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Updated: Jul 16, 2026
07:54
Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
[Central apnea developing during treatment with a mandibular advancement device]
L Gindre1, F Gagnadoux, N Meslier
1Département de Pneumologie, CHU, Angers, France.
Revue Des Maladies Respiratoires
|February 23, 2007
Summary
Mandibular advancement (MA) can treat obstructive sleep apnea syndrome (OSAS). However, this case report shows MA may cause central sleep apneas, especially in supine position, necessitating careful monitoring.
Area of Science:
- Sleep Medicine
- Respiratory Physiology
Background:
- Mandibular advancement (MA) is an alternative treatment for obstructive sleep apnea syndrome (OSAS).
- Nasal continuous positive airway pressure (nCPAP) is a common treatment for OSAS.
Observation:
- A case of moderate, supine-dependent OSAS with chronic atrial fibrillation is presented.
- Central sleep apneas emerged during bi-bloc MA therapy, increasing with advancement level and occurring predominantly supine.
Findings:
- Excessive MA in the supine position may cause pharyngeal narrowing and unstable ventilation.
- Sleep fragmentation from progressive MA could destabilize ventilatory control.
- Chronic atrial fibrillation may be a predisposing factor for central sleep apneas.
Implications:
- This case underscores the need for nocturnal monitoring during progressive MA therapy.
- Careful follow-up is crucial to detect and manage potential central sleep apnea development during MA treatment.
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