Evgenia Sp Gogou1, Vasilios Psarras2, Nikolaos Nikitas Giannakopoulos3,4, Ioannis Koutsourelakis5, Demetrios J Halazonetis6, Michail Ger Tzakis2. 1. Orofacial Pain Clinic, Dental School, National and Kapodistrian University of Athens, GR-11527, Athens, Greece. eugeniagogou@gmail.com. 2. Orofacial Pain Clinic, Dental School, National and Kapodistrian University of Athens, GR-11527, Athens, Greece. 3. Department of Prosthodontics, Dental School, National and Kapodistrian University of Athens, GR-11527 , Athens, Greece. 4. Department of Prosthodontics, University Clinic of Würzburg, Würzburg, Germany. 5. Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, NY, 10021, USA. 6. Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, GR-11527, Athens, Greece.
Abstract
PURPOSE: To compare the short-term treatment effect of a mandibular advancement device (MAD) with and without previous drug-induced sleep endoscopy (DISE) on polysomnography (PSG) and other sleep apnea-related treatment outcomes (Short Form Health Survey [SF-36] and Epworth Sleepiness Scale [ESS]) among adults with mild, moderate, and severe obstructive sleep apnea (OSA). We hypothesized that using DISE would improve the efficacy of MADs on the sleep apnea parameters. METHODS: The study sample consisted of patients with OSA who were unable or unwilling to tolerate a CPAP device, divided into an experimental (with DISE) and a control (without DISE) group. RESULTS: Of 50 patients with OSA, 40 men (80%), mean age was 48.8 ± 12,3 years. The mean apnea-hypopnea index (AHI) score of both groups decreased significantly between baseline and the 8-week follow-up titration PSG with MAD in situ, from 31.7 ± 17.3 (mean ± SD) apnea-hypopnea episodes/h to 7.0 ± 6.4/h (p < 0.0001) in the experimental group, and from 22.5 ± 16.6 episodes/h to 11.4 ± 8.0/h (p < 0.024) in the control group. Capillary oxygen saturation (SpO2) levels did not change significantly between the two timepoints for either group. The SF-36 (p < 0.023) and ESS (p < 0.036) results of both groups improved significantly between baseline and the 8-week follow-up after starting MAD treatment; however, the improvement in quality of life was significantly more pronounced in the experimental group than in the control group (p < 0.0001). CONCLUSION: DISE provides a significant benefit to patients with OSA undergoing MAD treatment. It can be used as a valuable prediction tool in clinical practice for the management of patients with OSA, even those with moderate and severe disease.
PURPOSE: To compare the short-term treatment effect of a mandibular advancement device (MAD) with and without previous drug-induced sleep endoscopy (DISE) on polysomnography (PSG) and other sleep apnea-related treatment outcomes (Short Form Health Survey [SF-36] and Epworth Sleepiness Scale [ESS]) among adults with mild, moderate, and severe obstructive sleep apnea (OSA). We hypothesized that using DISE would improve the efficacy of MADs on the sleep apnea parameters. METHODS: The study sample consisted of patients with OSA who were unable or unwilling to tolerate a CPAP device, divided into an experimental (with DISE) and a control (without DISE) group. RESULTS: Of 50 patients with OSA, 40 men (80%), mean age was 48.8 ± 12,3 years. The mean apnea-hypopnea index (AHI) score of both groups decreased significantly between baseline and the 8-week follow-up titration PSG with MAD in situ, from 31.7 ± 17.3 (mean ± SD) apnea-hypopnea episodes/h to 7.0 ± 6.4/h (p < 0.0001) in the experimental group, and from 22.5 ± 16.6 episodes/h to 11.4 ± 8.0/h (p < 0.024) in the control group. Capillary oxygen saturation (SpO2) levels did not change significantly between the two timepoints for either group. The SF-36 (p < 0.023) and ESS (p < 0.036) results of both groups improved significantly between baseline and the 8-week follow-up after starting MAD treatment; however, the improvement in quality of life was significantly more pronounced in the experimental group than in the control group (p < 0.0001). CONCLUSION: DISE provides a significant benefit to patients with OSA undergoing MAD treatment. It can be used as a valuable prediction tool in clinical practice for the management of patients with OSA, even those with moderate and severe disease.
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