Mandibular Device Doesn't Improve Quality of Life in Sleep Apnea

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A custom-made, adjustable oral appliance that moves the mandible forward during sleep does reduce obstructive sleep apnea and snoring, but does not appear to improve daytime sleepiness and quality of life, according to results from a clinical trial published in JAMA Internal Medicine.

Marie Marklund, PhD, DDS, of Umeå University, Sweden, and colleagues sought to examine whether a mandibular device would improve daytime sleepiness and quality of life in patients with daytime sleepiness and snoring or mild to moderate obstructive sleep apnea. In total, 96 patients with daytime sleepiness and a apnea-hypopnea index lower than 30 were randomized to either the mandibular device or placebo for four months of intervention.

At the four-month follow-up, those who used the mandibular device did not show improvements in daytime sleepiness from baseline compared to those using the placebo device. Snoring and symptoms of restless legs syndrome were reported less frequently in the group using the device compared to placebo, however this did not affect headache or insomnia. Apnea improved in those using the device, with 49% of patients with an apnea-hypopnea index lower than 5 compared to 11% of patients using the placebo device.

Adverse effects were more common in the device group, with patients reporting jaw pain (P=.004), tooth pain (P.02), hypersalivation (P=.03), and bite changes (P<.001).

Despite little to no improvement in daytime sleepiness or quality of life, 89% of those using the mandibular device wanted to continue use of the device after completion of the trial, while 52% of the placebo group also were interested in continuing use. 

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Mandibular Device Doesn't Improve Quality of Life in Sleep Apnea

Oral appliances that move the mandible forward during sleep are suggested as treatment for mild to moderate obstructive sleep apnea.

The purpose of the trial was to test whether an adjustable, custom-made oral appliance improves daytime sleepiness and quality of life in patients with daytime sleepiness and snoring or mild to moderate obstructive sleep apnea. Ninety-six patients with daytime sleepiness and an apnea-hypopnea index (AHI) lower than 30 were included in a randomized, placebo-controlled, parallel trial in Umeå, Sweden, from May 2007 through August 2011.

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