The effects of mandibular advancement appliance therapy on jaw-closing muscle activity during sleep in patients with obstructive sleep apnea: a 3-6 months follow-up.

Abstract

The main aim of this study was to investigate the effects of mandibular advancement appliance (MAA) therapy on jaw-closing muscle activity (JCMA) time-related to respiratory arousals, and on JCMA time-related to nonrespiratory arousals in patients with obstructive sleep apnea. Eighteen patients with OSA (mean ± standard deviation = 49.4 ± 9.8 years) with a mean ± standard deviation apnea-hypopnea index of 22.0 ± 16.0 events/h of sleep participated in a randomized controlled crossover trial in which two ambulatory polysomnographic recordings, 1 with an MAA in situ and another without the MAA in situ, were performed. JCMA was quantified as the sum of rhythmic masticatory muscle activities and other orofacial activities. Significant reductions in the apnea-hypopnea index (Z = -2.984; P = .003), in the respiratory arousal index (Z = -2.896; P = .004), and in the JCMA time-related to respiratory arousal index (Z = -3.434; P = .001) were found with MAA in situ. On the nonrespiratory arousal index, and on the JCMA time-related to nonrespiratory arousal index, MAA had no significant effect (T = 2.23; P = .82; and Z = -0.66; P = .51, respectively). This study shows that effective mandibular advancement appliance therapy significantly reduces jaw-closing muscle activities time-related to respiratory arousals in OSA patients. Future studies are needed to confirm these findings in obstructive sleep apnea patients with comorbid sleep bruxism. Registry: ClinicalTrials.gov; Name: The Effects of Oral Appliance Therapy on Masseter Muscle Activity in Obstructive Sleep Apnea; Identifier: NCT02011425.