Adjustable thermoplastic mandibular advancement device for obstructive sleep apnea: outcomes and practicability

Area of Science:

• Sleep Medicine
• Otolaryngology
• Medical Devices

Background:

• Obstructive sleep apnea (OSA) significantly impacts patient health and quality of life.
• Continuous positive airway pressure (CPAP) and surgery are common OSA treatments, but not suitable for all patients.
• An adjustable thermoplastic mandibular advancement device (AT-MAD) presents a potential alternative treatment option.

Purpose of the Study:

• To evaluate the efficacy, safety, and quality of life (QOL) outcomes of an AT-MAD for OSA treatment in Asian patients.
• To assess the impact of AT-MAD on sleep parameters and daytime sleepiness.
• To identify potential adverse effects and patient adherence to AT-MAD therapy.

Main Methods:

• Prospective, nonrandomized, before-after study involving 64 adult OSA patients.
• Patients had previously failed or refused CPAP and surgery.
• Outcomes measured via polysomnography, Epworth Sleepiness Scale (ESS), and Functional Outcomes of Sleep Questionnaire (FOSQ) pre- and post-treatment.

Main Results:

• Significant reduction in mean apnea-hypopnea index (AHI) from 17.7 to 7.5 (P < .001) and ESS scores from 8.7 to 6.5 (P < .001).
• 60.9% of patients achieved post-treatment AHI < 5; 75% success in mild OSA cases.
• Improved FOSQ global scores (P < .05) and largely tolerable adverse effects (TMJ discomfort, dry mouth).

Conclusions:

• AT-MAD is a practical, cost-effective short-term treatment for OSA in Asians, yielding good efficacy and improved QOL.
• The device demonstrates advantages in terms of low cost and ease of use.
• Further randomized controlled trials are recommended to validate these findings.