Objective: To evaluate an adjustable mandibular
positioning appliance for treatment of snoring and sleep apnea.
Methods: One hundred thirty-four patients with baseline
apnea/hypopnea index (AHI) of 37 ± 28 events/h (mean ± SD)
received the appliance. The efficacy of the appliance was assessed by
the following investigations, performed at baseline and with the
appliance: polysomnography, Epworth sleepiness scale, bedpartners’
assessment of snoring severity, patients’ assessment of side effects,
and overall satisfaction.
Results: Thirteen patients
were lost to follow-up. An additional 46 patients had no follow-up
polysomnography, but answered the questionnaires. A total of 75
patients had polysomnography at baseline and with the appliance. We
found a significant reduction in AHI from 44 ± 28 events/h to
12 ± 15 events/h (p < 0.0005) and a reduction in the arousal
index from 37 ± 27 events/h to 16 ± 13 events/h (p < 0.05).
Epworth scores fell from 11 ± 5 to 7 ± 3 (p < 0.0005).
Bedpartners’ assessment revealed marked improvement in snoring. For
example, at baseline 96% of patients were judged to snore loudly“
often” or “always” by their bedpartners, whereas only 2% were
judged so while using dental appliance. The most frequent side effect
was teeth discomfort, present “sometimes” or “often” in up to
32% of patients. Follow-up clinical assessment in 121 patients
conducted on the average 350 days after the insertion of the appliance
revealed that 86% of patients continued to use the appliance nightly;
60% were very satisfied with the appliance, 27% were moderately
satisfied, 11% were moderately dissatisfied, and 2% were very
Conclusion: We conclude that the
adjustable mandibular positioning appliance is an effective treatment
alternative for some patients with snoring and sleep