OBJECTIVE: Mandibular advancement devices (MADs) have been introduced as a conservative, non-invasive treatment for socially disturbing snoring and mild obstructive sleep apnea (OSA). A prospective, non-randomized pilot study was conducted to investigate the efficacy, feasibility, side-effects and compliance of Somnoguard, an immediately intraorally adaptable MAD made from thermoplastic material. MATERIAL AND METHODS: Twenty consecutive heavy snorers with a respiratory disturbance index of <20 events/h were prospectively selected. Prior to the adaptation of the appliance, ambulatory polygraphy was carried out without a MAD. After a 1-month habituation period, a polygraphic evaluation was carried out with the device. Treatment success was defined as a reduction in the apnea-hypopnea index (AHI) of at least 50%. RESULTS: The results indicated a success rate of 65%. The AHI decreased from 8.4 +/- 2.9 events/h at baseline to 3.9 +/- 1.8 events/h with the device (p = 0.001). At 1-month follow-up, significant reductions in the snoring index (p < 0.001) and the Epworth Sleepiness Scale (ESS) score (p = 0.036) were noted. At 6-month follow-up, similar results were achieved, with significant drops in the snoring index (p = 0.025) and ESS score (p = 0.033). CONCLUSION: We conclude that immediate intraoral adaptation of a low-cost fabricated "one-size-only" MAD is a feasible and well-tolerated treatment for snoring and mild OSA. Further research is needed to evaluate this thermoplastic appliance as a strategy to "screen" the efficacy of MAD treatment in the individual patient with a less expensive appliance before constructing a more expensive custom-made MAD.
OBJECTIVE: Mandibular advancement devices (MADs) have been introduced as a conservative, non-invasive treatment for socially disturbing snoring and mild obstructive sleep apnea (OSA). A prospective, non-randomized pilot study was conducted to investigate the efficacy, feasibility, side-effects and compliance of Somnoguard, an immediately intraorally adaptable MAD made from thermoplastic material. MATERIAL AND METHODS: Twenty consecutive heavy snorers with a respiratory disturbance index of <20 events/h were prospectively selected. Prior to the adaptation of the appliance, ambulatory polygraphy was carried out without a MAD. After a 1-month habituation period, a polygraphic evaluation was carried out with the device. Treatment success was defined as a reduction in the apnea-hypopnea index (AHI) of at least 50%. RESULTS: The results indicated a success rate of 65%. The AHI decreased from 8.4 +/- 2.9 events/h at baseline to 3.9 +/- 1.8 events/h with the device (p = 0.001). At 1-month follow-up, significant reductions in the snoring index (p < 0.001) and the Epworth Sleepiness Scale (ESS) score (p = 0.036) were noted. At 6-month follow-up, similar results were achieved, with significant drops in the snoring index (p = 0.025) and ESS score (p = 0.033). CONCLUSION: We conclude that immediate intraoral adaptation of a low-cost fabricated "one-size-only" MAD is a feasible and well-tolerated treatment for snoring and mild OSA. Further research is needed to evaluate this thermoplastic appliance as a strategy to "screen" the efficacy of MAD treatment in the individual patient with a less expensive appliance before constructing a more expensive custom-made MAD.
Authors: John Reid; Regina Taylor-Gjevre; John Gjevre; Robert Skomro; Mark Fenton; Femi Olatunbosun; John R Gordon; David Cotton Journal: J Clin Sleep Med Date: 2013-04-15 Impact factor: 4.062
Authors: Boris A Stuck; Alfred Dreher; Clemens Heiser; Michael Herzog; Thomas Kühnel; Joachim T Maurer; Hans Pistner; Helmut Sitter; Armin Steffen; Thomas Verse Journal: Sleep Breath Date: 2014-04-13 Impact factor: 2.816
Authors: M Dieltjens; O M Vanderveken; D Van den Bosch; K Wouters; J Denollet; J A Verbraecken; P H Van de Heyning; M J Braem Journal: Sleep Breath Date: 2012-11-13 Impact factor: 2.816
Authors: B A Stuck; A Dreher; C Heiser; M Herzog; T Kühnel; J T Maurer; H Pistner; H Sitter; A Steffen; T Verse Journal: HNO Date: 2013-11 Impact factor: 1.284
Authors: M Dieltjens; O M Vanderveken; E Hamans; J A Verbraecken; K Wouters; M Willemen; W A De Backer; P H Van de Heyning; M J Braem Journal: Sleep Breath Date: 2012-05-13 Impact factor: 2.816