Document Detail


Prevalence of residual excessive sleepiness during effective oral appliance therapy for sleep-disordered breathing.
MedLine Citation:
PMID:  24424099     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Oral appliance therapy with a mandibular advancement device (OAm) can yield to complete therapeutic response (apnea-hypopnea index [AHI]<5 events/h), though some patients show little or no improvement in daytime sleepiness. The prevalence of residual excessive sleepiness (RES) despite effective treatment with OAm therapy is unknown. We aimed to determine the prevalence of RES in patients treated with a titratable custom-made duobloc OAm.
METHODS: A prevalence study was performed, collecting data from 185 patients with an established diagnosis of sleep-disordered breathing (SDB) under OAm therapy with a titratable custom-made duobloc device (baseline data were male:female ratio, 129:56; age, 48±9years; body mass index [BMI], 27±4kg/m(2); Epworth Sleepiness Scale [ESS] score, 10±5; and AHI, 19±12 events/h). A full-night polysomnography was performed at baseline and after 3months of OAm therapy. Daytime sleepiness was assessed using the ESS with RES defined as an ESS score of 11 or higher out of 24, despite complete therapeutic response.
RESULTS: Out of 185 patients, 84 patients (45%) showed a complete therapeutic response with an AHI of <5 events per hour after 3months of OAm therapy. Despite this normalization of AHI, 27 out of these 84 patients (32%) showed RES and had a significantly higher baseline ESS (15±4 vs 9±4; P<.001) and were younger (43±9 vs 47±9; P=.028) compared to patients without RES.
CONCLUSION: RES under OAm therapy showed a prevalence of up to 32% in SDB patients effectively treated with respect to AHI. Patients with RES were younger and had higher baseline daytime sleepiness.
Authors:
A E R Verbruggen; M Dieltjens; K Wouters; I De Volder; P H Van de Heyning; M J Braem; O M Vanderveken
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-12-30
Journal Detail:
Title:  Sleep medicine     Volume:  -     ISSN:  1878-5506     ISO Abbreviation:  Sleep Med.     Publication Date:  2013 Dec 
Date Detail:
Created Date:  2014-1-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100898759     Medline TA:  Sleep Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Elsevier B.V. All rights reserved.
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