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A prospective 10-year follow-up polygraphic study of patients treated with a mandibular protruding device
Dept Dent Sleep Med, Postgrad Dent Educ Ctr, Region Örebro County, Örebro, Sweden.
Sleep Unit, Dept Neurol, Örebro University Hospital, Örebro, Sweden.
Dept Orofacial Pain, Västmanland Cty Hosp, Västerås, Sweden.
Örebro University Hospital. Dept Orthodont, Postgrad Dent Educ Ctr, , Region Örebro County, Örebro, Sweden; Dent Sleep Med Clin, Postgrad Dent Educ Ctr, Region Örebro County, Örebro, Sweden.
2015 (English)In: Sleep and Breathing, ISSN 1520-9512, E-ISSN 1522-1709, Vol. 19, no 1, p. 393-401Article in journal (Refereed) Published
Abstract [en]

This 10-year follow-up prospective study aimed to evaluate the effects of treatment with a mandibular protruding device (MPD) on respiratory parameters and subjective symptoms in patients with obstructive sleep apnea (OSA) or snoring. Seventy-seven consecutive patients diagnosed with OSA or snoring were treated with an MPD. At baseline and the 10-year follow-up, a polygraphic examination and questionnaires on sleep quality were administrated and weight, and neck size was measured. At the 10-year follow-up, we examined 64 of the 77 patients and recorded their current treatment (45 MPD, 9 continuous positive airway pressure (CPAP), and 10 no treatment). For MPD patients, 89 % reported MPD use every night and 9 % several nights a week. Compared to baseline, MPD users with OSA had a significantly decreased oxygen desaturation index (ODI) (p = 0.006) and increased lowest arterial oxygen saturation, SaO(2) nadir (p = 0.007) after 10 years. MPD treatment was successful for 70 % of OSA patients, yet 89 % subjectively considered themselves cured, indicating overestimation of the treatment effect. OSA patients who responded to treatment maintained baseline weight and neck size, while these increased for non-responders. Of the baseline snorers still using an MPD, 93 % maintained an ODI value of < 5. All CPAP users had an ODI value of < 5. Both OSA and snorers using an MPD had significantly fewer self- and relative reports of snoring, apnea, daytime tiredness, and poor night sleep quality (p < 0.001). MPD treatment is well tolerated and effective in a long-term, 10-year perspective. Weight gain may jeopardize MPD effects. Both patients and relatives reported significantly less snoring and fewer periods of apnea.

Place, publisher, year, edition, pages
2015. Vol. 19, no 1, p. 393-401
Keywords [en]
Obstructive sleep apnea, Snoring, Oral appliance, Mandibular advancement device, Polygraphy, Questionnaire, Prospective, Long-term follow-up
National Category
Neurosciences
Identifiers
URN: urn:nbn:se:oru:diva-56678DOI: 10.1007/s11325-014-1034-5ISI: 000349983900059OAI: oai:DiVA.org:oru-56678DiVA, id: diva2:1083580
Available from: 2017-03-21 Created: 2017-03-21 Last updated: 2018-07-08Bibliographically approved

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