Keywords: Sleep apnea, obstructive, orthodontic appliances, mandibular, advancement splint therapy, neuropsychology, neurobehavioral, manifestations, psychomotor, vigilance, fatigue, CPAP
Over the past 2 decades, the device of choice for treating obstructive sleep apnea is the CPAP or continuous positive airway pressure (CPAP) machine. However, the CPAP can be intrusive, costly, not easily portable and barely tolerable by some patients. As a result of these qualities, a compliment or alternative device has garnered much attention, such as a Mandibular Advancement Splint (MAS). In this article from Journal of Clinical Sleep Medicine, several doctors’ reported their findings after conducting a randomized control trial using the MAS and test patients with at least two symptoms of obstructive sleep apnea. This scientific investigation takes into account several other studies, which concluded no improvement or a little improvement respectively. In the findings of this controlled study, the patients experienced moderate enhancements in sleepiness. Also, the patients in reported increased energy levels, too. At AZ TMJ, Dr. Stan Farrell is a Diplomate with the American Board of Orofacial Pain and a Member of the American Academy of Dental Sleep Medicine; making him a premier choice for treating sleep apnea and its associated conditions. Schedule a consultation with Dr. Farrell at his office conveniently located in Scottsdale, AZ by calling 480-945-3629.
Sharon L. Naismith, BA Hons, DPsych1,2; Virginia R. Winter, BA Hons, MClinNPsych1; Ian B. Hickie, M.D.2; Peter A. Cistulli, M.D., Ph.D.1
Study Objective: This study aimed to assess the efficacy of a custom made mandibular advancement splint for the treatment of obstructive sleep apnea with respect to neuropsychological functioning and mood state.
Methods: A randomized controlled crossover design was used in which 73 participants (mean age = 48.4, SD = 11.0, % men = 80.8) with at least 2 symptoms of obstructive sleep apnea and an apnea hypopnea index ≥ 10 per hour underwent treatment with both mandibular advancement splint and an inactive oral device. Polysomnographic, neuropsychological and self-report measures were conducted at baseline and repeated after each of the two 4-week treatment phases.
Results: MAS treatment was associated with improvements on the somatic component of the Beck Depression Inventory and the Vigor-Activity and Fatigue-Inertia scales of the Profile of Mood States. While there were no improvements within the neuropsychological domains of attention/working memory, verbal memory, visuospatial or executive functioning, treatment with the mandibular advancement splint was associated with faster performance on a test of vigilance/psychomotor speed. These changes, however, did not correspond to the improved subjective sleepiness or apnea-hypopnea index during treatment.
Conclusions: Treatment with the mandibular advancement splint results in improvements in self-reported sleepiness, fatigue/energy levels and vigilance/psychomotor speed in patients with obstructive sleep apnea. J Clin Sleep Med 2005;1(4):374-380.