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Mandibular Repositioning Devices Improves Symptoms Associated With Sleep Apnoea: Presented at ERS
By Evelyn Harvey
VIENNA, Austria -- September 22, 2009 -- Custom-made mandibular repositioning devices (MRDs) can help patients with obstructive sleep apnoea syndrome (OSAS), significantly improving clinical and quality-of-life indicators over time, according to a study presented here at the 19th Annual Congress of the European Respiratory Society (ERS).
Antoine Geraards, MD, Centre Hospitalier Pneumologie, Auxerre, France, presented the findings of a prospective, multicentre study during a poster presentation on September 15.
The study included 129 patients aged 18 to 75 years who had symptomatic untreated OSAS. All patients had a body mass index (BMI) <=35 and were deemed suitable for an MRD by a dental specialist.
A traction-based optimised retention of the mandible (ORM) device was fitted to 85 patients and 44 received a compression-based Herbst-type device. Patients were followed-up for 1 year.
Efficacy was assessed according to objective and subjective criteria. Changes in the Apnea-Hypopnea Index (AHI) and Epworth Sleepiness Score were documented. Complaints of snoring from patients' partners were recorded, and patients' perceived quality of life and sleep parameters were scored using visual analogue scales (VAS).
MRD treatment was effective on all measures, with significant improvements from baseline seen in patients fitted with both the ORM and Herbst devices. AHI significantly decreased between days 0 and 90 (-56%; P < .001) and continued to decrease to day 360 (-66% from baseline).
Epworth scores fell from a mean of 11.2 at inclusion to a mean of 6.1 at day 360 (P < .001). A VAS assessment of tiredness at wake-up also showed a significant and stable improvement over time. There were no significant differences between the 2 types of device used.
High compliance rates were observed, with both types of MRD used by patients for 6.5 nights per week on average. Tolerance and treatment satisfaction were generally high, with no significant differences between the ORM and Herbst devices. The most commonly reported side effect was temporomandibular joint stiffness on waking.
Use of an MRD appears to significantly improve OSAS symptoms in untreated patients. The compression-based and traction-based MRDs are equally effective.
Funding for this study was provided by Laboratoires Narval and Artech.
[Presentation title: Mandibular Repositioning Devices Efficacy Over 1 Year as First Line Treatment for Obstructive Sleep Apnoea. Abstract P3731]
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