title: A prospective 10-year follow-up polygraphic study of patients treated with a mandibular protruding device.
abstract: OBJECTIVE
  This 10-year follow-up prospective study aimed to evaluate the effects of treatment with a mandibular protruding device (MPD) on respiratory parameters and subjective symptoms in patients with obstructive sleep apnea (OSA) or snoring.
  
  
  METHODS
  Seventy-seven consecutive patients diagnosed with OSA or snoring were treated with an MPD. At baseline and the 10-year follow-up, a polygraphic examination and questionnaires on sleep quality were administrated and weight, and neck size was measured.
  
  
  RESULTS
  At the 10-year follow-up, we examined 64 of the 77 patients and recorded their current treatment (45 MPD, 9 continuous positive airway pressure (CPAP), and 10 no treatment). For MPD patients, 89 % reported MPD use every night and 9 % several nights a week. Compared to baseline, MPD users with OSA had a significantly decreased oxygen desaturation index (ODI) (p = 0.006) and increased lowest arterial oxygen saturation, SaO2 nadir (p = 0.007) after 10 years. MPD treatment was successful for 70 % of OSA patients, yet 89 % subjectively considered themselves cured, indicating overestimation of the treatment effect. OSA patients who responded to treatment maintained baseline weight and neck size, while these increased for non-responders. Of the baseline snorers still using an MPD, 93 % maintained an ODI value of <5. All CPAP users had an ODI value of <5. Both OSA and snorers using an MPD had significantly fewer self- and relative reports of snoring, apnea, daytime tiredness, and poor night sleep quality (p < 0.001).
  
  
  CONCLUSIONS
  MPD treatment is well tolerated and effective in a long-term, 10-year perspective. Weight gain may jeopardize MPD effects. Both patients and relatives reported significantly less snoring and fewer periods of apnea.
authors.affiliation: Department of Dental Sleep Medicine, Postgraduate Dental Education Center, Örebro, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Wiman Eriksson
authors.forename: Lena
authors.initials: L
authors.lastname: Leissner
authors.forename: Göran
authors.initials: G
authors.lastname: Isacsson
authors.forename: Anette
authors.initials: A
authors.lastname: Fransson
mesh_terms: D045422:Continuous Positive Airway Pressure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019186:Mandibular Advancement / Q000295:instrumentation*; D008875:Middle Aged; D017090:Occlusal Splints; D010100:Oxygen / Q000097:blood; D017286:Polysomnography; D011446:Prospective Studies; D011788:Quality of Life; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000628:therapy*; D012913:Snoring / Q000628:therapy*
chemical_list: D010100:Oxygen