Abstract
Abstract Background The aim of this study was to determine the effects of an elastic mandibular advancement (EMA) appliance on upper airway dimensions, most constricted area (MCA) of the airway, and snoring in a sample of obstructive sleep apnoea (OSA) patients of varying severity. Methods Forty-seven male subjects were classified into two groups comprising12 controls and 35 suffering from OSA. The OSA group was further divided into three subgroups based on their apnoea-hypopnoea index (AHI). All subjects completed an Epworth questionnaire and an overnight home sleep test before (T1) and at the end of the study (T2). OSA subjects were provided with a custom-made EMA appliance. Cone beam computed tomographic images were obtained for each subject at T1 and T2. Airway parameters were measured and summarised by grouping. The differences in the measurements T1 – T2 were compared using repeated measures analysis of variance (rmANOVA) and p ≤ 0.05 was considered statistically significant. Results The use of the EMA produced a statistically significant increase in the nasopharyngeal, oropharyngeal, MCA, and total airway volume. Although sleep apnoea patients reported a reduction in snoring time, particularly in moderate and severe OSA groups, the level of improvement was not statistically significant. Patients with moderate and severe OSA demonstrated significant decreases in their AHI and Epworth scores. Conclusion EMA is effective in reducing OSA severity and changing airway dimensions in OSA patients, specifically in the moderate and severe cases.
Highlights
Obstructive sleep apnoea (OSA) is a common medical condition that is associated with adverse health consequences
The objectives of the present study were to evaluate the effects of using an elastic mandibular advancement (EMA) appliance on upper airway dimensions and the most constricted area (MCA) of airway as well as on improving snoring symptoms in a group of sleep apnoea patients with varying obstructive sleep apnoea (OSA) severity
Significant decreases were detected between T2 and T1 in the Epworth score for all test groups but groups 3 and 4 showed a statistically significant decrease in apnoea-hypopnoea index (AHI) and respiratory disturbance index (RDI) (Table III)
Summary
Obstructive sleep apnoea (OSA) is a common medical condition that is associated with adverse health consequences. It is characterised by repetitive, partial, or complete obstruction of the upper airway during sleep despite simultaneous respiratory efforts. The aim of this study was to determine the effects of an elastic mandibular advancement (EMA) appliance on upper airway dimensions, most constricted area (MCA) of the airway, and snoring in a sample of obstructive sleep apnoea (OSA) patients of varying severity. Sleep apnoea patients reported a reduction in snoring time, in moderate and severe OSA groups, the level of improvement was not statistically significant. Patients with moderate and severe OSA demonstrated significant decreases in their AHI and Epworth scores. Conclusion: EMA is effective in reducing OSA severity and changing airway dimensions in OSA patients, in the moderate and severe cases. (Aust Orthod J 2017; 33: 14-23)
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