[Comparison of the efficacy of 2 types of mandibular advancement device in severe obstructive sleep apnea hypopnea syndrome].

ABSTRACT

PURPOSE: To evaluate the efficacy of 2 mandibular advancement devices in 6-week treatment of patient with severe obstructive sleep apnea hypopnea syndrome (OSAHS) who refused to CPAP or CPAP therapy. METHODS: A randomized cross-over study was designed and conducted. Twenty-two male patients with severe OSAHS were included for treatment. Rod type and controllable type mandibular advancement devices (MADs) were used respectively in 6 weeks with 2-week interval, while the whole experimental duration was 14 weeks. The differences of the indexes of the polysomnography (PSG) were analyzed, which were gained before the intervention and 6 weeks after use of 2 types of MADs. Questionnaires with Epworth sleep and SCL-90 symptoms self evaluation scales were proceeded. Meanwhile, the parameters such as the stability of the MAD, the adverse reaction and the subjective symptom relief were assessed. The result was statistically analyzed by SPSS19.0 software package. RESULTS: Compared with the apnea hypopnea index (AHI) before the intervention (48.16±13.99 times/hr), both the AHI of the rod type (19.16±2.74 times/hr) and the controllable type (18.93±2.57 times/hr) were reduced by 50%. The remaining parameters showed that both types of MADs had a significant effect on mandibular advancement. There was significant different decrease in each index of the SCL-90 (P<0.01), while significant differences were found in somatization, interpersonal sensitivity and anxiety compared with those before intervention(P<0.05). At the same time, there were significant differences in the indexes of stability and results occlusive comfort between the rod type and the controllable MADs (P<0.05). CONCLUSIONS: The objective results and the patients' physical and mental health are improved obviously by using the 2 types of MADs. Controllable MADs have more advantages in compliance; however, further research should be conducted for long-time outcome.