[The use of mandibular advancing devices in the treatment of snoring and mild to moderate obstructive sleep apnoea syndrome]

Abstract

Mandibular advancing devices (MAD) are a therapeutic option for snoring, mild obstructive sleep apnoea (OSA) and some patients with moderate or severe OSA non compliant to CPAP.

Aim: evaluating the efficacy of MAD in the treatment of snoring and mild OSA.

Materials and method: MAD were applied in 26 patients (23 men) with a polysomnographic record (PSG) performed in the Polisomnography Lab II, Clinical Pneumophthysiology Hospital Iasi between 15 February- 15 October 2007. Nineteen patients were included (the rest were excluded for various reasons). Each patient was examined ENT. PSG used a Weinmann, Germany, device, SomnoManager 12.7 software. MAD were installed. After one month patients were checked with polygraph Weinmann SomnoCheck effort for evaluating the treatment efficacy.

Results: All included patients snored in over 30% of total sleeping time (TST), having over 30 snorring episodes per sleep hour. The mean of snoring episodes per hour was 40.42 +/- 7.15 at diagnosis and at evaluation after a month it was reduced to 20.64 +/- 5.66 episodes per sleep hour. Mean value of AHI (apnoea-hypopnoea index) at diagnosis was 12.78 +/- 3.95 and after 1 month of MAD was 6.35 +/- 2.84 events per sleep hour. Mean body mass index (BMI) was 27.7 kg/m2 +/- 2.89 and wasn't changed at check-up. Desaturation index was 19.15 +/- 6.4 at diagnosis and improved to 7.94 +/- 3.39 desaturation episodes per sleep hour after 1 month of treatment. The side effects reported were transient, consisting in discomfort of the temporo-mandibular joint and mild tooth ake. Most patients (16 subjects) use the device every night, displaying a high complianace to treatment.

Conclusions: The use of MAD proves to be efficient in snoring patients, reduce AHI and associate a good compliance.