TY - JOUR
T1 - Effect of vertical dimension on efficacy of oral appliance therapy in obstructive sleep apnea
AU - Pitsis, Andrew J.
AU - Ali Darendeliler, M.
AU - Gotsopoulos, Helen
AU - Petocz, Peter
AU - Cistulli, Peter A.
PY - 2002/9/15
Y1 - 2002/9/15
N2 - The aim of this study was to assess the effect of bite opening induced by a mandibular advancement splint (MAS) on efficacy and side effects in the treatment of obstructive sleep apnea. In a randomized crossover fashion, 23 adult patients received either MAS-1 (4 mm of interincisal opening) or MAS-2 (14 mm of interincisal opening) for 2 weeks, followed by the alternate treatment for 2 weeks, with an intervening 1-week washout. Complete response was defined as a resolution of symptoms and a reduction in apnea/hypopnea index (AHI) to less than 5 per hour. Partial response was defined as improved symptoms and a reduction in AHI of 50% or more, with the AHI remaining at a value of 5 or more per hour. Both MAS-1 and MAS-2 produced similar reductions in mean (± SEM) AHI from baseline: 21 ± 2 versus 8 ± 1/hour and 21 ± 2 versus 10 ± 2/hour, respectively (p < 0.001). Either complete response or partial response occurred in 74 and 61% of patients with MAS-1 and MAS-2, respectively. Subjective improvements were reported with both appliances by the majority of patients. Patients preferred MAS-1 (78 versus 22%, p = 0.007). This study suggests that the amount of bite opening induced by MAS does not have a significant impact on treatment efficacy but does have an impact on patient acceptance.
AB - The aim of this study was to assess the effect of bite opening induced by a mandibular advancement splint (MAS) on efficacy and side effects in the treatment of obstructive sleep apnea. In a randomized crossover fashion, 23 adult patients received either MAS-1 (4 mm of interincisal opening) or MAS-2 (14 mm of interincisal opening) for 2 weeks, followed by the alternate treatment for 2 weeks, with an intervening 1-week washout. Complete response was defined as a resolution of symptoms and a reduction in apnea/hypopnea index (AHI) to less than 5 per hour. Partial response was defined as improved symptoms and a reduction in AHI of 50% or more, with the AHI remaining at a value of 5 or more per hour. Both MAS-1 and MAS-2 produced similar reductions in mean (± SEM) AHI from baseline: 21 ± 2 versus 8 ± 1/hour and 21 ± 2 versus 10 ± 2/hour, respectively (p < 0.001). Either complete response or partial response occurred in 74 and 61% of patients with MAS-1 and MAS-2, respectively. Subjective improvements were reported with both appliances by the majority of patients. Patients preferred MAS-1 (78 versus 22%, p = 0.007). This study suggests that the amount of bite opening induced by MAS does not have a significant impact on treatment efficacy but does have an impact on patient acceptance.
UR - http://www.scopus.com/inward/record.url?scp=0037106387&partnerID=8YFLogxK
U2 - 10.1164/rccm.200204-342OC
DO - 10.1164/rccm.200204-342OC
M3 - Article
C2 - 12231498
AN - SCOPUS:0037106387
SN - 1073-449X
VL - 166
SP - 860
EP - 864
JO - American Journal of Respiratory and Critical Care Medicine
JF - American Journal of Respiratory and Critical Care Medicine
IS - 6
ER -