The use of mandibular advancing devices in the treatment of snorring and mild to moderate obstructiv
Abstract
Birleanu Lorena Adriana1, Gianina Rusu1, Traian Mihaescu1,21 Universitatea de Medicina si Farmacie „Gr. T. Popa" Iasi,
2 Spitalul de Pneumologie Iasi
Contact: Birleanu Adriana Lorena, bradudaniel2000@yahoo.com
ABSTRACT
Mandibular advancing devices (MAD) are a therapeutic option for snorring, mild obstructive sleep apnoea (OSA) and some patients with moderate or severe OSA non compliant to CPAP. Aim: evaluating the efficacy of MAD in the treatment of snorring and mild OSA. Materials and method: MAD were applied in 26 patients (23 men) with a polysomnographic record (PSG) performed in the Polisomnography Lab II, Clinical Pneumophthysiology Hospital Iasi between 15 February - 15 October 2007. Nineteen patients were included (the rest were excluded for various reasons). Each patient was examined ENT. PSG used a Weinmann, Germany, device, SomnoManager 12.7 software. MAD were installed. After one month patients were checked with polygraph Weinmann SomnoCheck effort for evaluating the treatment efficacy.
Results: All included patients snorred in over 30% of total sleeping time (TST), having over 30 snorring episodes per sleep hour. The mean of snorring episodes per hour was 40.42 ± 7.15 at diagnosis and at evaluation after a month it was reduced to 20.64 ± 5.66 episodes per sleep hour. Mean value of AHI (apnoea-hypopnoea index) at diagnosis was 12.78 } 3.95 and after 1 month of MAD was 6.35 ± 2.84 events per sleep hour. Mean body mass index (BMI) was 27.7 kg/m2 } 2.89 and wasn't changed at check-up. Desaturation index was 19.15 ± 6.4 at diagnosis and improved to 7.94 ± 3.39 desaturation episodes per sleep hour after 1 month of treatment. The side effects reported were transient, consisting in discomfort of the temporo-mandibular joint and mild tooth ake. Most patients (16 subjects) use the device every night, displaying a high complienace to treatment.
Conclusions: The use of MAD proves to be efficient in snorring patients, reduce AHI and have a good associate a good compliance.
Keywords: MAD, snorring, OSAS.