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CC BY-NC-ND 4.0 · Sleep Sci 2018; 11(02): 118-122
DOI: 10.5935/1984-0063.20180022
CASE REPORT

Severe obstructive sleep apnea treatment with mandibular advancement device: A case report

Maria de Lourdes Rabelo Guimarães
1   Universidade Federal de Minas Gerais, Faculdade de Odontologia - Belo Horizonte, MG, Brasil.
,
Ana Paula Hermont
1   Universidade Federal de Minas Gerais, Faculdade de Odontologia - Belo Horizonte, MG, Brasil.
,
Thais Moura Guimarães
2   Universidade Federal de São Paulo, Departamento de Psicobiologia - São Paulo, SP, Brasil.
,
Cibele Dal-Fabbro
2   Universidade Federal de São Paulo, Departamento de Psicobiologia - São Paulo, SP, Brasil.
,
Lia Bittencourt
2   Universidade Federal de São Paulo, Departamento de Psicobiologia - São Paulo, SP, Brasil.
,
Cauby Maia Chaves Junior
3   Universidade Federal do Ceará, Departamento de Clínica odontológica - Fortaleza, CE, Brasil.
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Mandibular advancement device (MAD) has been described as an alternative treatment to the severe obstructive sleep apnea (OSA), once it is not as effective as the continuous positive airway pressure therapy (CPAP) in reducing the apnea and hypopnea index (AHI). The objective of this study is to report a case using a MAD in a CPAP-intolerant patient suffering from severe OSA. Polysomnography exams were performed before and after treatment. Five months after fitting and titrating the MAD, the AHI was reduced from 80.5 events/hour to 14.6 events/hour and the minimum oxyhemoglobin saturation (SpO2) increased from 46% to 83%. A two-year assessment of therapy revealed an AHI of 8 events/hour and SpO2 of 85%.

Sleep Apnea, Obstructive - Polysomnography - Mandibular Advancement


Publikationsverlauf

Eingereicht: 18. Juli 2017

Angenommen: 20. März 2018

Artikel online veröffentlicht:
13. Oktober 2023

© 2023. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • REFERENCES

  • 1 Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The report of an American Academy of Sleep Medicine Task Force. Sleep. 1999;22(5):667-89.
  • 2 Somers VK, White DP, Amin R, Abraham WT, Costa F, Culebras A, et al.; American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology; American Heart Association Stroke Council; American Heart Association Council on Cardiovascular Nursing; American College of Cardiology Foundation. Sleep apnea and cardiovascular disease: an American Heart Association/American College of Cardiology Foundation Scientific Statement from the American Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council On Cardiovascular Nursing. In collaboration with the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research (National Institutes of Health). Circulation. 2008;118(10):1080-111.
  • 3 Marin JM, Carrizo SJ, Vicente E, Agusti AG. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet. 2005;365(9464):1046-53.
  • 4 Yaggi HK, Concato J, Kernan WN, Lichtman JH, Brass LM, Mohsenin V. Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med. 2005;353(19):2034-41.
  • 5 Anandam A, Patil M, Akinnusi M, Jaoude P, El-Solh AA. Cardiovascular mortality in obstructive sleep apnoea treated with continuous positive airway pressure or oral appliance: an observational study. Respirology. 2013;18(8):1184-90.
  • 6 Kushida CA, Littner MR, Hirshkowitz M, Morgenthaler TI, Alessi CA, Bailey D, et al.; American Academy of Sleep Medicine. Practice parameters for the use of continuous and bilevel positive airway pressure devices to treat adult patients with sleep-related breathing disorders. Sleep. 2006;29(3):375-80.
  • 7 Weaver TE, Grunstein RR. Adherence to continuous positive airway pressure therapy: the challenge to effective treatment. Proc Am Thorac Soc. 2008;5(2):173-8.
  • 8 Kushida CA, Morgenthaler TI, Littner MR, Alessi CA, Bailey D, Coleman J Jr, et al.; American Academy of Sleep. Practice parameters for the treatment of snoring and Obstructive Sleep Apnea with oral appliances: an update for 2005. Sleep. 2006;29(2):240-3.
  • 9 Bachour P, Bachour A, Kauppi P, Maasilta P, Mäkitie A, Palotie T. Oral appliance in sleep apnea treatment: respiratory and clinical effects and long-term adherence. Sleep Breath. 2016;20(2):805-12.
  • 10 Ferguson KA, Cartwright R, Rogers R, Schmidt-Nowara W. Oral appliances for snoring and obstructive sleep apnea: a review. Sleep. 2006;29(2):244-62.
  • 11 Ramar K, Dort LC, Katz SG, Lettieri CJ, Harrod CG, Thomas SM, et al. Clinical Practice Guideline for the Treatment of Obstructive Sleep Apnea and Snoring with Oral Appliance Therapy: An Update for 2015. J Clin Sleep Med. 2015;11(7):773-827.
  • 12 Sutherland K, Takaya H, Qian J, Petocz P, Ng AT, Cistulli PA. Oral Appliance Treatment Response and Polysomnographic Phenotypes of Obstructive Sleep Apnea. J Clin Sleep Med. 2015;11(8):861-8.
  • 13 Dieltjens M, Braem MJ, Vroegop AVMT, Wouters K, Verbraecken JA, De Backer WA, et al. Objectively measured vs self-reported compliance during oral appliance therapy for sleep-disordered breathing. Chest. 2013;144(5):1495-502.
  • 14 Bertolazi AN, Fagondes SC, Hoff LS, Pedro VD, Menna Barreto SS, Johns MW. Portuguese-language version of the Epworth sleepiness scale: validation for use in Brazil. J Bras Pneumol. 2009;35(9):877-83.
  • 15 Chowdhuri S, Quan SF, Almeida F, Ayappa I, Batool-Anwar S, Budhiraja R, et al.; ATS Ad Hoc Committee on Mild Obstructive Sleep Apnea. An Official American Thoracic Society Research Statement: Impact of Mild Obstructive Sleep Apnea in Adults. Am J Respir Crit Care Med. 2016;193(9):e37-54.
  • 16 Phillips CL, Grunstein RR, Darendeliler MA, Mihailidou AS, Srinivasan VK, Yee BJ, et al. Health outcomes of continuous positive airway pressure versus oral appliance treatment for obstructive sleep apnea: a randomized controlled trial. Am J Respir Crit Care Med. 2013;187(8):879-87.
  • 17 Trzepizur W, Gagnadoux F, Abraham P, Rousseau P, Meslier N, Saumet JL, et al. Microvascular endothelial function in obstructive sleep apnea: Impact of continuous positive airway pressure and mandibular advancement. Sleep Med. 2009;10(7):746-52.
  • 18 Cunha TCA, Guimarães TM, Schultz TCB, Almeida FR, Cunha TM, Simamoto PC Junior, et al. Predictors of success for mandibular repositioning appliance in obstructive sleep apnea syndrome. Braz Oral Res. 2017;31:e37.