Alternatives to continuous positive airway pressure 2

Quinnell, Timothy; Clutterbuck-James, Abigail

doi:10.1097/mcp.0000000000000096

Cited by 2 publications

(4 citation statements)

References 27 publications

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“…While more pronounced mandibular advancement has been shown to be more effective in reducing AHI [8,9], the untoward effects are increased with excessive protrusion and compliance is reduced. This 50% of maximal mandibular protrusion is therefore accepted as a good compromise [7]. According to the results of this study an average fall of 65% in AHI can be expected with MAD treatment in the OSAS patients in this cohort.…”

Section: Discussionmentioning

confidence: 75%

“…The mandibular protrusion was set at 50% of the maximal protrusion because this amount of advancement has been shown to be effective by other authors [7,8]. While more pronounced mandibular advancement has been shown to be more effective in reducing AHI [8,9], the untoward effects are increased with excessive protrusion and compliance is reduced.…”

Section: Discussionmentioning

confidence: 99%

“…It has been recommended as an initial treatment in the presence of severe disease [5,6]. Many patients, however, complain that C-PAP is cumbersome and difficult to tolerate [7]. This is especially so among elderly patients in whom C-PAP is regarded as the treatment of choice [8,9].…”

Section: Introductionmentioning

confidence: 99%

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The Influence of a Mandibular Advancement Plate on Polysomnography in Different Grades of Obstructive Sleep Apnea

Raunio¹,

Mattila²,

Huuskonen³

et al. 2015

JOMR

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Objectives: The purpose of this study was to investigate the effect of a mandibular advancement device on different grades of obstructive sleep apnea using a relatively simple test for the apnea-hypopnea index to determine if a mandibular device will be effective. Material and Methods: A total of 68 patients with obstructive sleep apnea syndrome (OSAS) including, 31 with mild, 23 with moderate and 14 with severe OSAS were treated with a mandibular advancement device (MAD) and monitored with polysomnography. Results: 25 of the 31 mild, 15 of the 23 moderate and 2 of the 14 severe OSAS patients were cured of their OSAS if a post treatment apnea-hypopnea index of less than 5 is regarded as cured. The odds ratios for success with MAD therapy are 3 for women over men, 14.9 for mild obstructive sleep apnea, 5.42 for moderate obstructive sleep apnea if severe obstructive sleep apnea is assigned an odds ratio of 1. Conclusions: The use of the apnea-hypopnea index alone is useful in mild and moderate disease to predict the effectiveness of mandibular advancement device. Treatment with a mandibular advancement device is very effective in treating mild and moderate obstructive sleep apnea. Conservative treatment with a mandibular advancement device can be successful in less severe grades of sleep apnea and may be an alternative for non-surgical patients with severe obstructive sleep apnea intolerant of Continuous Positive Airway Pressure management.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

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The Influence of a Mandibular Advancement Plate on Polysomnography in Different Grades of Obstructive Sleep Apnea

Raunio¹,

Mattila²,

Huuskonen³

et al. 2015

JOMR

View full text Add to dashboard Cite

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“…OSAS is a common sleep‐related breathing disorder, affecting 10–17% of middle‐aged men and 3–9% of middle‐aged women . The gold standard therapy for severe OSAS is continuous positive airway pressure (CPAP) . In mild‐to‐moderate OSAS patients, a mandibular advancement device (MAD) therapy is often recommended as a primary treatment option .…”

Section: Introductionmentioning

confidence: 99%

Oral appliance therapy versus nasal continuous positive airway pressure in obstructive sleep apnoea syndrome: a randomised, placebo‐controlled trial on self‐reported symptoms of common sleep disorders and sleep‐related problems

Nikolopoulou

Byraki

Ahlberg

et al. 2017

J of Oral Rehabilitation

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Obstructive sleep apnoea syndrome (OSAS) is associated with several sleep disorders and sleep-related problems. Therefore, the aim of this study was to compare the effects of a mandibular advancement device (MAD) with those of nasal continuous positive airway pressure (nCPAP) on self-reported symptoms of common sleep disorders and sleep-related problems in mild and moderate OSAS patients. In this randomised placebo-controlled trial, sixty-four OSAS patients (52·0 ± 9·6 years) were randomly assigned to an MAD, nCPAP or an intra-oral placebo appliance in a parallel design. All participants filled out the validated Dutch Sleep Disorders Questionnaire (SDQ) twice: one before treatment and one after six months of treatment. With 88 questions, thirteen scales were constructed, representing common sleep disorders and sleep-related problems. Linear mixed model analyses were performed to study differences between the groups for the different SDQ scales over time. The MAD group showed significant improvements over time in symptoms corresponding with 'insomnia', 'excessive daytime sleepiness', 'psychiatric sleep disorder', 'periodic limb movements', 'sleep apnoea', 'sleep paralysis', 'daytime dysfunction', 'hypnagogic hallucinations/dreaming', 'restless sleep', 'negative conditioning' and 'automatic behaviour' (range of P values: 0·000-0·014). These improvements in symptoms were, however, not significantly different from the improvements in symptoms observed in the nCPAP and placebo groups (range of P values: 0·090-0·897). It can be concluded that there is no significant difference between MAD and nCPAP in their positive effects on self-reported symptoms of common sleep disorders and sleep-related problems in mild and moderate OSAS patients. These beneficial effects may be a result of placebo effects.

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Alternatives to continuous positive airway pressure 2

Cited by 2 publications

References 27 publications

The Influence of a Mandibular Advancement Plate on Polysomnography in Different Grades of Obstructive Sleep Apnea

The Influence of a Mandibular Advancement Plate on Polysomnography in Different Grades of Obstructive Sleep Apnea

Oral appliance therapy versus nasal continuous positive airway pressure in obstructive sleep apnoea syndrome: a randomised, placebo‐controlled trial on self‐reported symptoms of common sleep disorders and sleep‐related problems

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