Life is a present but you must open it. Malcolm Kohler More Quotes by Malcolm Kohler More Quotes From Malcolm Kohler Most doctors still consider CPAP as first-line treatment for patients with obstructive sleep apnea, if a patient can not really use CPAP adequately e.g. only two to three hours per night, but does fine with a MAD which he can tolerate for seven hours a night, then he should be treated with a MAD. Malcolm Kohler health-news