title: Complex sleep apnea unmasked by the use of a mandibular advancement device.
abstract: According to most accepted definitions, complex sleep apnea syndrome (CompSAS) is described as an emergence of central apneas in a patient with obstructive sleep apnea (OSA) upon introduction of continuous positive airway pressure therapy (CPAP). We present two patients who developed comparable central apnea activity when treated with either a CPAP device or a mandibular advancement device. As similar findings have been previously documented in patients with OSA treated with maxillofacial surgery or tracheostomy, we propose that the current definition of CompSAS should broaden to include diagnosis of CompSAS in non-PAP-treated patients, who are managed with either a dental appliance or a surgical procedure.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, NorthShore University HealthSystem, 2650 Ridge Ave, Evanston, IL 60201, USA. tkuzniar@northshore.org
authors.forename: Tomasz J
authors.initials: TJ
authors.lastname: Kuźniar
authors.forename: Ružica
authors.initials: R
authors.lastname: Kovačević-Ristanović
authors.forename: Thomas
authors.initials: T
authors.lastname: Freedom
mesh_terms: D045422:Continuous Positive Airway Pressure; D006801:Humans; D008297:Male; D019186:Mandibular Advancement / Q000295:instrumentation*; D008875:Middle Aged; D009968:Orthodontic Appliances, Removable; D017286:Polysomnography; D020182:Sleep Apnea, Central / Q000175:diagnosis* / Q000628:therapy*; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000628:therapy*