A mandibular advancement device for the treatment of obstructive sleep apnea: Long-term use and tolerance

Mandibular advancement device therapy in obstructive sleep apnea and snoring in community dental care: two-year follow-up study on self-reported sleep quality, side effects, and compliance Vuorjoki-Ranta, T.R.; Lobbezoo, F.; Tuomilehto, H.; Könönen, M.; Pihakari, A.; Ahlberg, J. Published in:Journal of Sleep Disorders & Therapy DOI:10.4172/2167-0277.1000180 Link to publication Citation for published version (APA):Vuorjoki-Ranta, T. R., Lobbezoo, F., Tuomilehto, H., Könönen, M., Pihakari, A., & Ahlberg, J. (2014). Mandibular advancement device therapy in obstructive sleep apnea and snoring in community dental care: two-year followup study on self-reported sleep quality, side effects, and compliance. Journal of Sleep Disorders & Therapy, 3(5), 1000180. DOI: 10.4172/2167-0277.1000180 General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: http://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. AbstractStudy background: Obesity is constantly increasing health problem worldwide and so are its detrimental consequences, including obstructive sleep apnea (OSA). Mandibular advancement devices (MADs) are proven to be efficient in treating mild to moderate OSA and snoring. We followed for two years 103 patients treated with a titrable MAD in a Community Dental Care setting. Methods:A follow-up questionnaire was mailed in 2012 to 124 patients who had participated in a survey 2010 and given their consent for further study. Results:Of all the 103 respondents 85% (n=88) still used MAD. Subjective tiredness (p<0.05) and the presence of any snoring (p<0.01) were reported more often in the long-term study than in the short-term study. In contrast, difficulty in initiating sleep with the device in situ was seen less often (p<0.05). According to the logistic regression, reduced loud snoring was significantly associated with the compliance of frequent wear of MAD (p<0.05). The majority (82%) of the patients also reported a positive impact of MAD in social (family) life due to reduced loud snoring. Conclusion:Titrable MAD is a noteworthy treatment modality for mild to moderate OSA and especially snoring. Compliance in using MADs and reported subjective health seem to remain at good level. General dentists could probably perform a great part of the care. However, possible worsening of OSA and side effects of MADs should be borne in mind.

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“…This is also supported in studies carried out in specialist settings [16,17,[23][24][25]. MAD was found to reduce loud snoring.…”

Section: Discussionsupporting

confidence: 60%

“…However, the adverse symptoms are often transient. Also, loss or frequent breakage of the device, along with the cost of repairing or replacing it, may lead to cessation of treatment [17].…”

Section: Journal Of Sleep Disorders and Therapymentioning

confidence: 99%

Mandibular Advancement Device Therapy in Obstructive Sleep Apnea and Snoring in Community Dental Care: Two-year Follow-up Study on Self-reported Sleep Quality, Side Effects, and Compliance

Vuorjoki-Ranta¹,

Lobbezoo²,

Tuomilehto³

et al. 2014

J Sleep Disord Ther

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“…In a recent study Brette et al evaluate a long term assessment of a two-piece adjustable device called OPM4 J, measuring symptoms, compliance rate, and adverse effects in a cohort of 140 consecutive patients treated with the device for an average period of three years. Out of 140 patients aged 62 ± 10 years with body mass index (BMI) 27 ± 4 kg/m 2 and initial apnea/hypopnea index (AHI) 27 ± 16, complete reversal of OSAS was achieved in 65% [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Long Term Therapeutic Efficacy of a Soft Monobloc Mandibular Advancement Device in Adults with Obstructive Sleep Apnea

Ballanti

Ranieri

Baldini

et al. 2015

The Scientific World Journal

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Aim. To evaluate the long term (48 months) therapeutic efficacy of a soft monobloc mandibular advancement device in adult patients with mild or moderate obstructive sleep apnea. Methods. The study population comprised 28 patients (6 female and 22 male, mean age 52.2 ± 6.8 years) affected by obstructive sleep apnea. After a baseline medical and somnographic examination, a functional examination of the stomatognathic system, and a questionnaire focused on sleep-related qualities and a daytime somnolence, each patient received an individual device. Two follow-ups were made 6 months (T1) and 48 months (T2) after soft monobloc mandibular advancement device treatment had been initiated, and all initial examinations were repeated. Results. The statistical analysis showed a significant decrease in body mass index value between T1 and T2 (ρ = 0,012), an increase of Epworth sleepiness scale value between T1 and T2 (ρ = 0,012), and a significant improvement and decrease of apnea/hypopnea index between T0 and T1 (ρ = 0,010) and between T0 and T2 (ρ = 0,013). Conclusion. Treatment with the soft monobloc mandibular advancement device is a therapeutic solution with long term and stable effects (48 months) for patients suffering from mild or moderate obstructive sleep apnea.

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“…[12][13][14][15] Long-term tolerance of OAs has been shown by many researchers. 13,[16][17][18] Such long-term tolerance may result from quitting time concentrating in the first 3 months of treatment. Patients with little tolerance usually gave up early, that is, those who did not kept using the OA for a long time.…”

Section: Tolerance Of Oasmentioning

confidence: 99%

“…Patients with little tolerance usually gave up early, that is, those who did not kept using the OA for a long time. 14,18 Tolerance of OAs is better than tolerance of CPAP devices in the long term. In the research done by Gagnadoux et al, 3 a two-way cross-classification experiment of OAs and CPAP devices indicated that OAs processed significant advantages in comfort, and most patients chose OAs if both methods were equally effective.…”

Section: Tolerance Of Oasmentioning

confidence: 99%

Long-term therapeutic efficacy of oral appliances in treatment of obstructive sleep apnea-hypopnea syndrome

Zhang

Zhao

et al. 2012

The Angle Orthodontist

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A mandibular advancement device for the treatment of obstructive sleep apnea: Long-term use and tolerance

Cited by 10 publications

References 13 publications

Mandibular Advancement Device Therapy in Obstructive Sleep Apnea and Snoring in Community Dental Care: Two-year Follow-up Study on Self-reported Sleep Quality, Side Effects, and Compliance

Mandibular Advancement Device Therapy in Obstructive Sleep Apnea and Snoring in Community Dental Care: Two-year Follow-up Study on Self-reported Sleep Quality, Side Effects, and Compliance

Long Term Therapeutic Efficacy of a Soft Monobloc Mandibular Advancement Device in Adults with Obstructive Sleep Apnea

Long-term therapeutic efficacy of oral appliances in treatment of obstructive sleep apnea-hypopnea syndrome

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