Related Experiment Video
Updated: Jun 1, 2025
Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Evaluating the effectiveness of mandibular advancement devices in treating very severe obstructive sleep apnea: a
Shirley Leibovitz1, Shai Levi2, Aiham Hanut3
1Department of Pediatric Dentistry, Barzilai Medical Center, Ashkelon, Israel.
Background:
The repeated airway obstructions in the common disorder Obstructive Sleep Apnea (OSA) cause health risks. Continuous Positive Airway Pressure (CPAP), the standard treatment, faces adherence challenges. Mandibular Advancement Devices (MADs) have been used successfully for mild to moderate OSA, as a good alternative for these patients.
Objective:
to evaluate the effectiveness of MADs in reducing the Apnea-Hypopnea Index (AHI) and improving symptoms in patients with very severe OSA unable to tolerate CPAP.
Methods:
This retrospective study included 22 patients with very severe OSA (AHI ≥ 50) treated with MADs. Baseline characteristics, including: age, sex, BMI, and AHI, were recorded, and changes in AHI following treatment were assessed. Adherence was monitored using patient-reported data. Unlike previous studies, this research focuses exclusively on the efficacy of MADs in treating patients with very severe OSA, a population often excluded from similar inspections.
Results:
median AHI significantly decreased from 60.0 (IQR: 57.0-65.0) to 15.0 (IQR: 10.0-24.0) after treatment (P < 0.001), with a mean reduction of 72.5% (± 14.3). Notably, 95.5% of patients achieved at least a 50% reduction in AHI. Symptom improvements, including reduced snoring and daytime tiredness, were reported by 72.7% of patients. BMI positively correlated with baseline AHI, and significant AHI reductions were observed across overweight and obese categories, although some patients remained in the severe AHI range post-treatment. Adherence varied, with 63.6% continuing to use the device.
Conclusions:
MADs are effective in managing very severe OSA, providing significant reductions in AHI and symptom improvements. MADs may be a viable alternative for patients unable to tolerate CPAP. Further investigations into the long-term efficacy and impact on quality of life are needed.
