Elastic retracted oral appliance to treat sleep apnea in mentally impaired patients and patients with neuromuscular disabilities.

STATEMENT OF PROBLEM: Various oral appliances have been successfully used in the treatment of sleep apnea. However, it is difficult for mentally impaired patients and patients with neuromuscular disabilities to insert and remove the appliance and to maintain it intraorally through the night.
PURPOSE: This study described the fabrication of an elastic retracted-type oral appliance to treat sleep apnea in mentally impaired patients and patients with neuromuscular disabilities and to evaluate its efficiency.
MATERIAL AND METHODS: Five patients, 3 with cerebral palsy and 2 with Down's syndrome, with sleep apnea were included in this study. Maxillary and mandibular splints were molded individually on casts by using copolyester foils. The splints were retracted forward by elastics, attached to wire hooks in the maxillary and mandibular incisal areas. The effect of the appliance was examined polysomnographically.
RESULTS: The apnea index was decreased significantly (P <.03) by the appliance. The appliance was easily inserted and removed, and the elastic force and mandibular position could be adjusted. The appliance, as used in this study, allowed free mandibular movement and maintained its correct position during sleep despite involuntary or voluntary mandibular movements.
CONCLUSIONS: The oral appliance was useful as an alternative to relieve the sleep apnea of patients with mental deficiencies and neuromuscular disabilities.