Quality of life of patients with obstructive sleep apnea syndrome treated with an intraoral mandibular repositioner

Abstract

-Background: Obstructive sleep apnea syndrome (OSAS) is a very important and prevalent disease, which is associated with a poor quality of life in many patients. Treatments for OSAS include surgery, Continuos Positive Air way Pressure, and an intraoral mandibular repositioner (IOMR), but the tendency of sleep centers is to emphasize the apnea index, neglecting quality of life as treatment outcome. Objective: To verify to what extent treatment with an IOMR improves the OSAS patient's quality of life. Method: Eleven male patients aged 34 to 63 years (mean=49) with mild to moderate OSAS were evaluated using the Calgary SAQLI questionnaire applied before and four weeks after treatment with an IOMR. The mandibular repositioners were manufactured individually for each patient with acrylic polymer and equipped with a retentive device to maintain the mandible in a forward position during sleep. Results: Excellent improvement in the quality of life was observed in five patients (45.5%) and excellent improvement in symptoms in 10 (90.9%). Conclusion: The systematic use of the IOMR indicates a clear improvement in the global quality of life as well as in the symptoms of patients with OSAS.KEY WORDS: obstructive sleep apnea syndrome, intraoral mandibular repositioner, and quality of life.Qualidade de vida em pacientes com síndrome de apnéia obstrutiva do sono tratados com reposicionador mandibular intra-oral RESUMO -Contexto. A síndrome da apnéia obstrutiva do sono (SAOS) é importante e prevalente doença associada à má qualidade de vida em muitos pacientes. Os tratamentos disponíveis incluem cirurgias, CPAP e o aparelho reposicionador mandibular intraoral (ARMIO). Muitos centros de distúrbios de sono valorizam apenas a redução do número de apnéias no tratamento da SAOS, dando pouca atenção à qualidade de vida como desfecho do tratamento. Objetivo: Graduar melhora da qualidade de vida dos pacientes com SAOS usando ARMIO. Método: O questionário Calgary SAQLI foi aplicado, antes e após, 4 semanas de tratamento com ARMIO, a 11 pacientes masculinos, entre 34 e 63 anos de idade (média de 49 anos), com SAOS leve a moderada. ARMIOs foram manufaturados com polímero acrílico e providos com retentivos para manter a mandíbula em posição anterior durante o sono. Resultados: Observamos grande melhora na qualidade de vida em 5 pacientes (45,5%) e melhora dos sintomas em 10 (90,9%). Conclusão: O uso do ARMIO associa-se principalmente à melhora dos sintomas, como também à melhora da qualidade de vida global.PALAVRAS-CHAVE: síndrome da apnéia obstrutiva do sono, aparelho reposicionador mandibular intra-oral, qualidade de vida.The quality of life of modern humans is dependent on socioeconomic, cultural and health factors. Disease, in addition to affecting the psychological and emotional state of the individual, compromises family income, causing damage to education, housing and social interaction 1,2 . Obstructive sleep apnea syndrome (OSAS) is characterized by complete or partial obstruction of the upper airways during sleep, mainly...

Clinical co-morbidities in obstructive sleep apnea syndrome treated with mandibular repositioning appliance

“…Awareness of the patient regarding his/her parallel health problems and how they may interfere with the treatment of OSAS with IOMRAs is fundamental to guarantee success and to prevent frustration for both the dental surgeon and the patient. We have already presented data showing that about 80% of the patients improve upon treatment with an IOMRA, 25 and this study allow us to suspect that patients who do not improve probably present co-morbidities associated with the sleep related respiratory condition, as shown in Fig. 2.…”

Titratable mandibular repositioner appliances for obstructive sleep apnea syndrome: are they an option?

“…Titratable mandibular repositioner appliances The Brazilian titratable mandibular repositioning appliance ARMIO™ and the Klearway™ are custom oral appliances fabricated using the same criteria as described elsewhere [12,[17][18][19]. In short, these appliances were designed to maintain the mandible in a more anteriorized position than usual during sleep, increasing airway dimensions.…”

Quality of Life and Public Health Issues in Patients Suffering from Obstructive Sleep Apnea Syndrome

“…Other treatment options as the systematic use of mandibular repositioners improved the global quality of life (Calgary SAQLI) of patients with mild to moderate OSAHS [36]. Regular physical activity may help in the improvement of QoL as it has been found that OSAHS patients who performed regular physical activity for at least 2 h/week or more scored higher on all eight QoL domains of SF-36 than patients that were non-physically active [25].…”