Médecine pulmonaire et respiratoire

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

Abstract

Aida M. Yousef and Fatma El-Waseef

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.