Can Oral Appliances be an Alternative Treatment for Severe Obstructive Sleep Apnea Syndrome Patients?

Fatma Elwaseef

doi:10.4172/2161-105x.1000182

Abstract

Background: Obstructive Sleep Apnea Syndrome (OSAS) is recognized as a serious health problem that impairs quality of life. Although, optimal treatment of OSAS with continuous positive airway pressure (CPAP) reduce the number of respiratory events during sleep, and thus improve quality of life, a large number of patients do not tolerate CPAP. In the last decade, there has been an explosion of interest in the using of oral appliances to treat OSAS; however, in severe OSAS there is only scanty evidence available indicating that dental appliances are effective. Objectives: This study aimed at evaluating the efficacy of the mandibular advancing appliance (MAA) in the treatment of severe OSAS patients. Material and Methods: Thirty three polysomnography (PSG) diagnosed cases of severe OSAS patients were included. The mean apnea/hypopnea index (AHI) was 42.36 ± 7.92. The cases were subjectively assessed by the Epworth Sleepiness Scale (ESS). Outcome measurements included sleep study, sleepiness; side-effects and compliance were assessed. Results: The polysomnographic variables and clinical assessments revealed a significant improvement in the patients. Conclusion: Mandibular Advancement Appliance therapy can be an actual alternative treatment for severe OSAS patients who cannot tolerate CPAP. The better compliance seen with the MAA may be advantageous.

Highlights

Obstructive Sleep Apnea Syndrome (OSAS) is a highly prevalent disease leading to severe medical consequences if left untreated [1]
The better compliance seen with the mandibular advancing appliance (MAA) may be advantageous
The patients either male or female were recruited with a documented Polysomnography (PSG) diagnosed severe OSA cases (AHI ≥30 events/h) and, Intolerance to continuous positive airway pressure (CPAP) use, patients who refused using CPAP, can’t afford its price, patient with adequate dentition, CPAP failure, which is defined as the inability to use of CPAP ≥4 hours per night on 70% of nights during a consecutive thirty (30) day period anytime during the first three (3) months of initial usage

Summary

Introduction

Obstructive Sleep Apnea Syndrome (OSAS) is a highly prevalent disease leading to severe medical consequences if left untreated [1]. OSAS affects about 2% - 4% of the adult population It is the most common progressive and serious sleep breathing disorder that is responsible for more mortality and morbidity than any other sleep disorder [2]. It impairs quality of life by increasing the risk of hypertension and cardiovascular disease [3]. Among the different treatment modalities currently available to treat OSAS is Continuous Positive Airway Pressure (CPAP) which was considered the most efficient and is known as the gold standard in the treatment of this condition. There has been an explosion of interest in the using of oral appliances to treat OSAS; in severe OSAS there is only scanty evidence available indicating that dental appliances are effective

Objectives

Methods

Results

Discussion

Conclusion