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The sleep apnea syndrome, first described by Gestaut since 1965, is a disorder associated with repetitive cessation of breathing during sleep. Not only does sleep apnea syndrome affect the sleep quality, but can be a manifestation of potentially life- threatening disorders. During the past 30 years, treatment of snoring and sleep apnea syndrome has become a team work of chest division, otolaryngology, neurology, psychiatry and dentistry. The objective of this study was to evaluate the efficacy of the mandibular advancement device(MAD) as a treatment modality for obstructive sleep apnea(OSA)patients with subjective and objective testing methods. Twenty adults with obstructive sleep apnea(OSA) diagnosed by polysomography (Apnea/Hypopnea Index, AHI>10) were used as subjects. Each subject received another polysomographic monitoring after 23. 3±14.14 days since MAD treatment. Epworth sleep scale (ESS) was used to evaluate excessive daytime sleepiness, snoring frequencyscale(SFS)and snoring intensity scale (ESS) were also used. The result exhibited a reduction of AHI by 63.33% (from 30.00±14.94 to 11.09±11. 71,p<0.05),the success rate was 70%(AHI<10). The success rate increased to 80% if AHI<20 yet reduction over 50% was defined as success. The desaturation index decreased from 16.67±17.55 to 4.81±6.88(p<0.05),and highly correlated with AHI before and after treatment (r=0.904,r=0.827 respectively). The mean saturation also increased from 94. 15%±1.69% to 94.90%±1.16%(p<0.05). The arousal index decreased from 9.62±7.26 to7.96±5.67(p<0.05). The subjective responses were improved. The ESS score decreased from 11.79±4.47 to 6.62±3.06 (p<0.05). The SFS score decreased from 4.73±6.56 to 2.84±1.16( p<0.05),SIS score decreased from 4.58±0.61 to 2.26±0.45 (p<0.05). A survey three months later since MAD treatment showed:100% of the patients were still using the MAD regularly, none has suffered temporomandibular disorders or orofacial pain. We concluded that the MAD can be an acceptable and effective treatment for snoring and obstructive sleep apnea.
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