[The use of mandibular advancing devices in the treatment of snoring and mild to moderate obstructive sleep apnoea syndrome].
Mandibular advancing devices (MAD) are a therapeutic option for snoring, mild obstructive sleep apnoea (OSA) and some patients with moderate or severe OSA non compliant to CPAP.


OBJECTIVE
evaluating the efficacy of MAD in the treatment of snoring and mild OSA.


METHODS
MAD were applied in 26 patients (23 men) with a polysomnographic record (PSG) performed in the Polisomnography Lab II, Clinical Pneumophthysiology Hospital Iasi between 15 February- 15 October 2007. Nineteen patients were included (the rest were excluded for various reasons). Each patient was examined ENT. PSG used a Weinmann, Germany, device, SomnoManager 12.7 software. MAD were installed. After one month patients were checked with polygraph Weinmann SomnoCheck effort for evaluating the treatment efficacy.


RESULTS
All included patients snored in over 30% of total sleeping time (TST), having over 30 snorring episodes per sleep hour. The mean of snoring episodes per hour was 40.42 +/- 7.15 at diagnosis and at evaluation after a month it was reduced to 20.64 +/- 5.66 episodes per sleep hour. Mean value of AHI (apnoea-hypopnoea index) at diagnosis was 12.78 +/- 3.95 and after 1 month of MAD was 6.35 +/- 2.84 events per sleep hour. Mean body mass index (BMI) was 27.7 kg/m2 +/- 2.89 and wasn't changed at check-up. Desaturation index was 19.15 +/- 6.4 at diagnosis and improved to 7.94 +/- 3.39 desaturation episodes per sleep hour after 1 month of treatment. The side effects reported were transient, consisting in discomfort of the temporo-mandibular joint and mild tooth ake. Most patients (16 subjects) use the device every night, displaying a high complianace to treatment.


CONCLUSIONS
The use of MAD proves to be efficient in snoring patients, reduce AHI and associate a good compliance.
Adriana
Birleanu Lorena
BL
Universitatea de Medicină şi Farmacie Gr T Popa Iaşi. bradudaniel2000@yahoo.com
Rusu
Gianina
G
Mihăescu
Traian
T
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019186:Mandibular Advancement / Q000295:instrumentation* / Q000379:methods; D009967:Orthodontic Appliances; D017060:Patient Satisfaction; D017286:Polysomnography; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000628:therapy*; D012913:Snoring / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome