Treatment success with a mandibular advancement device is related to supine-dependent sleep apnea

Chest. 1998 Dec;114(6):1630-5. doi: 10.1378/chest.114.6.1630.

Abstract

Study objective: To evaluate the effect of a mandibular advancement device in patients with supine-dependent sleep apnea and patients with non-supine-dependent sleep apnea.

Design: Prospective study.

Setting: Department of Respiratory Medicine, University Hospital, Umeå, Sweden.

Patients: Twenty-six patients with obstructive sleep apnea.

Intervention: Individually fabricated and adjusted mandibular advancement devices.

Measurements: Overnight polysomnographic sleep recordings with and without the device. Supine-dependent sleep apnea was defined when the supine apnea-hypopnea index was > or = 10, together with a lateral apnea-hypopnea index of < 10. Non-supine-dependent sleep apnea was considered when the lateral apnea-hypopnea index was > or = 10.

Results: In 12 patients with supine-dependent sleep apnea, the device reduced the supine apnea-hypopnea index from a median of 41 (range, 16 to 70) to 5.9 (range, 0.0 to 15) (p < 0.01). In 14 patients with non-supine-dependent sleep apnea, the treatment reduced the supine apnea-hypopnea index from 44 (range, 1.8 to 73) to 21 (range, 6.3 to 60) (p < 0.05) and the lateral apnea-hypopnea index from 21 (range, 12 to 70) to 4.5 (range, 0.0 to 31) (p < 0.01). The odds ratio for a successful apnea reduction to an apnea-hypopnea index of < 10 in both the supine and the lateral positions was 30 for supine-dependent sleep apnea adjusted for age, obesity, mandibular advancement, and mandibular opening (p < 0.01).

Conclusion: Successful apnea reduction with a mandibular advancement device is highly related to supine-dependent sleep apnea.

Publication types

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

MeSH terms

  • Adult
  • Aged
  • Humans
  • Mandibular Advancement / instrumentation*
  • Middle Aged
  • Odds Ratio
  • Polysomnography
  • Sleep Apnea Syndromes / therapy*
  • Supine Position
  • Treatment Outcome