EFFECT OF 2 TYPES OF MANDIBULAR ADVANCEMENT SPLINTS ON SNORING AND OBSTRUCTIVE SLEEP-APNEA

Snoring and obstructive sleep apnoea (OSA) both seem at least to be as sociated with narrowing of the upper airway and sleep-induced loss of muscle-tone. Mandibular advancement splints (MAS) have been proposed a s a relatively simple method to increase oro- and hypo-pharyngeal dime nsions thereby increasing the size of the airway. However, data on the ir effectiveness are conflicting and there are no clear indications as to which design is most effective or when they should be used. The ef fects of two designs of splint (types A and B) have been evaluated in 14 and nine subjects, respectively, using the Epworth Sleepiness Score (ESS) and domiciliary sleep monitoring on separate nights. Both splin ts reduced the median ESS (type A from 12 to 4.5; P = 0.003, type B fr om 7 to 4; P = 0.005). The apnoea-hypopnoea index was not affected by type A, but was reduced from 7.1 to 0.8; P = 0.005 by type B splints. There was evidence of a small improvement in overnight oxygen saturati on for type B splints (P = 0.02). The splints were well tolerated and continued to be used nightly by 18 subjects. Mandibular advancement sp lints may offer a simple and effective alternative for the treatment o f snoring and mild OSA in selected patients. Splint design may have co nsiderable bearing on efficacy.