The effect of mandibular advancement device on apneas and sleep in patients with obstructive sleep apnea

• Objective: To evaluate the effects of a mandibular advancement device on apneas and sleep in, mild, moderate and severe obstructive sleep apnea. Design: Prospective study. Subjects: Forty-four of 47 patients included. Intervention: Individually adjusted mandibular advancement devices. Measurements: Polysomnographic sleep recordings for 1 night without the device and 1 night with it, with a median of 1 day and no changes in weight, medication, or sleep position between the recordings. Results: The device reduced the median apnea-hypopnea index from 11 (range, 7 to 19) to 5 (range, 0 to 17) (p<0.001) in 21 patients with mild sleep apnea, from 27 (range, 20 to 38) to 7 (range 1 to 19) (p<0.001) in 15 patients with moderate sleep apnea, and from 53 (range 44 to 66) to 14 (range, 2 to 32) (p=<0.05) in 8 patients with severe sleep apnea. The arousal index decreased and the sleep stage patterns improved in all severity groups. Twenty-eight of 44 patients were successfully treated with an obstructive apnea-hypopnea index of below 10 and a subjective reduction in snoring. Nine of 16 patients with treatment failure still reported a reduction in snoring. The success rate correlated inversely to the disease severity (r=-0.41; p<0.01). Conclusions: A mandibular advancement device reduces apnea and improves sleep quality in patients with obstructive sleep apnea, especially in those with mild and moderate disease. A follow-up sleep recording during treatment is necessary because of the risk of silent obstructive apneas without subjective snoring with the device.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Odontologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Dentistry (hsv//eng)

Nyckelord

Dental appiances

polysomnography

sleep apnea

sleep stages

snoring

ODONTOLOGY

ODONTOLOGI

Orthodontics

Ortodonti

MEDICINE

MEDICIN

lungmedicin

Lung Medicine

odontologi

Odontology

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