title: Controlled, prospective trial of psychosocial function before and after mandibular advancement splint therapy.
abstract: BACKGROUND
  The aim of the study was to investigate psychosocial function in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS), before and after mandibular advancement splint (MAS) therapy.
  
  
  METHODS
  In a prospective, parallel-group study, changes in psychosocial scores were compared before and after MAS therapy for OSAHS. Patients from the top (MAS treated, n = 40) or bottom (conservatively treated n = 35) of a MAS waiting list rated quality of life (Short Form 36 [SF-36] Health Survey) and sleepiness (Epworth Sleepiness Scale [ESS]). Both groups' ratings at baseline were completed while on conservative therapy.
  
  
  RESULTS
  Baseline variables did not differ between groups. At follow-up, psychosocial scores showed improvement in MAS-treated patients, with odds ratios (confidence interval) of 0.26 (0.09, 0.75) and 0.36 (0.14, 0.92) for sleepiness and energy/vitality domain, respectively. Statistically significant improvement in the median (range) sleepiness score (10 [1 to 18] to 6 [1 to 14]; P <0.001) and energy/vitality domain (18 [7 to 20] to 19 [14 to 20]; P = 0.03) were observed with MAS therapy. Reductions were detected in median apnea-hypopnea index (median [range] 16 [5.2 to 30] to 4.6 [0.8 to 17.2] events/hour; P <0.001), and oxygen desaturation index (ODI) (11 [3 to 16] to 0 [0 to 5] events/hour; P <0.001) at follow-up with MAS therapy. Similar changes were observed in the comparison group when they went on to be treated with MAS.
  
  
  CONCLUSIONS
  This study demonstrated that treatment with MAS produced statistically and clinically significant psychosocial and cardio-respiratory improvements.
authors.affiliation: Barts and The London School of Medicine and Dentistry, Institute of Dentistry, United Kingdom. a.s.johal@qmul.ac.uk
authors.forename: Ama
authors.initials: A
authors.lastname: Johal
authors.forename: Joanna
authors.initials: J
authors.lastname: Battagel
authors.forename: Mark
authors.initials: M
authors.lastname: Hector
mesh_terms: D000203:Activities of Daily Living; D004644:Emotions; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D019186:Mandibular Advancement / Q000295:instrumentation* / Q000379:methods; D008603:Mental Health; D008875:Middle Aged; D016382:Orthodontic Appliance Design; D017289:Orthodontic Appliances, Functional; D010100:Oxygen / Q000097:blood; D010147:Pain Measurement; D011446:Prospective Studies; D011788:Quality of Life; D012119:Respiration; D016037:Single-Blind Method; D012890:Sleep / Q000502:physiology; D020181:Sleep Apnea, Obstructive / Q000628:therapy*; D012894:Sleep Stages / Q000502:physiology; D012913:Snoring / Q000628:therapy; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology
chemical_list: D010100:Oxygen