Eficacia de una prótesis de avance mandibular en el tratamiento del síndrome de apneas obstructivas del sueño

Abstract

To assess the efficacy of a mandibular advancement prosthesis for treating obstructive sleep apnea syndrome (OSAS). Mandibular advancement appliances were prescribed for 21 patients (20 men) with OSAS diagnosed by polysomnography. Mean age was 51 (8) years, BMI was 30 (4) kg/m2, and the apnea-hypopnea index (AHI) per hour was 48 (17). If the device was well tolerated, regardless of clinical response, polysomnography was repeated between 1 to 3 months after start of treatment. The device was considered effective if the AHI decreased to < 15/h and symptoms related to OSAS disappeared. Seven patients withdrew from treatment after only a few days. The remaining 14 (66%) tolerated treatment well and the second polysomnogram was performed. In six of the 14 (43%), the device proved effective for correcting OSAS. In six more patients, the AHI decreased but failed to become normal. In the remaining two patients, no improvement was observed. Improvement in the AHI was unrelated to severity of OSAS. The mandibular advancement prosthesis is effective for some patients with OSAS, including those in whom the AHI is high. Larger studies are needed to allow us to define the type of patients that might benefit.