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Obstructive sleep apnea: oral appliance therapy and severity of condition.

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodonties 1998;85(4):388-92.


Harvard University School of Dental Medicine, Boston, MA 02115-5888, USA

Objective: The purpose of this study was to determine whether an oral appliance can effectively treat severe obstructive sleep apnea.

Design: The study was conducted at a tertiary care military facility with an accredited sleep laboratory. Results of the treatment of the first 25 patients with obstructive sleep apnea referred for oral appliance therapy were retrospectively analyzed. Each patient received a mandibular advancement appliance and underwent polysomnography 2 weeks after delivery of the appliance. Patients were divided into two groups: those with slight-to-mild obstructive sleep apnea who had a respiratory disturbance index less than 21, and those with more severe disease. Treatment was considered to be successful if the posttreatment respiratory disturbance index was less than S. RESULTS: Nine (90%) of the 10 patients with slight-to-moderate disease were successfully managed with the oral appliance. Of the 15 patients in the moderate-to-severe group, 9 (60%) were successfully managed.

Conclusion: Oral appliances have commonly been recommended only for mild obstructive sleep apnea. This study indicates that they may also have a role to play in selected cases in which the condition is more severe. There is a paucity of information about long-term success. This short-term (2-week) study should be followed by others evaluating the effect over longer periods.