The Effect of Oral Appliance Therapy on Obstructive Sleep Apnea

Introduction:

Obstructive Sleep Apnea (OSA) is the most common type of Sleep Disordered Breathing (SDB) and is due to an obstruction in the throat that occurs during sleep.

Three years ago, the Tsurumi Univ. School of Dental Med. established the Snoring and OSA clinic. This clinic was established to further develop cooperation between the Medical Department, Oral Surgery and the Prosthodontic Department.

The purpose of this study is to evaluate the Oral Appliance (OA) as treatment for OSA, and to gain insight on the patient opinion on the appliance, in particular to issues involving comfort, efficacy, convenience and overall device satisfaction.

Methods:

To verify the exact nature of their condition, patients underwent a Pre-treatment Polysomnography (PSG). Upon completing their PSG, depending on their results, an OA was fitted for use on the nightly basis, where it advanced patient maximum protrusive mandibular distance by 75%.

In the follow-up exam a questionnaire with the VAS method was administered, which asked patients to evaluate the OA on issues concerning comfort, convenience, drooling, or excessive dryness. Patients were asked to assess the OA as remarkable, effective or non-effective.

Results:

The study involved 80 OSA patients who were recruited from April 2005-October 2007. We prepared OA for 22 patients. The Post-PSG results were as follows: remarkable effect in 12 cases (55%), effective in 4 cases (18%) and non-effective in 6 cases (27%). 85% of patients reported they slept very well. However some side-effects were reported, headache (10%), TMJ or teeth pain (10%).

Conclusion:

Over all, patient satisfaction with OA was high, with only an occasional report of drooling or excessive dryness. Of the 22 patients who completed the questionnaire, 70% reported the OA as either remarkable or effective. Subsequently, the OA was a successful treatment option for OSA patients.