Premium
Long‐term effects of mandibular repositioning appliances on symptoms of sleep apnoea
Author(s) -
MARKLUND MARIE,
FRANKLIN KARL A.
Publication year - 2007
Publication title -
journal of sleep research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.297
H-Index - 117
eISSN - 1365-2869
pISSN - 0962-1105
DOI - 10.1111/j.1365-2869.2007.00615.x
Subject(s) - medicine , mras , excessive daytime sleepiness , polysomnography , cohort , headaches , physical therapy , pediatrics , sleep disorder , anesthesia , surgery , apnea , insomnia , psychiatry , physics , vector control , quantum mechanics , voltage , induction motor
Summary Mandibular repositioning appliances (MRAs) reduce symptoms of obstructive sleep apnoea in the short term, but the long‐term effects are unknown. Our objective was to evaluate the long‐term symptomatic effects of custom‐made MRAs and to identify the patients who will experience subjective benefits from treatment. A cohort of 260 consecutive patients treated with appliances for non‐apnoeic snoring or sleep apnoea was followed up by a questionnaire and examination after an average of 5.4 years. The subjective effect was defined as good when complaints of daytime sleepiness occurred less than once a week. A total of 185 patients (71%) responded to the questionnaires. Of the respondents, 96 reported frequent use, 33 reported infrequent use, 26 reported discontinued treatment and 30 reported modified treatment. Mild cases (apnoea–hypopnoea index [AHI] < 15) were likelier than more severe cases to continue treatment. Patients who had used MRAs reported fewer complaints of sleepiness, headaches and daytime naps. Frequent use ( P = 0.001), few night‐time awakenings before start of treatment ( P = 0.02) and effective apnoea reduction during treatment of more severe cases ( P = 0.02) correlated with a good subjective effect at long‐term follow‐up. Our conclusion is that custom‐made MRAs reduce sleep apnoea symptoms in the long term. The mildest cases will experience the greatest long‐term benefit. The reason is that non‐apnoeic snorers and patients with a mild disease are more likely to continue treatment and that their long‐term results with regard to excessive sleepiness are similar to patients with a more severe disease.