Effect of oral appliance therapy on neurobehavioral functioning in obstructive sleep apnea: a randomized controlled trial

J Clin Sleep Med. 2005 Oct 15;1(4):374-80.


Study objectives: This study aimed to assess the efficacy of a custom-made mandibular advancement splint for the treatment of obstructive sleep apnea with respect to neuropsychological functioning and mood state.

Methods: A randomized controlled crossover design was used in which 73 participants (mean age = 48.4, SD = 11.0, % men = 80.8) with at least 2 symptoms of obstructive sleep apnea and an apnea hypopnea index > or = 10 per hour underwent treatment with both mandibular advancement splint and an inactive oral device. Polysomnographic, neuropsychological and self-report measures were conducted at baseline and repeated after each of the two 4-week treatment phases.

Results: MAS treatment was associated with improvements on the somatic component of the Beck Depression Inventory and the Vigor-Activity and Fatigue-Inertia scales of the Profile of Mood States. While there were no improvements within the neuropsychological domains of attention/working memory, verbal memory, visuospatial or executive functioning, treatment with the mandibular advancement splint was associated with faster performance on a test of vigilance/psychomotor speed. These changes, however, did not correspond to the improved subjective sleepiness or apnea-hypopnea index during treatment.

Conclusions: Treatment with the mandibular advancement splint results in improvements in self-reported sleepiness, fatigue/energy levels and vigilance/psychomotor speed in patients with obstructive sleep apnea.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activator Appliances*
  • Brain / physiopathology*
  • Cross-Over Studies
  • Disorders of Excessive Somnolence / epidemiology
  • Female
  • Humans
  • Male
  • Memory Disorders / diagnosis
  • Memory Disorders / epidemiology
  • Middle Aged
  • Neuropsychological Tests
  • Oropharynx / physiopathology*
  • Polysomnography
  • Prospective Studies
  • Single-Blind Method
  • Sleep Apnea, Obstructive / epidemiology
  • Sleep Apnea, Obstructive / physiopathology*
  • Sleep Apnea, Obstructive / therapy*
  • Sleep, REM / physiology
  • Verbal Learning