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Article: Use of oral appliance in treatment of obstructive sleep apnoea: Hong Kong experience

TitleUse of oral appliance in treatment of obstructive sleep apnoea: Hong Kong experience
Authors
Issue Date1998
PublisherAmerican College of Chest Physicians. The Journal's web site is located at http://www.chestjournal.org
Citation
Chest, 1998, v. 114 n. 4 SUPPL., p. 382S How to Cite?
AbstractPurpose: The role of oral appliance (OA) in the treatment of obstructive sleep apnoea (OSA) has been investigated and reported with variable success in several Caucasian studies. However, mandibular cervical anatomy varies with ethnicity, hence the efficacy of such appliances may also differ. Methods: We prospectively evaluated the role of mandibular advancing device in the treatment of Chinese patients with symptomatic mild to moderate OSA. Consecutive patients were recruited if the following criteria were fulfilled: Apnoea-hypopnoea index (AHI) 10-20 plus nocturnal choking or excessive daytime sleepiness (ESS = 9 or above), AHI 20-40, and AHI>40 but refused to use nCPAP. Parameters analysed include demographic, polysomnographic, and cephalometric data (supine CT of the upper airway). Efficacy, compliance, and side effects were evaluated by in-patient sleep study (2 months after using OA) and a questionnaire (2 and 6 months after using OA). Results: 13 patients (10 M, 3F) have been recruited with mean age of 51.2 yrs. The mean BMI was 26.1 and 26.2 at baseline and reassessment respectively. All patients have subjective (ESS) and objective (AHI) improvement. The mean ESS decreased from 11.6 to 5.5. The mean AHI decreased from 21.2 to 5.5, and the mean arousal index decreased from 23 to 10.6. Change in sleep stage were observed, more slow wave sleep and more REM sleep after using OA while the sleep efficiency remained the same. The mean mandible-hyoid bone distance decreased from 23.1 to 16.1 cm while the posterior airway space remains essentially the same (7.2 → 7.5 cm). The average time of using OA was 6.2 nights/week. 3 patients had dryness of throat, 2 had toothache, 2 had tooth discomfort and 6 had no complaint after using OA. Conclusions: In this preliminary analysis, we show that OA is a simple and effective treatment in Chinese patients with mild-moderate OSA. It has little side effects and a good compliance in the short term evaluation. Clinical Implications: Oral appliance may be useful in the treatment of mild-moderate OSA. Predictive factors guiding its success should be explored.
Persistent Identifierhttp://hdl.handle.net/10722/162884
ISSN
2015 Impact Factor: 5.94
2015 SCImago Journal Rankings: 3.176

 

DC FieldValueLanguage
dc.contributor.authorIp, MSMen_US
dc.contributor.authorLam, Ben_US
dc.contributor.authorSam, Ken_US
dc.contributor.authorPeh, Wen_US
dc.contributor.authorCooke, Men_US
dc.date.accessioned2012-09-05T05:24:45Z-
dc.date.available2012-09-05T05:24:45Z-
dc.date.issued1998en_US
dc.identifier.citationChest, 1998, v. 114 n. 4 SUPPL., p. 382Sen_US
dc.identifier.issn0012-3692en_US
dc.identifier.urihttp://hdl.handle.net/10722/162884-
dc.description.abstractPurpose: The role of oral appliance (OA) in the treatment of obstructive sleep apnoea (OSA) has been investigated and reported with variable success in several Caucasian studies. However, mandibular cervical anatomy varies with ethnicity, hence the efficacy of such appliances may also differ. Methods: We prospectively evaluated the role of mandibular advancing device in the treatment of Chinese patients with symptomatic mild to moderate OSA. Consecutive patients were recruited if the following criteria were fulfilled: Apnoea-hypopnoea index (AHI) 10-20 plus nocturnal choking or excessive daytime sleepiness (ESS = 9 or above), AHI 20-40, and AHI>40 but refused to use nCPAP. Parameters analysed include demographic, polysomnographic, and cephalometric data (supine CT of the upper airway). Efficacy, compliance, and side effects were evaluated by in-patient sleep study (2 months after using OA) and a questionnaire (2 and 6 months after using OA). Results: 13 patients (10 M, 3F) have been recruited with mean age of 51.2 yrs. The mean BMI was 26.1 and 26.2 at baseline and reassessment respectively. All patients have subjective (ESS) and objective (AHI) improvement. The mean ESS decreased from 11.6 to 5.5. The mean AHI decreased from 21.2 to 5.5, and the mean arousal index decreased from 23 to 10.6. Change in sleep stage were observed, more slow wave sleep and more REM sleep after using OA while the sleep efficiency remained the same. The mean mandible-hyoid bone distance decreased from 23.1 to 16.1 cm while the posterior airway space remains essentially the same (7.2 → 7.5 cm). The average time of using OA was 6.2 nights/week. 3 patients had dryness of throat, 2 had toothache, 2 had tooth discomfort and 6 had no complaint after using OA. Conclusions: In this preliminary analysis, we show that OA is a simple and effective treatment in Chinese patients with mild-moderate OSA. It has little side effects and a good compliance in the short term evaluation. Clinical Implications: Oral appliance may be useful in the treatment of mild-moderate OSA. Predictive factors guiding its success should be explored.en_US
dc.languageengen_US
dc.publisherAmerican College of Chest Physicians. The Journal's web site is located at http://www.chestjournal.orgen_US
dc.relation.ispartofChesten_US
dc.titleUse of oral appliance in treatment of obstructive sleep apnoea: Hong Kong experienceen_US
dc.typeArticleen_US
dc.identifier.emailIp, MSM:msmip@hku.hken_US
dc.identifier.authorityIp, MSM=rp00347en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.scopuseid_2-s2.0-25744465171en_US
dc.identifier.volume114en_US
dc.identifier.issue4 SUPPL.en_US
dc.identifier.spage382Sen_US
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridIp, MSM=7102423259en_US
dc.identifier.scopusauthoridLam, B=9246012800en_US
dc.identifier.scopusauthoridSam, K=6603582227en_US
dc.identifier.scopusauthoridPeh, W=7101824984en_US
dc.identifier.scopusauthoridCooke, M=7202147454en_US

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