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Neuropsychobiology. 2007;55(3-4):184-93. Epub 2007 Aug 14.

Effects of a mandibular repositioning appliance on sleep structure, morning behavior and clinical symptomatology in patients with snoring and sleep-disordered breathing.

Author information

1
Department of Periodontology, Bernhard Gottlieb University Dental School, Medical University of Vienna, Vienna, Austria. alexander.saletu@meduniwien.ac.at

Abstract

BACKGROUND:

Mandibular repositioning appliances (MRAs) have become an established treatment for snoring and sleep-disordered breathing - though most studies only focused on the evaluation of respiratory variables.

METHODS:

This single-blind, placebo-controlled case-series study investigated the effects of an individually adjustable MRA on psychopathology, macro-/microstructure of sleep, periodic leg movements, morning performance, mood/affect and psychophysiology. Fifty patients (37 males) aged 59.7 +/- 10.3 years, suffering from primary snoring (7), mild (22), moderate (15) and severe apnea (6), spent 4 nights in the sleep laboratory (adaptation, placebo, drug and MRA night). The drug night is not subject of the present paper.

RESULTS:

Confirmatory statistics showed an improvement of the snoring index by 72%. Descriptively, the apnea index and the apnea-hypopnea index normalized. A clinical improvement was seen in the Pittsburgh Sleep Quality Index, the Zung Anxiety/Depression Scales and the Epworth Sleepiness Scale. The restless legs syndrome also improved. Polysomnographically, sleep stages REM and 4 as well as REM latency increased, stage 3, movement time, stage shifts and periodic leg movements decreased, as did all arousal measures. Subjectively, morning well-being, drive, affectivity and wakefulness improved. Objectively, attention, motor and reaction time performance, critical flicker frequency as well as muscular strength increased, diastolic blood pressure and the pulse rate decreased.

CONCLUSION:

Apart from its good therapeutic effects on snoring and respiratory variables (snoring showed complete or partial response in 68%, the apnea-hypopnea index in 67% of the apnea patients), the MRA also improved psychopathology, objective and subjective sleep and awakening quality.

PMID:
17700043
DOI:
10.1159/000107071
[Indexed for MEDLINE]
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