EFFECTIVENESS OF MANDIBULAR ADVANCEMENT DEVICES IN THE MANAGEMENT OF MILD TO MODERATE OBSTRUCTIVE SLEEP APNEA: A PROSPECTIVE INTERVENTIONAL STUDY

Abstract

Background: Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder characterized by recurrent upper airway collapse during sleep, leading to intermittent hypoxia, sleep fragmentation, and excessive daytime sleepiness. Continuous positive airway pressure (CPAP) is the standard treatment; however, poor tolerance and compliance have increased interest in alternative therapies such as mandibular advancement devices (MADs), particularly for patients with mild to moderate disease.

Aim: To evaluate the effectiveness of mandibular advancement devices in improving polysomnographic parameters and clinical symptoms in patients with mild to moderate obstructive sleep apnea.

Materials and Methods: This prospective interventional study included 40 adults diagnosed with mild to moderate OSA based on overnight polysomnography. All participants were treated with a custom-made adjustable mandibular advancement device and followed for three months. Baseline and post-treatment assessments included Apnea–Hypopnea Index (AHI), oxygen saturation parameters, Epworth Sleepiness Scale (ESS), total sleep time, and sleep efficiency. Pre- and post-intervention values were compared using paired statistical analysis.

Results: Following MAD therapy, there was a significant reduction in mean AHI from 18.6 ± 6.4 to 10.9 ± 4.8 events/hour (p < 0.001). Significant improvements were also observed in oxygen desaturation index, minimum and mean oxygen saturation, ESS scores, total sleep time, and sleep efficiency (p < 0.05). Thirty percent of participants achieved normalization of AHI. Good compliance was reported in 85% of patients, with only mild and transient adverse effects.

Conclusion: Mandibular advancement devices are an effective and well-tolerated treatment option for patients with mild to moderate obstructive sleep apnea, resulting in significant improvements in both objective sleep parameters and subjective symptoms.