STUDY OBJECTIVES: The purpose of this study was to determine if subjects with moderate-to-severe obstructive sleep apnea would experience increasing treatment effect when a tongue retention component was added to a mandibular repositioning appliance. DESIGN: Cohort study. SETTING: Sleep clinic. PATIENTS: Forty-four sequentially recruited patients with moderate-to-severe obstructive sleep apnea. INTERVENTIONS: Subjects were sleep tested at 4 treatment stages of oral appliance therapy. The 4 stages were: 6-mm mandibular protrusion, 8-mm protrusion, 6-mm protrusion with a tongue retention bulb, and 8-mm protrusion with a tongue retention bulb. MEASUREMENTS AND RESULTS: Forty-one of 44 subjects completed the protocol. There was a decrease in mean respiratory disturbance index from 33.5 events/h at baseline to 18.1 events/h at stage 4 (p = 0.001). Mean Epworth Sleepiness Scale (ESS) decreased from 12.3 at baseline to 9.0 at stage 4 (p = 0.0001. CONCLUSIONS: A combined approach utilizing both mandibular protrusion and tongue retention can provide effective treatment for moderate-to-severe obstructive sleep apnea. The addition of a tongue bulb may provide further treatment effect when mandibular protrusion is limited. Appliance designs that allow for convenient combination therapy need to be developed for this purpose.
STUDY OBJECTIVES: The purpose of this study was to determine if subjects with moderate-to-severe obstructive sleep apnea would experience increasing treatment effect when a tongue retention component was added to a mandibular repositioning appliance. DESIGN: Cohort study. SETTING: Sleep clinic. PATIENTS: Forty-four sequentially recruited patients with moderate-to-severe obstructive sleep apnea. INTERVENTIONS: Subjects were sleep tested at 4 treatment stages of oral appliance therapy. The 4 stages were: 6-mm mandibular protrusion, 8-mm protrusion, 6-mm protrusion with a tongue retention bulb, and 8-mm protrusion with a tongue retention bulb. MEASUREMENTS AND RESULTS: Forty-one of 44 subjects completed the protocol. There was a decrease in mean respiratory disturbance index from 33.5 events/h at baseline to 18.1 events/h at stage 4 (p = 0.001). Mean Epworth Sleepiness Scale (ESS) decreased from 12.3 at baseline to 9.0 at stage 4 (p = 0.0001. CONCLUSIONS: A combined approach utilizing both mandibular protrusion and tongue retention can provide effective treatment for moderate-to-severe obstructive sleep apnea. The addition of a tongue bulb may provide further treatment effect when mandibular protrusion is limited. Appliance designs that allow for convenient combination therapy need to be developed for this purpose.
Authors: Olivier M Vanderveken; Annick Devolder; Marie Marklund; An N Boudewyns; Marc J Braem; Walter Okkerse; Johan A Verbraecken; Karl A Franklin; Wilfried A De Backer; Paul H Van de Heyning Journal: Am J Respir Crit Care Med Date: 2007-08-02 Impact factor: 21.405
Authors: Nancy A Collop; W McDowell Anderson; Brian Boehlecke; David Claman; Rochelle Goldberg; Daniel J Gottlieb; David Hudgel; Michael Sateia; Richard Schwab Journal: J Clin Sleep Med Date: 2007-12-15 Impact factor: 4.062
Authors: Kate Sutherland; Hisashi Takaya; Jin Qian; Peter Petocz; Andrew T Ng; Peter A Cistulli Journal: J Clin Sleep Med Date: 2015-08-15 Impact factor: 4.062
Authors: Kate Sutherland; Olivier M Vanderveken; Hiroko Tsuda; Marie Marklund; Frederic Gagnadoux; Clete A Kushida; Peter A Cistulli Journal: J Clin Sleep Med Date: 2014-02-15 Impact factor: 4.062
Authors: Terri E Weaver; Michael W Calik; Sarah S Farabi; Anne M Fink; Maria T Galang-Boquiren; Mary C Kapella; Bharati Prasad; David W Carley Journal: Nat Sci Sleep Date: 2014-11-18