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Non-CPAP therapies in obstructive sleep apnoea: mandibular advancement device therapy
Umeå University, Faculty of Medicine, Department of Odontology, Ortodontics.
2012 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 39, no 5, 1241-1247 p.Article in journal (Refereed) Published
Abstract [en]

Mandibular advancement devices (MADs) represent the main non-continuous positive airway pressure (non-CPAP) therapy for patients with obstructive sleep apnoea (OSA). The aim of the European Respiratory Society Task Force was to review the evidence in favour of MAD therapy . Effects of tongue-retaining devices are not included in this report.

 Custom-made MADs reduce apnoea/hypopnoea index (AHI) and daytime sleepness compared with placebo devices. CPAP more effectively dIminishes AHI, while increasing data suggest fairly similar outcomes in relation to symptoms and cardiovascular health from these treatments. Patients often prefer MADs to CPAP. Milder  cases and patients with a proven increase in upper airway size as a result of mandibular advancement are most likely to experience treatment success with MADs. A custom-made device titrated from an initial 50% of  maximum mandibular  advancement has been recommended. More research is needed to define the patients who will benefit from MAD treatment compared with CPAP, in terms of the effects on sleep—disordered breathing and on other diseases related to OSA.

 In conclusion,  MADs are recommended for patients with mild to moderate OSA (Recommendation Level A) and for those who do not tolerate CPAP. The treatment must be followed up and the device adjusted or exchanged in relation to the outcome.

Place, publisher, year, edition, pages
2012. Vol. 39, no 5, 1241-1247 p.
Keyword [en]
Mandibular advancement device, mandibular advancement splint, mandibular repositioning appliance, oral appliance, sleep apnoea
National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:umu:diva-55202DOI: 10.1183/09031936.00144711OAI: oai:DiVA.org:umu-55202DiVA: diva2:526298
Available from: 2012-05-11 Created: 2012-05-11 Last updated: 2017-12-07Bibliographically approved

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CiteExportLink to record
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