Influence of MAD Application on Episodes of Obstructive Apnea and Bruxism during Sleep—A Prospective Study

Abstract

The condition of sleep bruxism (SB) is defined by many authors as the body’s response to obstructive sleep apnea (OSA). In the conservative treatment of OSA, mandibular advancement devices (MADs) have found their application. The aim of the study iso assess the impact of MADs on the occurrence of episodes and the intensity of OSA and SB. The study sample consisted of eight patients with OSA and SB diagnosed with these conditions on the basis of clinical examinations and polysomnography (PSG). The prospective study was designed to assess the use of MADs for OSA and SB. MADs were prepared for the patients who subsequently underwent control examinations after one week of wear, and another PSG (PSG II) with an MAD was performed in conditions resembling the first qualification examination (PSG I). The same parameters were assessed in both PSG examinations. Following treatment with the MAD, a favorable lowering of the mean values of the examined parameters was observed. The statistically significant differences were demonstrated only for the apnea–hypopnea index (AHI), the oxygen desaturation index (ODI), and the number of apneas and hypopneas, obstructive apneas, apneas in OSA, and phasic episodes of bruxism. The application of MADs in patients with OSA has a beneficial effect on the same manifestations of OSA and SB, even though only the number of phasic episodes of bruxism was statistically significant.

Novel Technologies in the Diagnosis and Management of Sleep-disordered Breathing

“…Genio is a bilateral HGNS device produced by Nyxoah (74). Genio provides stimulation to both branches of the hypoglossal nerve (65).…”

“…This device requires a single midline submental incision with placement of paddled electrodes over bilateral distal medial hypoglossal nerve branches. The preferential selection of the distal branches reportedly activates genioglossus alone without the recruitment of adjacent muscles (74). An external, submental stimulator is placed on an adhesive, disposable patch to activate the cuffs (74).…”

“…The preferential selection of the distal branches reportedly activates genioglossus alone without the recruitment of adjacent muscles (74). An external, submental stimulator is placed on an adhesive, disposable patch to activate the cuffs (74). The stimulator must be recharged daily but has the advantage of not having an implanted battery.…”

“…The Genio does not have respiratory sensing leads and delivers stimulation via adjustable, pre-programmed rates and duty-cycles in order to match the patient's breathing frequency. The BLAST OSA study was pivotal for this device (74). Inclusion criteria were adults 21-65 years old, AHI 15-65 events/h, BMI < 32 kg/m 2 , and fewer than ten central events/h on PSG (74).…”

Translation of obstructive sleep apnea pathophysiology and phenotypes to personalized treatment: a narrative review

“…Their ability to adjust the level of mandibular advancement allows for patient comfort and therapeutic efficacy ( 72 ), enhancing treatment adherence and outcomes. MADs are also effective for treating bruxism alongside OSA ( 73 , 74 ). They offer a promising step toward individualizing OSA treatment, with ongoing research set to further enhance their utility in this area.…”