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Impact of an oral appliance on obstructive sleep apnea severity, quality of life, and biomarkers
Author(s) -
FernándezJulián Enrique,
PérezCarbonell Tomás,
Marco Rocío,
Pellicer Verónica,
RodriguezBorja Enrique,
Marco Jaime
Publication year - 2018
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.26913
Subject(s) - medicine , obstructive sleep apnea , polysomnography , epworth sleepiness scale , continuous positive airway pressure , quality of life (healthcare) , gastroenterology , c reactive protein , oxygen saturation , hypopnea , apnea , anesthesia , inflammation , chemistry , nursing , organic chemistry , oxygen
Objective/Hypothesis To investigate outcomes including efficacy, quality of life, and levels of inflammatory markers of a mandibular advancement device (MAD) for moderate‐to‐severe obstructive sleep apnea (OSA). Study Design Case‐control study. Methods Patients with apnea‐hypopnea index (AHI) ≥ 15/hr who only accepted MAD therapy (study group) or who refused any treatment (control group) were recruited. At baseline and at 6 months, polysomnography, Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), C‐reactive protein (CRP), interleukin 1β, interleukin 6, and tumor necrosis factor α (TNF‐α) were assessed in both groups. Results At baseline, the study group (n = 30) showed a higher percentage of rapid eye movement sleep and higher CRP levels ( P < .05) than the control group (n = 10). At 6 months, the MAD significantly improved AHI and lowest oxygen saturation ( P < .01), non–rapid eye movement (N)1 and N3 sleep stages ( P < .05), ESS score ( P < .05), FOSQ total score ( P < .01), interleukin 1β ( P < .05), and TNF‐α ( P < .01) compared with the untreated group. In the overall, moderate, and severe OSA groups, 63.3%, 75%, and 50%, respectively, achieved at least good response. Conclusions Use of a MAD significantly improved polysomnographic parameters, quality of life, and some inflammatory markers (CRP, IL‐β, and TNF‐α) in a significant proportion of patients with moderate OSA and in some patients with severe OSA. Hence, a MAD may be a viable alternative therapy in patients with moderate‐to‐severe OSA who refuse continuous positive airway pressure. Level of Evidence 3b. Laryngoscope , 128:1720–1726, 2018