Can Mandibular Advancement Splint Treatment Effectively Treat Obstructive Sleep Apnea?

Take Home Pearl: You may be able to help a patient with mild-to-moderate obstructive sleep apnea by using a mandibular advancement splint.

Background: Many patients today suffer from obstructive sleep apnea, which can have a negative effect on their health and quality of life. Would doing something as simple as placing a mandibular advancement splint significantly improve their sleep apnea?

Objective: The purpose of this study was to investigate psychosocial function in patients with obstructive sleep apnea before and after mandibular advancement splint therapy.

Participants: The sample for this study consisted of 85 patients with mild-to-moderate obstructive sleep apnea.

Methods: The participants in this study were separated into 2 groups. One group received conservative treatment consisting of advice on sleeping position, avoidance of alcohol in the evenings, and weight loss. The second group received mandibular advancement splint therapy, which included a modified Herbst appliance. Two standardized tests to evaluate psychosocial health and daytime sleepiness were used to evaluate each participant at baseline and again 3 months later.

Results: 68% of the patients in the mandibular splint therapy group showed an improvement in energy and vitality, and 80% showed improvement in sleepiness. This was a significant improvement compared with the conservatively treated group. The improvements in energy and vitality scores in the mandibular advancement splint therapy group were similar to those seen in continuous positive airway pressure (CPAP) studied.

Conclusions: The use of mandibular advancement splints can result in a significant improvement in energy, vitality, and sleepiness for patients with obstructive sleep apnea.

Reviewer’s Comments: The results of this study were very impressive. I would not have thought that improvements with a mandibular advancement splint could be comparable to CPAP. In interpreting the results of this study, it is important to understand that the participants had mild-to-moderate sleep apnea and were preselected based on the likelihood that they would respond positively to mandibular advancement splint therapy.

Reviewer: John S. Casko, DDs, MS, PhD