneously performed to urge the pharyngeal airway to an open state.   
     
     
         6 . A method according to  claim 5  comprising the act of resiliently depressing the rear portion of the user's tongue and resiliently pushing the soft palate away from the rear portion of the user's tongue with a force that is overcome by swallowing by the user such that the pharyngeal airway is closable during such swallowing. 
     
     
         7 . A multilevel oral appliance for resisting closure of the pharyngeal airway of a user of the appliance, the appliance comprising:
 a tongue protrusion mechanism comprising a first tongue gripping portion coupled to the upper jaw of the appliance user and a second tongue gripping portion coupled to the lower jaw of the appliance user, at least one biasing member operable to bias the first and second tongue gripping portions toward a tongue gripping position to hold the tongue of the appliance user in a protruded position;   a rear tongue portion depressing mechanism coupled to the tongue protrusion mechanism and positioned to engage a rear surface portion of the tongue of the user of the appliance; and   a soft palate elevating mechanism coupled to the tongue protrusion mechanism and positioned to engage and support the soft palate of the user of the appliance, the tongue depressing mechanism and soft palate elevating mechanism urging the engaged portion of the soft palate and engaged rear surface portion of the tongue away from one another.   
     
     
         8 . An upper jaw coupling portion of a pharyngeal airway maintaining apparatus comprising:
 a support adapted for coupling to an upper jaw of a user of the apparatus;   a tongue gripping element coupled to the support, the tongue gripping element comprising a tongue gripping surface with plural upper tongue surface engaging projections; and   first and second tissue contacting members carried by the support, the first tissue contacting member being adapted for positioning to engage a rear surface of the tongue of the user at least during a portion of the time that the support is coupled to the upper jaw of the user, the first tissue contacting member being operable to apply a biasing force to the engaged rear surface of the tongue of the user, the second tissue contacting member being adapted for positioning to engage a portion of the soft palate of the user at least during a portion of the time that the support is coupled to the upper jaw of the user, the second tissue contacting member being operable to apply a biasing force to the engaged portion of the soft palate of the user.   
     
     
         9 . An apparatus according to  claim 8  wherein the first tissue contacting member comprises a first arm carried by the support and at least one tongue engager comprising a tongue engagement surface, the tongue engager being carried by the first arm, the tongue engager being positioned such that the tongue engagement surface engages the rear surface of the tongue at least during a portion of the time that the support is coupled to the upper jaw of the user, the first arm biasing the engaged tongue engagement surface against the engaged rear surface of the tongue. 
     
     
         10 . An apparatus according to  claim 9  wherein the second tissue contacting member comprises a second arm carried by the support and at least one soft palate engager comprising a soft palate engagement surface, the soft palate engager being carried by the second arm, the soft palate engager being positioned such that the soft palate engagement surface engages a portion of the soft palate of the user at least during a portion of the time that the support is coupled to the upper jaw of the user, the second arm biasing the engaged portion of the soft palate engagement surface against the engaged rear portion of the soft palate. 
     
     
         11 . An apparatus according to  claim 8  wherein the first and second elongated arms apply a biasing force that allows movement of the tongue engager and soft palate engager toward one another to close the pharyngeal airway during swallowing by the user. 
     
     
         12 . An apparatus according to  claim 8  wherein the tongue engager comprises first and second spaced apart tongue engagement elements positioned on opposite sides of the center line of the tongue of the user. 
     
     
         13 . An apparatus according to  claim 12  wherein the first and second spaced apart tongue engagement elements are positioned sufficiently close to one another to resist the tongue of the user filling the space between the first and second spaced apart tongue engagement elements. 
     
     
         14 . An apparatus according to  claim 13  wherein the soft palate engager comprises a single soft palate engagement element positioned approximately along the center line of the soft palate of the user. 
     
     
         15 . An apparatus according to  claim 8  wherein the second tissue contacting member comprises a soft palate engager spaced from the support, the apparatus further comprises a spring coupling the soft palate engager to the tongue engager, the spring biasing the soft palate engager and tongue engager away from one another and toward the respective engaged portion of the soft palate and engaged rear surface of the tongue. 
     
     
         16 . An apparatus according to  claim 8  wherein the first and second tissue contacting members comprise magnets of the same polarity, the first and second tissue contacting members being positioned such that magnetic forces of the magnets cause the first tissue contacting member to repel the second tissue contacting member.