Titre | Mandibular Advancement for Obstructive Sleep Apnea: Dose Effect on Apnea, Long-Term Use and Tolerance |
Type de publication | Article de revue |
Auteur | Gindre, Louise, Gagnadoux, Frédéric , Meslier, Nicole , Gustin, Jean-Marie, Racineux, Jean-Louis |
Pays | Suisse |
Editeur | Karger |
Ville | Basel |
Type | Article scientifique dans une revue à comité de lecture |
Année | 2008 |
Langue | Anglais |
Date | 2008 |
Numéro | 4 |
Pagination | 386 - 392 |
Volume | 76 |
Titre de la revue | Respiration |
ISSN | 1423-0356 |
Résumé en anglais | Background: Previous studies have documented an effect of mandibular advancement (MA) on pharyngeal airway size and collapsibility. Objectives: We aimed to describe the course of the apnea-hypopnea index (AHI) and the snoring index (SI) during progressive MA and to evaluate the long-term efficacy, tolerance and usage of MA therapy after progressive MA titration in sleep apnea patients. Methods: Sixty-six patients with obstructive sleep apnea syndrome underwent sequential sleep recordings during progressive MA titration. Long-term effectiveness, compliance and side effects of oral appliance (OA) in the titrated position were evaluated by questionnaires. Results: OA therapy was started at 80% of the maximum MA. Seventy percent of the patients had only one increment in MA with a marked decrease in mean AHI from 36 to 10. In the remaining cases, further increments in MA were associated with a progressive reduction in AHI and an increase in the number of patients responding to treatment. OA in the titrated position resulted in a 70% decrease in AHI, with 54% of patients showing complete responses, 29% partial responses and 17% no response. Daytime sleepiness and quality of life improved, too. Seventeen months after the start of treatment, 82% of the patients declared that they were still using OA almost all nights. Reported side effects including subjective occlusal changes were frequent but mild. Conclusions: Improvement in AHI during OA is dependent on the amount of MA. Sequential sleep recordings facilitate MA titration. Long-term MA therapy in the titrated position is effective and well tolerated. Reported side effects are frequent but mild. |
URL de la notice | http://okina.univ-angers.fr/publications/ua284 |
DOI | 10.1159/000156861 |
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Titre abrégé | Mandibular Advancement for Obstructive Sleep Apnea |