A NEW TONGUE ADVANCEMENT TECHNIQUE FOR SLEEP-DISORDERED BREATHING - SIDE-EFFECTS AND EFFICACY

We examined the efficacy and the acceptance of an oral device (SnorEx( R)) causing a forward displacement of the tongue for the treatment of sleep-disordered breathing (SDB). Twenty-three consecutive subjects wi th SDB were investigated. Noncompliance (NC) of use of the oral applia nce was observed in 74% (12 of 23) of the subjects, NC patients were c haracterized by unacceptable local side effects of the prosthesis, lac king improvement of indicators of daytime well-being, and a missing re duction of the respiratory disturbance index (RDI). The device was tol erated without side effects in 26% (6 of 23) of the subjects. In these compliant (C) subjects the RDI, EDS, and snoring improved significant ly (p < 0.05) compared with baseline values. After 6 mo using the devi ce, five of the six C patients were still using it. We conclude that t he high rate of noncompliance and the low efficacy of the SnorEx(R) pr osthesis preclude large-scale use of this treatment modality in patien ts with SDB and snoring since the local side effects are the principal cause of NC. No useful predictive parameter of treatment compliance o r treatment success was found. Thus, this dental appliance should be p rescribed only for selected patients failing other treatment modalitie s seen by an experienced sleep-disorders specialist.