title: The effect of a mandibular advancement device on apneas and sleep in patients with obstructive sleep apnea.
abstract: OBJECTIVE
  To evaluate the effects of a mandibular advancement device on apneas and sleep in mild, moderate, and severe obstructive sleep apnea.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Forty-four of 47 patients included.
  
  
  METHODS
  Individually adjusted mandibular advancement devices.
  
  
  METHODS
  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 obstructive 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 apneas 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.
authors.affiliation: Department of Orthodontics, Umeå University, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Marklund
authors.forename: K A
authors.initials: KA
authors.lastname: Franklin
authors.forename: C
authors.initials: C
authors.lastname: Sahlin
authors.forename: R
authors.initials: R
authors.lastname: Lundgren
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D019186:Mandibular Advancement; D008875:Middle Aged; D009968:Orthodontic Appliances, Removable; D017286:Polysomnography; D011446:Prospective Studies; D012119:Respiration; D012891:Sleep Apnea Syndromes / Q000503:physiopathology / Q000628:therapy*