Faculdade de Odontologia da UFAL, Universidade Federal de Alagoas, Maceio, AL, Brazil.
Department of Prosthodontics and Periodontology. Piracicaba Dental School, UNICAMP, Piracicaba, SP, Brazil.
J Oral Rehabil. 2019 Nov;46(11):1031-1035. doi: 10.1111/joor.12898. Epub 2019 Oct 6.
Excessive daytime sleepiness (EDS) is frequently reported as a symptom for obstructive sleep apnoea (OSA), leading to problems with concentration, mood and memory. Mandibular advance device (MAD) is considered as an effective therapy to control OSA, reducing EDS and improving sleep quality.
The present study aimed to investigate the effects MAD therapy on EDS of patients diagnosed with OSA.
Ten patients from the Sleep Medicine Service of the "Hospital Geral Sanatório" (Maceió, Alagoas, Brazil) were diagnosed with EDS, and a personalised MAD was made for each one of them. Nocturnal polysomnography (NPSG) and maintenance of wakefulness test (MWT) were applied before (baseline) and 3 months after the continuous use of the MAD. The number of arousals and micro-arousals at baseline and after treatment was also evaluated.
All 10 patients completed the investigation. A significant decrease in the number of arousals and micro-arousals per night of sleep was observed after the use of MAD for three consecutive months (P = 0.0078; Wilcoxon signed-rank test). Also, there was a significant reduction on the apnoea/hypopnea index between baseline and post-treatment values (P = 0.0001; paired t test), as well as an increase in the mean latency for the onset of sleep (MSL) in the MTW (P = 0.0047; paired t test), indicating a significant difference among baseline and after treatment.
We conclude that the improvement on EDS is associated with the used of MAD in patients diagnosed with OSA, improving their quality of sleep.
日间嗜睡（EDS）是阻塞性睡眠呼吸暂停（OSA）的常见症状，可导致注意力、情绪和记忆力问题。下颌前移装置（MAD）被认为是控制 OSA 的有效疗法，可减少 EDS 并改善睡眠质量。
本研究旨在调查 MAD 治疗对 OSA 患者 EDS 的影响。
从巴西马塞约的“General Sanatório”医院睡眠医学科诊断出 10 名 EDS 患者，为每位患者制作了个性化的 MAD。在连续使用 MAD 之前（基线）和 3 个月后进行了夜间多导睡眠图（NPSG）和维持觉醒试验（MWT）。还评估了基线和治疗后每个睡眠周期的觉醒和微觉醒次数。
所有 10 名患者均完成了调查。使用 MAD 连续 3 个月后，夜间的觉醒和微觉醒次数明显减少（P=0.0078；Wilcoxon 符号秩检验）。此外，在治疗前后的基础值之间，呼吸暂停/低通气指数也显著降低（P=0.0001；配对 t 检验），MWT 的平均潜伏期（MSL）也显著增加（P=0.0047；配对 t 检验），表明治疗前后有显著差异。
我们得出结论，改善 EDS 与 OSA 患者使用 MAD 相关，可改善他们的睡眠质量。
