Otolaryngology office-based treatment of obstructive sleep apnea-hypopnea syndrome with titratable and nontitratable thermoplastic mandibular advancement devices

Michael Friedman, Tanya Pulver, Meghan N. Wilson, Dina Golbin, Christopher Leesman, George Lee, Ninos J. Joseph

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Objective: 1) Share our experiences treating patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) with titratable and nontitratable thermoplastic mandibular advancement devices (MADs) fitted in our otolaryngology clinic. 2) Compare these devices in terms of objective response (OR), as defined by a ≥ 50 percent decrease in baseline apnea-hypopnea index (AHI) and an AHI < 20, and subjective parameters, including adherence. 3) Determine overall success, as defined by OR plus adherence at two months follow-up. Study Design: Cohort study. Setting: Tertiary care center. Subjects and Methods: Patients with OSAHS who tried and failed or refused both continuous positive airway pressure (CPAP) and surgical therapy were fitted with a nontitratable Snore Guard (n = 38), nontitratable SomnoGuard 2.0 (n = 8), or titratable SomnoGuard AP (n = 41). Pre- and post-treatment assessment included: 1) Epworth Sleepiness Scale, 2) snoring level, 3) polysomnogram. Patients were contacted at two months follow-up to assess adherence and subjective parameters. Results: OR was achieved in 62.1 percent of patients. Overall mean reduction in AHI was from 39.96 ± 23.70 to 14.86 ± 13.46 (P = 0.000). Adherence at two months was 58.5 percent. No significant differences were observed in OR or adherence according to MAD type, though improvements in AHI and minimum oxygen saturation were significantly better for the SomnoGuard AP than for the nontitratable devices. Overall success was 38.6 percent. Conclusion: Thermoplastic MADs are a relatively inexpensive treatment alternative for patients with OSAHS who fail/refuse CPAP and upper airway surgery. They can be easily fitted in the otolaryngology clinic. Long-term compliance, efficacy, and safety are unknown at this time.

Original languageEnglish (US)
Pages (from-to)78-84
Number of pages7
JournalOtolaryngology - Head and Neck Surgery
Volume143
Issue number1
DOIs
StatePublished - Jul 1 2010

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Mandibular Advancement
Otolaryngology
Obstructive Sleep Apnea
Apnea
Equipment and Supplies
Continuous Positive Airway Pressure
Therapeutics
Snoring
Tertiary Care Centers
Compliance
Cohort Studies
Oxygen
Safety

All Science Journal Classification (ASJC) codes

  • Surgery
  • Otorhinolaryngology

Cite this

Friedman, Michael ; Pulver, Tanya ; Wilson, Meghan N. ; Golbin, Dina ; Leesman, Christopher ; Lee, George ; Joseph, Ninos J. / Otolaryngology office-based treatment of obstructive sleep apnea-hypopnea syndrome with titratable and nontitratable thermoplastic mandibular advancement devices. In: Otolaryngology - Head and Neck Surgery. 2010 ; Vol. 143, No. 1. pp. 78-84.
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Otolaryngology office-based treatment of obstructive sleep apnea-hypopnea syndrome with titratable and nontitratable thermoplastic mandibular advancement devices. / Friedman, Michael; Pulver, Tanya; Wilson, Meghan N.; Golbin, Dina; Leesman, Christopher; Lee, George; Joseph, Ninos J.

In: Otolaryngology - Head and Neck Surgery, Vol. 143, No. 1, 01.07.2010, p. 78-84.

Research output: Contribution to journalArticle

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