Revista Española de Cirugía Oral y Maxilofacial
versión impresa ISSN 1130-0558
SANCHEZ-MOLINI, Manuel et al. Sleep apnea-hypopnea syndrome management using a mandibular advancement device: Preliminary study. Rev Esp Cirug Oral y Maxilofac [online]. 2010, vol.32, n.4, pp.152-158. ISSN 1130-0558.
The most effective treatment in patients with sleep apnea-hypopnea syndrome (SAHS) is CPAP (continuous positive airway pressure). The main drawback of CPAP is the discomfort and claustrophobic sensation that it causes, which elicits rejection or intolerance by some patients. A non-surgical alternative to CPAP is the mandibular advancement device (MAD), which consists of a plastic splint inserted between the dental arches to shift the jaw and tongue forward and thus increase airway volume. Objective: Report our experience with the treatment of SAHS using the Herbst mandibular advancement device. Material and method: A prospective follow-up study was carried out from June 2006 until January 2009 at the Virgen Macarena University Hospital with 7 patients with SAHS who refused treatment with CPAP and were treated with the mandibular advancement device. The outcome variables analyzed were: apnea-hypopnea disruptions per hour index, desaturations per hour index, subjective intensity of snoring, and the Epworth Sleepiness Scale. Variables were evaluated pre-treatment and at least once 6 months after initiation MAD use. The Wilcoxon test for paired samples was used to detect statistically significant differences (p<0.05). Results: A statistically significant reduction in the hourly indices of apnea-hypopnea disruptions (p<0.018) and desaturations (p<0.018) was observed, as well as a statistically nonsignificant reduction in snoring and sleepiness. Conclusions: Use of the Herbst mandibular advancement device in patients with obstructive sleep apnea syndrome who refuse CPAP may be helpful as it improves the clinical and functional parameters of the condition.
Palabras clave : Mandibular advancement device; Herbst; Sleep apnea-hypopnea syndrome (SAHS); Polysomnography.