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» Ten year follow-up on snoring mouthpieces
» Mouthpiece research for sleep apnea and snoring
» Snoring Overview
» Ten year follow-up on snoring mouthpieces
» Mouthpiece research for sleep apnea and snoring
Mandibular Advancement Devices in 630 Men and Women With Obstructive Sleep Apnea and Snoring*
Tolerability and Predictors of Treatment Success Marie Marklund, DDS, PhD; Hans Stenlund, PhD and Karl A. Franklin, MD, PhD, FCCP
* From the Department of Orthodontics (Dr. Marklund), Umeå University; and the Departments of Public Health and Clinical Medicine, Epidemiology (Dr. Stenlund), and Respiratory Medicine (Dr. Franklin), University Hospital, Umeå, Sweden.
Correspondence to: Marie Marklund, DDS, PhD, Department of Orthodontics, Umeå University SE-901 87 Umeå, Sweden; e-mail: Marie.Marklund@odont.umu.se
Study objective:
To evaluate the tolerability and to find predictors of treatment success for an individually adjusted, one-piece mandibular advancement device in patients with snoring and obstructive sleep apnea.
Design:
Prospective study.
Setting:
Departments of Respiratory Medicine and Orthodontics, Umeå University.
Patients:
Six hundred nineteen of 630 patients (98%), who consecutively received treatment for sleep apnea and snoring from February 1989 to August 2000, were followed up. They had a mean apnea-hypopnea index of 16 (range, 0.0 to 76) and a mean body mass index of 28 (range, 19 to 42).
Measurements:
Interviews, questionnaires, and overnight sleep apnea recordings. Patients with an apnea-hypopnea index of >= 10 in the supine and/or lateral position were considered to have obstructive sleep apnea. A lateral apnea-hypopnea index of < 10, together with a supine apnea-hypopnea index of >= 10, defined supine-dependent sleep apneas.
Results:
One hundred forty-eight of the 619 patients (24%) discontinued treatment. Female gender predicted treatment success, defined as an apnea-hypopnea index of < 10 in both the supine and lateral positions, with an odds ratio of 2.4 (p = 0.01). In the women, the odds ratios for treatment success were 12 for mild sleep apnea (p = 0.04), and 0.1 for complaints of nasal obstruction (p = 0.03). In the men, the odds ratios for treatment success were 6.0 for supine-dependent sleep apneas (p < 0.001), 2.5 for mild sleep apnea (p = 0.04), 1.3 for each millimeter of mandibular advancement (p = 0.03), and 0.8 for each kilogram of weight increase (p = 0.001).
Conclusions:
The mandibular advancement device is recommended for women with sleep apnea, for men with supine-dependent sleep apneas defined by a lateral apnea-hypopnea index of < 10, and for snorers without sleep apnea. Men who increase in weight during treatment reduce their chance of treatment success and are advised to be followed up with a new sleep apnea recording with the device.
How It Works
This new Anti-Snoring Device works by gently moving the lower jaw slightly forward while sleeping, opening the throat and keeping the airway unobstructed.
Various research studies and reviews published in the Journal of the American Dental Association and elsewhere have found that this type of dental device reduces or eliminates snoring in 70% to 90% of the wearers.
The beauty of this device is that is can be sold and purchased OTC (over the counter) for only $40 to $60. All other devices of this type must be fitted by a dentist and custom-made by a dental lab technician so they cost $400 to $800. Now there is a proven medical device for snoring that is affordable for everyone.
Tolerability and Predictors of Treatment Success Marie Marklund, DDS, PhD; Hans Stenlund, PhD and Karl A. Franklin, MD, PhD, FCCP
* From the Department of Orthodontics (Dr. Marklund), Umeå University; and the Departments of Public Health and Clinical Medicine, Epidemiology (Dr. Stenlund), and Respiratory Medicine (Dr. Franklin), University Hospital, Umeå, Sweden.
Correspondence to: Marie Marklund, DDS, PhD, Department of Orthodontics, Umeå University SE-901 87 Umeå, Sweden; e-mail: Marie.Marklund@odont.umu.se
Study objective:
To evaluate the tolerability and to find predictors of treatment success for an individually adjusted, one-piece mandibular advancement device in patients with snoring and obstructive sleep apnea.
Design:
Prospective study.
Setting:
Departments of Respiratory Medicine and Orthodontics, Umeå University.
Patients:
Six hundred nineteen of 630 patients (98%), who consecutively received treatment for sleep apnea and snoring from February 1989 to August 2000, were followed up. They had a mean apnea-hypopnea index of 16 (range, 0.0 to 76) and a mean body mass index of 28 (range, 19 to 42).
Measurements:
Interviews, questionnaires, and overnight sleep apnea recordings. Patients with an apnea-hypopnea index of >= 10 in the supine and/or lateral position were considered to have obstructive sleep apnea. A lateral apnea-hypopnea index of < 10, together with a supine apnea-hypopnea index of >= 10, defined supine-dependent sleep apneas.
Results:
One hundred forty-eight of the 619 patients (24%) discontinued treatment. Female gender predicted treatment success, defined as an apnea-hypopnea index of < 10 in both the supine and lateral positions, with an odds ratio of 2.4 (p = 0.01). In the women, the odds ratios for treatment success were 12 for mild sleep apnea (p = 0.04), and 0.1 for complaints of nasal obstruction (p = 0.03). In the men, the odds ratios for treatment success were 6.0 for supine-dependent sleep apneas (p < 0.001), 2.5 for mild sleep apnea (p = 0.04), 1.3 for each millimeter of mandibular advancement (p = 0.03), and 0.8 for each kilogram of weight increase (p = 0.001).
Conclusions:
The mandibular advancement device is recommended for women with sleep apnea, for men with supine-dependent sleep apneas defined by a lateral apnea-hypopnea index of < 10, and for snorers without sleep apnea. Men who increase in weight during treatment reduce their chance of treatment success and are advised to be followed up with a new sleep apnea recording with the device.
How It Works
This new Anti-Snoring Device works by gently moving the lower jaw slightly forward while sleeping, opening the throat and keeping the airway unobstructed.
Various research studies and reviews published in the Journal of the American Dental Association and elsewhere have found that this type of dental device reduces or eliminates snoring in 70% to 90% of the wearers.
The beauty of this device is that is can be sold and purchased OTC (over the counter) for only $40 to $60. All other devices of this type must be fitted by a dentist and custom-made by a dental lab technician so they cost $400 to $800. Now there is a proven medical device for snoring that is affordable for everyone.