Assessment of Anterior Mandibular Positioning Device for OSAS

Objectives: The purpose of this study was to evaluate usefulness of anterior mandibular positioning (AMP) device for patients with OSA (Obstructive sleep apnea) and treatment effects of AMP device.
Methods: 135 patients with OSA who provided AMP device were recruited in this study. Their overnight PSG at pre- and post-treatment were recorded. They were mailed to determine whether they were still using the AMP device. If yes, they were asked whether their subjective symptoms were improved by treatment. If not, they were asked why they stopped using it.
Results: 33 patients of the 48 responding patients were still using the AMP device. 30 patients of them had improved subjective symptoms; snore (n=32), apnea (n=21), daytime sleepiness (n=11), morning awakeness (n=10). The most common compliance was excessive salivation (n=10). AI*, AHI** at pre-treatment were significantly lower than that at post- treatment. The lowest SaO₂ ** at pre- treatment was significantly higher than that post-treatment in the still using group (*: p<0.001, **: p<0.05). However, arousal index did not differ between pre- and post-treatment.
15 patients were stopped using the AMP devices, Their primary reason for stopped using the device was “no treatment effect” (n=5). Four indexes from PSG recording did not differ between pre- and post-treatment in this group.
Conclusions: These results suggested that both the subjective symptoms and the parameters from PSG recording were improved with using the AMP device in the still using group. However, the patients stopped using the device had no subjective symptoms and no different sleep qualities between pre and post treatment. It was necessary to improve device to get more treatment effect and acceptable to use it.