Study objectives: To evaluate the long-term effects on
apneas and sleep and the tolerability of a mandibular advancement
device in patients with obstructive sleep apnea.
Design: Prospective study.
Department of Respiratory Medicine, University Hospital, Umeå,
Patients: Thirty-three consecutively treated
Interventions: Individually adjusted
mandibular advancement devices.
results: Polysomnographic sleep recordings on 1 night without the
device and 1 night with the device were performed after 0.7 ± 0.5
years (mean ± SD) and after 5.2 ± 0.4 years from the start of
treatment. Nineteen of the 33 patients experienced a short-term
satisfactory treatment result with an apnea-hypopnea index of < 10
events per hour and a satisfactory reduction in snoring. Fourteen
patients were regarded as being insufficiently treated with the device.
Seventeen of the short-term satisfactorily treated patients (90%) and
2 of the remaining patients continued treatment on a long-term basis.
The apnea-hypopnea index was reduced by the device from 22 ± 17 to
4.9 ± 5.1 events per hour (p < 0.001) in these 19 long-term
treatment patients, which did not differ from what was found at the
short-term follow-up visits in these patients. Patients with their
devices replaced or adjusted experienced a better long-term effect than
patients still using their original devices (p < 0.05).
Conclusions: The long-term effect and tolerability of a
mandibular advancement device are good in patients who are recommended
the treatment on the basis of a short-term sleep recording, provided
that the device is continuously adjusted or replaced with a new one
when needed. A short-term follow-up is valuable in the selection of
patients who will benefit from long-term treatment with a mandibular