Association between mandibular advancement device therapy and reduction of excessive daytime sleepiness due to obstructive sleep apnoea.

Abstract

Excessive daytime sleepiness (EDS) is frequently reported as a symptom for obstructive sleep apnoea (OSA), leading to problems with concentration, mood and memory. Mandibular advance device (MAD) is considered as an effective therapy to control OSA, reducing EDS and improving sleep quality. The present study aimed to investigate the effects MAD therapy on EDS of patients diagnosed with OSA. Ten patients from the Sleep Medicine Service of the "Hospital Geral Sanatório" (Maceió, Alagoas, Brazil) were diagnosed with EDS, and a personalised MAD was made for each one of them. Nocturnal polysomnography (NPSG) and maintenance of wakefulness test (MWT) were applied before (baseline) and 3months after the continuous use of the MAD. The number of arousals and micro-arousals at baseline and after treatment was also evaluated. All 10 patients completed the investigation. A significant decrease in the number of arousals and micro-arousals per night of sleep was observed after the use of MAD for three consecutive months (P=0.0078; Wilcoxon signed-rank test). Also, there was a significant reduction on the apnoea/hypopnea index between baseline and post-treatment values (P=0.0001; paired t test), as well as an increase in the mean latency for the onset of sleep (MSL) in the MTW (P=0.0047; paired t test), indicating a significant difference among baseline and after treatment. We conclude that the improvement on EDS is associated with the used of MAD in patients diagnosed with OSA, improving their quality of sleep.