Effect of oral appliances on quality of sleep in obstructive sleep apnea syndrome

Takehiro ARISAKA, Chiemi Ito, Hitoshi MORISHITA, Yusuke TSUKAMOTO, Kazumichi SATO, Morio TONOGI, Gen-yuki YAMANE, Tsuneya NAKAJIMA
2013 Japanese Journal of Oral & Maxillofacial Surgery  
Purpose: Obstructive sleep apnea syndrome (OSAS) is a disease that can affect life prognosis, against a background of respiratory disorder during sleep and decreased quality of sleep. The first-choice treatment for OSAS is continuous positive airway pressure (CPAP) , but dislodgment of the CPAP device has been described in a number of cases. Oral appliances (OA) work well in mild to moderate OSAS, even in cases where CPAP devices are displaced. Respiratory impairment has been evaluated in many
more » ... nstitutions to assess therapeutic effectiveness. The present study evaluated and compared the quality of sleep before and after use of OA. We focused on changes in the quality of sleep. Methods: The study group comprised 73 patients who underwent OA treatment at Tokyo Dental College Ichikawa General Hospital between July 2003 and December 2008. The patients were divided into an improvement group and non-improvement group and studied. The improvement group comprised 42 patients in whom the apnea hypopnea index on overnight polysomnography improved to >50% or ≦5/h. The other 31 patients were in the non-improvement group. Sleep parameters (i.e., sleep stage, sleep latency, rapid eye movement [REM] sleep latency, sleep efficiency, and total arousal index) before and after treatment were compared, and the effect of OA on the quality of sleep was investigated, adjusting for disease severity. Results: In patients with moderate and severe OSAS in the improvement group, the proportion of Stage REM significantly increased and the proportion of Stage Ⅰ as well as the total arousal index significantly decreased. In addition, the proportion of Stage Ⅱ in patients with moderate OSAS in the improvement group decreased significantly. Discussion: The use of OA improved breathing disorders such as apnea and hypopnea in patients with moderate and severe OSAS and reduced the total arousal index, resulting in normalization of the sleep stage cycle. The present study demonstrates that treatment of OSAS requires not only improvements in respiratory disorders, but also adequate consideration of sleep quality.
doi:10.5794/jjoms.59.294 fatcat:746i2x5yingwpewkr4zxvm56sm