Effect of Mandibular Advancement Splint on Psycho-Intellectual Derangements in Patients with Sleep Apnea Syndrome.

Abstract

The mandibular advancement splint (MAS) was recently introduced for the management of sleep apnea syndrome (SAS), although its effects on psycho-intellectual functions have not been elucidated yet. We examined psycho-intellectual function before and after treatment with MAS in patients with SAS. Twenty patients with SAS underwent psycho-intellectual function testing before and after treatment with MAS for 3 to 4 weeks. The apnea index significantly decreased from 19.0+/-15.6 to 2.4+/-1.9. The state anxiety score significantly decreased from 44.6+/-12.1 to 33.7+/-11.1, the trait anxiety score significantly decreased from 46.2+/-13.4 to 37.6+/-13.8, and the depression scale score significantly decreased from 39.2+/-11.0 to 30.8+/-9.9 with MAS treatment. By the Cornell Medical Index and the Yatabe-Guilford test, the patients became less neurotic and less eccentric after treatment. By the Uchida-Kraepelin psychodiagnostic test, calculation ability significantly increased from 1247.4+/-402.1 to 1950.2+/-651.9. We conclude that MAS treatment reduces apneic episodes and improves psycho-intellectual derangements in patients with SAS.

Effects of mandibular advancement on brain activation during inspiratory loading in healthy subjects: a functional magnetic resonance imaging study

“…Moreover, the amount of mandibular advancement by an OA has been determined in the light of the best balance between clinical indications and contraindications (42,48). Only one study has previously revealed that mandibular advancement with an OA significantly reduces clinical symptoms and improves cognitive function (43). Based on the findings in the present study, it may be possible to specifically determine the most efficient mandibular position by referring to the decrease in brain activation triggered by respiratory loading.…”

Anxiety in middle-aged men with obstructive sleep apnea: State of the science

“…Alternative treatments for OSA were explored. One study involved mandibular advancement splinting (Nambu et al, 1999), and two others involved surgical intervention by way of extended uvulopalatal flap (Li et al, 2004) and radiofrequency tissue ablation (Uloza et al, 2009). All three of these studies involving alternative interventions resulted in statistically significant decreases in anxiety levels.…”

“…Motivational strategies, referred to as motivational enhancement therapy for CPAP (ME-CPAP), have been developed to improve CPAP compliance (Aloia et al, 2004). Alternative interventional strategies include mandibular advancement splinting (Nambu, Nagasaka, Fujita, Hamada, & Fukuoka, 1999), and surgical dilation of the upper airway by way of extended uvulopalatal flap (Li et al, 2004) or radiofrequency tissue ablation (Uloza, Balsevicius, Sakalauskas, Miliauskas, & Zemaitiene, 2009).…”

Depression and anxiety in obstructive sleep apnea syndrome: a review

“…A selected group of patients was recruited in 34 out of 55 studies (21–54). In 21 studies (55–75) the patient sample was drawn from consecutive series.…”

“…The mean severity of OSAS ranged from 10 to 99 apneas and hypopneas per hour (median: 48 apneas and hypopneas per hour), and the standard deviations varied widely. One study (42) reported the range and the median of AHI, one study (59) specified severity using the desaturation index indicating ≥4% decrease in minimum oxygen saturation at least five times per hour or at least 30 saturations during 7 h sleep, and one study (31) using the apnea index indicating the frequency of apneas per hour of sleep and apneic episodes per night. In two studies (34, 58) severity was reported categorically (mild, moderate, severe) without specifying the mean number of apneas and hypopneas per hour.…”