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Published on: December 6, 2016
Mandibular advancement devices and treatment-emergent central sleep apnea (TECSA): Coincidental or critical finding?
Gilles Lavigne1, Julia Cohen-Levy2, Erika Treptow3
1Faculty of Dental Medicine and Oral Health Sciences, McGill University, 2001 McGill College Avenue, Montreal, QC, H3A 1G1, Canada; Faculty of Medecine, Neurology and Neurosurgery, McGill University, Montreal Neurological Institute and Hospital, 3801 University Street, Montreal, QC, H3A 2B4, Canada; Faculty of Dental Medicine, Universite de Montreal2900 Bd Edouard-Montpetit, Montreal, QC, H3T 1J4, Canada.
Abstract:
Treatment-emergent central sleep apnea (TECSA) can occasionally be observed when obstructive sleep apnea (OSA) is managed with most therapeutic approaches, including the mandibular advancement device (MAD). Although TECSA appears to be a low-incidence condition, evidence is lacking on its mechanism and possible health risks. The primary objective of this critical review is to provide guidance to clinicians managing OSA with MAD. Prompt return to a sleep medicine specialist is recommended, however, when a patient continues to present complaints or reports potentially associated with central sleep apnea (CSA): sleepiness, difficulty initiating or maintaining sleep, frequent awakenings or nonrestorative sleep, awakening from sleep with shortened breath, or witnessed apneas.
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