Preliminar results of oral apliance device in mild to moderate obstructive sleep apnea syndrome

Abstract

The first line treatment of Obstructive Sleep Apne-Hyponea Syndrome (OSAHS) is CPAP. Oral appliances are an useful therapeutic alterntive, but its efficacy can varies between different studies, with aproximetly a mean efficiency of 52%, if we define therapeutic success as a final AHI of <5. To evaluate the efficacy of oral appliance (Orthoapnea®) in patientes with mild to moderate OSAHS. We evaluated the quality of sleep (Pittsburgh), somnolence (Epworth Sleepiness scale (ESS), subjective snore (visual analogue snore scale (VASS), Snore Outcome Survey (SOS), Spouse/Bed Partner Survey (SBPS), and sleep parameters with conventional nocturnal Video-Polysomnography (V-PSG) before and after oral appliance treatment. We studied 25 patients 72% male 28% female with a mean age 50,6 ± 10,3, mean body mass index (BMI) 27.6 ± 2.8, and mean RDI 16.8 ± 6.3. We obtain statistical differences in ESS, VASS, Pittsburgh, SOS and SBPS, N1, Arousal, Snore index, respiratory effort related to arousal, hypopnea, obstructive apnea, and ODI > 3%. There is statistically significant improvement in: global RDI (−11.6) with RDI < 5 in 68%, Supine RDI (−22.5) with RDI < 5 in 55.6, non-supine RDI (−7.3) RDI < 5 in 78.9% and NREM-RDI (−10.8) with RDI < 5 in 80%. No significant improvement were observed in REM-RDI (−7.7) with RDI < 5 in 53.3%. The improvement of the RDI did not have correlation with the age weight, and time in postural position. Oral appliances are an effective treatment for mild to moderate OSAHS, with improvement of both, subjective and objective sleep parameters. Thanks to the partial financial support by Orthoplus®.