[Mandibular advancement devices in patients with severe OSAHS]

Area of Science:

• Sleep Medicine
• Respiratory Medicine
• Dental Sleep Medicine

Background:

• Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS) is a prevalent condition.
• Oral Appliances (OAs), or Mandibular advancement devices, are a recognized treatment for OSAHS.
• This study focuses on the efficacy of OAs in severe OSAHS patients.

Purpose of the Study:

• To evaluate the efficacy of Oral Appliances (OAs) in treating severe Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS).
• To identify predictors of OA treatment success.
• To assess patient tolerance and reasons for treatment discontinuation.

Main Methods:

• Prospective follow-up of 271 severe OSAHS patients treated with OAs.
• Collected data on Apnea-Hypopnea Index (AHI) reduction, complications, and discontinuation rates.
• Analyzed OA effectiveness over time and identified predictive factors.

Main Results:

• OA treatment significantly reduced the mean AHI by 21.5 events/h (P<10^-5).
• 70.7% of patients achieved >50% AHI reduction, and 58.5% had an AHI <15/h.
• Discontinuation occurred in 9.6% of patients, primarily due to ineffectiveness.

Conclusions:

• Oral Appliances are an effective and well-tolerated treatment for severe OSAHS.
• OAs provide significant AHI reduction in a majority of severe OSAHS patients.
• Consider OAs for patients with CPAP failure or intolerance.