Association between mandibular advancement device therapy and reduction of Excessive Daytime Sleepiness due to Obstructive Sleep Apnea

Cynthia Valeria Silva Gomes Ribeiro; Djalma Ribeiro-Sobrinho; Victor Ricardo Manuel Muñoz Lora; Louise Morais Dornellas Bezerra; Altair Antoninha Del Bel Cury

doi:10.1111/joor.12792

Association between mandibular advancement device therapy and reduction of Excessive Daytime Sleepiness due to Obstructive Sleep Apnea

J Oral Rehabil. 2019 Mar 15. doi: 10.1111/joor.12792. Online ahead of print.

Authors

Cynthia Valeria Silva Gomes Ribeiro¹, Djalma Ribeiro-Sobrinho¹, Victor Ricardo Manuel Muñoz Lora², Louise Morais Dornellas Bezerra², Altair Antoninha Del Bel Cury²

Affiliations

¹ Universidade Federal de Alagoas, Faculdade de Odontologia da UFAL. Av., Lourival Melo Mota, s/n, Maceió, Alagoas, Brazil, 57072-900.
² Department of Prosthodontics and Periodontology. Piracicaba Dental School, UNICAMP, Av Limeira 901, Piracicaba, SP, Brazil, 13414-903.

PMID: 30873626
DOI: 10.1111/joor.12792

Abstract

Background: Excessive daytime sleepiness is frequently reported as a symptom for OSA, leading to problems with concentration, mood and memory. MAD are considered as an effective therapy to control OSA, reducing EDS and improving sleep quality.

Objectives: The present study aimed to investigate the effects of mandibular advance device (MAD) therapy on excessive daytime sleepiness (EDS) of patients diagnosed with obstructive sleep apnea (OSA).

Methods: Ten patients from the Sleep Medicine Service of the "Hospital Geral Sanatório" (Maceió, Alagoas, Brazil) were diagnosed with EDS, and a personalized MAD was made for each one of them. Nocturnal polysomnography (NPSG) and Maintenance of wakefulness test (MWT) were applied before (baseline) and three months after the continuous use of the MAD. The number of arousals and microarousals at baseline and after treatment were also evaluated.

Results: All 10 patients completed the investigation. A significant decrease in the number of arousals and microarousals per night of sleep was observed after the use of MAD for three consecutive months (P=0.0078; Wilcoxon signed-ranks test). Also, there was a significant reduction on the apnea/hypopnea index between baseline and post-treatment values (P=0.0001; paired-t test), as well as an increase in the mean latency for the onset of sleep (MSL) in the MTW (P=0.0047; paired t- test), indicating a significant difference among baseline and after treatment.

Conclusion: We conclude that the improvement on EDS is associated with the used of MAD in patients diagnosed with OSA, improving their quality of sleep. This article is protected by copyright. All rights reserved.

Keywords: Arousal disorders, sleep; Daytime Sleepiness; Obstructive Sleep Apnea; Polysomnography; Progressive Mandibular Advancement; Sleep Initiation and Maintenance disorders.