Published ahead of print on April 30, 2003, doi:10.1164/rccm.200211-1275OC
Am. J. Respir. Crit. Care Med., Volume 168, Number 2, July 2003, 238-241
A more recent version of this article appeared on July 15, 2003
Submitted on November 7, 2002
Accepted on April 28, 2003
Effect of Oral Appliance Therapy on Upper Airway Collapsibility in Obstructive Sleep Apnea
Andrew T Ng1, Helen Gotsopoulos2, Jin Qian2, and Peter A Cistulli1*
1 Respiratory and Sleep Medicine, St George Hospital, Sydney, NSW, Australia; Medicine, University of New South Wales, Sydney, NSW, Australia,
2 Respiratory and Sleep Medicine, St George Hospital, Sydney, NSW, Australia
* To whom correspondence should be addressed. E-mail: p.cistulli{at}unsw.edu.au.
Oral appliance therapy is emerging as an alternative to continuous positive airway pressure for the treatment of obstructive sleep apnea. However, its precise mechanisms of action are yet to be defined. We examined the effect of a mandibular advancement splint on upper airway collapsibility during sleep in obstructive sleep apnea. Ten patients with proven obstructive sleep apnea had a custom-made mandibular advancement splint incrementally adjusted during an acclimatization period until the maximum comfortable limit of mandibular advancement was reached. Polysomnography with the splint was then performed. Following a one-week washout period, upper airway closing pressures during sleep (with and without mandibular advancement splint) were determined. Significant improvements with mandibular advancement splint therapy were seen in Apnea/Hypopnea Index (25.0 ± 3.1 versus 13.2 ± 4.5 /hour, p<0.03) and upper airway closing pressure in stage 2 sleep (-1.6 ± 0.4 versus -3.9 ± 0.6 cmH2O, p<0.01) and in slow wave sleep (-2.5 ± 0.7 versus -4.7 ± 0.6 cmH2O, p<0.02) compared to no therapy. These preliminary data indicate that mandibular advancement splint therapy is associated with improved upper airway collapsibility during sleep. The mediators of this effect remain to be determined.
Key words: Sleep apnea, oral appliances, upper airway collapsibility
This article has been cited by other articles:
|
|
|
|
 
O. M. Vanderveken, A. Devolder, M. Marklund, A. N. Boudewyns, M. J. Braem, W. Okkerse, J. A. Verbraecken, K. A. Franklin, W. A. De Backer, and P. H. Van de Heyning
Comparison of a Custom-made and a Thermoplastic Oral Appliance for the Treatment of Mild Sleep Apnea
Am. J. Respir. Crit. Care Med.,
July 15, 2008;
178(2):
197 - 202.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. S. L. Chan, R. W. W. Lee, and P. A. Cistulli
Non-Positive Airway Pressure Modalities: Mandibular Advancement Devices/Positional Therapy
Proceedings of the ATS,
February 15, 2008;
5(2):
179 - 184.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Boudewyns, M. Marklund, and W. Hochban
Alternatives for OSAHS treatment: selection of patients for upper airway surgery and oral appliances
Eur. Respir. Rev.,
December 1, 2007;
16(106):
132 - 145.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. S. L. Chan, R. W. W. Lee, and P. A. Cistulli
Dental Appliance Treatment for Obstructive Sleep Apnea
Chest,
August 1, 2007;
132(2):
693 - 699.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. R. Schwartz, J. Kirkness, and P. Smith
Extraluminal tissue pressure: what does it mean?
J Appl Physiol,
January 1, 2006;
100(1):
5 - 6.
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Kairaitis, R. Stavrinou, R. Parikh, J. R. Wheatley, and T. C. Amis
Mandibular advancement decreases pressures in the tissues surrounding the upper airway in rabbits
J Appl Physiol,
January 1, 2006;
100(1):
349 - 356.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Johal, J. M. Battagel, and B. T. Kotecha
Sleep nasendoscopy: a diagnostic tool for predicting treatment success with mandibular advancement splints in obstructive sleep apnoea
Eur J Orthod,
December 1, 2005;
27(6):
607 - 614.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Y. Huang, D. P. White, and A. Malhotra
The Impact of Anatomic Manipulations on Pharyngeal Collapse: Results From a Computational Model of the Normal Human Upper Airway
Chest,
September 1, 2005;
128(3):
1324 - 1330.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Inazawa, T. Ayuse, S. Kurata, I. Okayasu, E. Sakamoto, K. Oi, H. Schneider, and A.R. Schwartz
Effect of Mandibular Position on Upper Airway Collapsibility and Resistance
J. Dent. Res.,
June 1, 2005;
84(6):
554 - 558.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Barnes, R. D. McEvoy, S. Banks, N. Tarquinio, C. G. Murray, N. Vowles, and R. J. Pierce
Efficacy of Positive Airway Pressure and Oral Appliance in Mild to Moderate Obstructive Sleep Apnea
Am. J. Respir. Crit. Care Med.,
September 15, 2004;
170(6):
656 - 664.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. Fleury, D. Rakotonanahary, B. Petelle, G. Vincent, N. P. Fleury, B. Meyer, and B. Lebeau
Mandibular Advancement Titration for Obstructive Sleep Apnea: Optimization of the Procedure by Combining Clinical and Oximetric Parameters
Chest,
May 1, 2004;
125(5):
1761 - 1767.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. J. Tobin
Sleep-Disordered Breathing, Control of Breathing, Respiratory Muscles, Pulmonary Function Testing in AJRCCM 2003
Am. J. Respir. Crit. Care Med.,
January 15, 2004;
169(2):
254 - 264.
[Full Text]
[PDF]
|
|
|
Copyright © 2003 American Thoracic Society
|
|
|
