Treatment success with a mandibular advancement device is related to supine-dependent sleep apnea.
OBJECTIVE
To evaluate the effect of a mandibular advancement device in patients with supine-dependent sleep apnea and patients with non-supine-dependent sleep apnea.


METHODS
Prospective study.


METHODS
Department of Respiratory Medicine, University Hospital, Umeå, Sweden.


METHODS
Twenty-six patients with obstructive sleep apnea.


METHODS
Individually fabricated and adjusted mandibular advancement devices.


METHODS
Overnight polysomnographic sleep recordings with and without the device. Supine-dependent sleep apnea was defined when the supine apnea-hypopnea index was > or = 10, together with a lateral apnea-hypopnea index of < 10. Non-supine-dependent sleep apnea was considered when the lateral apnea-hypopnea index was > or = 10.


RESULTS
In 12 patients with supine-dependent sleep apnea, the device reduced the supine apnea-hypopnea index from a median of 41 (range, 16 to 70) to 5.9 (range, 0.0 to 15) (p < 0.01). In 14 patients with non-supine-dependent sleep apnea, the treatment reduced the supine apnea-hypopnea index from 44 (range, 1.8 to 73) to 21 (range, 6.3 to 60) (p < 0.05) and the lateral apnea-hypopnea index from 21 (range, 12 to 70) to 4.5 (range, 0.0 to 31) (p < 0.01). The odds ratio for a successful apnea reduction to an apnea-hypopnea index of < 10 in both the supine and the lateral positions was 30 for supine-dependent sleep apnea adjusted for age, obesity, mandibular advancement, and mandibular opening (p < 0.01).


CONCLUSIONS
Successful apnea reduction with a mandibular advancement device is highly related to supine-dependent sleep apnea.
Marklund
M
M
Department of Orthodontics, Umeå University, Sweden.
Persson
M
M
Franklin
K A
KA
D000328:Adult; D000368:Aged; D006801:Humans; D019186:Mandibular Advancement / Q000295:instrumentation*; D008875:Middle Aged; D016017:Odds Ratio; D017286:Polysomnography; D012891:Sleep Apnea Syndromes / Q000628:therapy*; D016683:Supine Position; D016896:Treatment Outcome