title: Treatment of sleep apnea with prosthetic mandibular advancement (PMA).
abstract: Nine males with sleep apnea DOES syndrome and three males with sleep apnea DIMS syndrome were treated with prosthetic mandibular advancement (PMA). The method uses a prosthesis, which is designed to advance the mandible 3-5 mm to prevent upper airway occlusion during sleep. The apnea index in the obstructive-type apnea and the percentage of time spent in obstructive apnea decreased significantly with PMA. Although the apnea index showed merely a tendency to decrease in central apnea (p < 0.1), the percentage of time spent in central apnea decreased significantly with PMA. A marked improvement in sleep structures was observed with PMA; a significant increase was seen in total sleep time, percent slow wave sleep (SWS) and percent rapid eye movement (REM) sleep, and the time spent in intra-sleep awakening decreased remarkably. PMA had excellent effects on snoring, and daytime hypersomnolence was reduced in almost all patients. Moreover, a survey on the therapeutic effects of PMA on sleep apnea syndrome and problems associated with wearing PMA was performed with a questionnaire for the sample of nine DOES patients and an additional 22 patients who were treated over a long time. The therapeutic effects could be maintained without any problems in about 2/3 of these patients. The therapeutic mechanisms of PMA in its reduction of both obstructive and central apnea are discussed.
authors: Department of Neuropsychiatry, School of Medicine, Kurume University, Japan.
authors: Y
authors: Y
authors: Nakazawa
authors: T
authors: T
authors: Sakamoto
authors: R
authors: R
authors: Yasutake
authors: K
authors: K
authors: Yamaga
authors: T
authors: T
authors: Kotorii
authors: Y
authors: Y
authors: Miyahara
authors: Y
authors: Y
authors: Ariyoshi
authors: T
authors: T
authors: Kameyama
mesh_terms: D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008334:Mandible; D008875:Middle Aged; D009968:Orthodontic Appliances, Removable; D010342:Patient Acceptance of Health Care; D017286:Polysomnography; D012891:Sleep Apnea Syndromes / Q000628:therapy*; D012894:Sleep Stages; D012913:Snoring / Q000628:therapy; D014851:Wakefulness