[Mandibular advancement orthoses used in the treatment of obstructive sleep apnea syndrome].
Mandibular advancement devices represent a therapeutic option for obstructive sleep apnea syndrome (OSAS). Clinical improvement has been proven in the different available studies, mainly on nocturnal respiratory events and quality of sleep. Less snoring have been noted by bed partners and objective studies have demonstrated decrease in snoring frequency and intensity. The effect of these ortheses on upper airways resistance syndrome is not yet well documented. The significant clinical improvement is secondary to the decrease in the occurrence of apneas and hypopneas. Polysomnographic improvement criteria with an apnea hypopnea index less than 10 per hour has been noted in certain cases. Although no improvement or even worsening was noted in other cases. Sleep architecture has also changed in these patients, with a decrease in the time spent in stages 1 and 2, and an increase in the time spent in stages 3 and 4 and rapid eye movement sleep. Micro-arousals are also decreased in number certainly with the decrease in the occurrence of respiratory events. Somnolence and loss of attention are improved; these have been evaluated subjectively or by a well known and approved somnolence scale. In some cases a test for vigilance was done.
Laboratoire des Troubles Respiratoires liés au Sommeil, Hôpital de la Croix-Rousse, Lyon, France.
T
T
Petitjean
M T
MT
Garcia Tejero
B
B
Langevin
F
F
Philit
D
D
Robert
D000403:Airway Resistance; D001143:Arousal; D001288:Attention; D004867:Equipment Design; D006801:Humans; D019186:Mandibular Advancement / Q000009:adverse effects / Q000295:instrumentation*; D009989:Orthotic Devices; D018579:Patient Selection; D017286:Polysomnography; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000145:classification / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D012894:Sleep Stages; D016896:Treatment Outcome