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Sleep Breath. 2016 May;20(2):689-94. doi: 10.1007/s11325-015-1280-1. Epub 2015 Nov 2.

Long-term efficacy of an oral appliance in early treated patients with obstructive sleep apnea.

Author information

1
Department of Odontology, Umeå University, SE-901 87, Umeå, Sweden. marie.marklund@odont.umu.se.

Abstract

PURPOSE:

The purpose of the present study was to evaluate the long-term efficacy of oral appliances (OAs) in early treated patients with obstructive sleep apnea (OSA).

METHOD AND PATIENTS:

Polysomnographic sleep recordings without and with an OA were performed at treatment start and in patients who had been continuously treated with OAs for at least 15 years.

RESULTS:

Nine patients (eight men) with a median age of 68.1 years (interquartile range (IQR) 60.0 to 76.3 years) and a median treatment time of 16.5 years (IQR 16.3 to 18.0 years) were included. The apnea-hypopnea index decreased from a median of 17.3 (IQR 9.7 to 26.5) to 7.2 (IQR 4.0 to 9.6; p = 0.03) at the short-term follow-up. After long-term use, the apnea-hypopnea index was 32.4 (IQR 22.2 to 58.8) without the device and 35.1 (IQR 13.6 to 46.2) with it (p = 0.08). There were increases in the apnea-hypopnea index, both without the device (p = 0.02) and with it (p = 0.008). The degree of mandibular advancement did not differ between the two study occasions (p = 1.0).

CONCLUSIONS:

Patients treated with oral appliances may experience deteriorations in disease severity and treatment efficacy during continuous long-term OA treatment. Regular follow-up schedules with renewed sleep apnea recordings should be considered for these patients in order to avoid suboptimal or a total loss of effects on sleep apneas.

KEYWORDS:

Long-term; Mandibular advancement device; Obstructive sleep apnea; Oral appliance

PMID:
26527204
DOI:
10.1007/s11325-015-1280-1
[Indexed for MEDLINE]

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