Effect of MADs on various degrees of obstructive sleep apnea

Method: Seventy-two adult patients with OSA who were referred for MADs from Sleep center in Toranomon Hospital from October 1^st, 2012 to September 30^th, 2013 were evaluated. As MADs, either Monoblock type appliance or Somnodent^® was made according to patients’ preferences. The typical magnitude of this anterior advancement is between 70-80% of patient’s maximum possible protrusive jaw motion. Full-polysomnography or portable polygraphy was underwent for the diagnosis of OSA and repeated while on MADs. Demographic data were collected. And changes in parameters of OSA severity such as apnea-hypopnea index (AHI) and minimum level of oxygen saturation were assessed on and off MADs.

Result: Overall 72 patients including 52 men (72.2%), 20 women (27.8%), and were evaluated (mean age, 58.5±11.6). Compared with diagnostic study (Off CPAP), the AHI decreased significantly in the second study while on MADs (from 21.9±15.6 to 5.7±5.5, p<0.05) Furthermore, 80.6% of patients achieved ≧50% of AHI reduction. As a result of multiple regression analysis, initial AHI and initial SpO₂ associated with AHI decreasing rate (p <005). While no correlation with AHI decreasing rate to gender, age and type of MAS (p>0.05).

Conclusion: MAD treatment significantly reduced AHI values even in various degrees of OSA patients but MAD compliance rate is likely to be different.