Maria de Lourdes Rabelo Guimarães1,2, Ana Paula Hermont3, Pedro Guimarães de Azevedo4, Poliana Lima Bastos5, Millena Teles Portela de Oliveira6, Iracema Matos de Melo7, Guilherme Salles Ottoboni8, Gabriela Vedolin9, Jorge Machado Caram3. 1. Faculty of Dentistry, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627-Pampulha, Belo Horizonte, MG, 31270-901, Brazil. mlourdesrg@gmail.com. 2. , Benvinda de Carvalho, 105/101, Santo Antônio, Belo Horizonte, Minas Gerais, 30330-180, Brazil. mlourdesrg@gmail.com. 3. Faculty of Dentistry, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627-Pampulha, Belo Horizonte, MG, 31270-901, Brazil. 4. Pontifícia Universidade Católica de Minas Gerais, Av: Dom José Gaspar, 500 Coração Eucaristíco, Belo Horizonte, MG, 30535-901, Brazil. 5. Department of Prosthesis and Occlusion, Universidade Federal do Ceará, Av. da Universidade, 2853-Benfica, Fortaleza, CE, 60020-181, Brazil. 6. Universidade Federal do Ceará, Av. da Universidade, 2853-Benfica, Fortaleza, CE, 60020-181, Brazil. 7. Department of Physiology and Pharmacology, Universidade Federal do Ceará, Av. da Universidade, 2853-Benfica, Fortaleza, CE, 60020-181, Brazil. 8. Faculdade de Odontologia de Piracicaba, Unicamp, Av. Limeira, 901-Bairro Areião, Piracicaba, SP, 13414-903, Brazil. 9. Pontificia Universidade Catolica do Rio Grande do Sul, Av. Ipiranga, 6681-Partenon, Porto Alegre, RS, 90619-900, Brazil.
Abstract
PURPOSE: The aim of this study is to evaluate the effectiveness of two types of oral appliance (OA) in the treatment of severe obstructive sleep apnea syndrome (OSAS) and their impact on the reduction of obstructive, central and mixed apneas. METHODS: Forty-eight patients suffering from severe OSAS with a history of non-adherence to positive airway pressure therapy were treated with OA (lingual orthosis and combined orthosis). Polysomnography exams were performed before and after treatment. Computed tomography and cephalometric radiography were requested for all patients to evaluate the titrated position of the OA and the airspace obtained. Statistical tests used the Minitab, version 17, program. The level of statistical significance was 5%. RESULTS: Before treatment, the mean AHI was 56.3 ± 19.1 events/h. It decreased to 8.1 ± 5.2 after the OA titration (p ≤ 0.001). There was a significant reduction in obstructive events from 43.0 ± 20.2 to 7.1 ± 4.6 events/h (p ≤ 0.001). The reduction in central events after OA treatment was also significant (from 5.1 ± 9.3 to 0.8 ± 1.9 events/h; p ≤ 0.001), whereas that in mixed events decreased from 6.4 ± 9.5 to 0.1 ± 0.3 events/h (p ≤ 0.001). The minimum oxygen saturation also showed significant improvement after treatment (p ≤ 0.001). There was no statistically significant difference between both OA with respect to central events (p = 0.22) or mixed events (p = 0.98). CONCLUSION: The treatment was effective in reducing obstructive events which were evaluated through the AHI and minimum oxygen saturation. The oral appliances also normalized central and mixed events among patients with severe OSAS.
PURPOSE: The aim of this study is to evaluate the effectiveness of two types of oral appliance (OA) in the treatment of severe obstructive sleep apnea syndrome (OSAS) and their impact on the reduction of obstructive, central and mixed apneas. METHODS: Forty-eight patients suffering from severe OSAS with a history of non-adherence to positive airway pressure therapy were treated with OA (lingual orthosis and combined orthosis). Polysomnography exams were performed before and after treatment. Computed tomography and cephalometric radiography were requested for all patients to evaluate the titrated position of the OA and the airspace obtained. Statistical tests used the Minitab, version 17, program. The level of statistical significance was 5%. RESULTS: Before treatment, the mean AHI was 56.3 ± 19.1 events/h. It decreased to 8.1 ± 5.2 after the OA titration (p ≤ 0.001). There was a significant reduction in obstructive events from 43.0 ± 20.2 to 7.1 ± 4.6 events/h (p ≤ 0.001). The reduction in central events after OA treatment was also significant (from 5.1 ± 9.3 to 0.8 ± 1.9 events/h; p ≤ 0.001), whereas that in mixed events decreased from 6.4 ± 9.5 to 0.1 ± 0.3 events/h (p ≤ 0.001). The minimum oxygen saturation also showed significant improvement after treatment (p ≤ 0.001). There was no statistically significant difference between both OA with respect to central events (p = 0.22) or mixed events (p = 0.98). CONCLUSION: The treatment was effective in reducing obstructive events which were evaluated through the AHI and minimum oxygen saturation. The oral appliances also normalized central and mixed events among patients with severe OSAS.
Authors: Francesco Gambino; Marta Maria Zammuto; Alessandro Virzì; Giosafat Conti; Maria Rosaria Bonsignore Journal: Intern Emerg Med Date: 2022-04-23 Impact factor: 5.472
Authors: Maria de Lourdes Rabelo Guimarães; Pedro Guimarães Azevedo; Sérgio Barros-Vieira; Maxime Elbaz; Damien Leger; Ana Paula Hermont Journal: Sleep Sci Date: 2022 Jan-Mar