Effects of a mandibular protruding device on the sleep of patients with obstructive sleep apnea and snoring problems: a 2-year follow-up.
OBJECTIVE
To evaluate subjective discomfort and somnographic measures of patients with obstructive sleep apnea and snoring problems who had been treated for 2 years with a mandibular protruding device (MPD).


METHODS
The study population comprised 65 patients with a pretreatment diagnosis of obstructive sleep apnea (OSA) ( n = 44) or habitual snoring without apnea (n = 21). After a baseline medical and somnographic examination, a functional examination of the stomatognathic system, and a questionnaire focused on sleep-related qualities, each patient received an MPD. Two follow-ups were made 6 months and 2 years after MPD treatment had been initiated, and all initial examinations were repeated.


RESULTS
At the 2-year follow-up, significant subjective improvements were registered in 90% of the patients regarding a reduction of snoring and apneas, in 76% regarding a reduction in daytime tiredness, and in 84% regarding an improvement in the quality of the night sleep (change of > or = 50% from baseline data). At the 2-year follow-up of the OSA group, the oxygen desaturation index (ODI) had dropped significantly from a mean value of 14.7 (SD, 12.7) to 3.1 (SD, 4.2) ( P < 0.001), and the mean SaO2 nadir rose from 78.2% (SD, 8.1) to 89.0% (SD, 4.7) ( P < 0.001). Only one of the snorers increased his ODI value; the others retained their initial healthy values. The OSA patients significantly reduced the amount of time they snored during their sleep.


CONCLUSIONS
MPD treatment is associated with a significant reduction in subjective complaints such as disturbing snoring, apneas, daytime tiredness, and poor quality of night sleep, and with a significant reduction in ODI values in the OSA group. In addition, favorable 6-month results were unchanged after 2 years.
Department of Orthodontics, Postgraduate Dental Education Center, Orebro, Sweden. anette.fransson@orebroll.se
Anette M C
AM
Fransson
Ake
A
Tegelberg
Lena
L
Leissner
Bengt
B
Wenneberg
Göran
G
Isacsson
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019186:Mandibular Advancement / Q000379:methods*; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism; D017286:Polysomnography; D012890:Sleep; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D012913:Snoring / Q000175:diagnosis / Q000209:etiology; D011795:Surveys and Questionnaires
D010100:Oxygen