Long-Term Oral Appliance Therapy Improves Daytime Function and Mood in Upper Airway Resistance Syndrome Patients

Long-Term Oral Appliance Therapy Improves Daytime Function and Mood in Upper Airway Resistance Syndrome Patients

Author Godoy, Luciana B. M. Autor UNIFESP Google Scholar
Palombini, Luciana Autor UNIFESP Google Scholar
Poyares, Dalva Autor UNIFESP Google Scholar
Dal-Fabbro, Cibele Autor UNIFESP Google Scholar
Guimaraes, Thais Moura Autor UNIFESP Google Scholar
Klichouvicz, Priscila Calixto Autor UNIFESP Google Scholar
Tufik, Sergio Autor UNIFESP Google Scholar
Togeiro, Sonia Maria Autor UNIFESP Google Scholar
Abstract Objectives: To evaluate the long-term effects of an oral appliance on clinical symptoms, respiratory sleep parameters, sleep quality, and sustained attention in patients with upper airway resistance syndrome (UARS) were compared with placebo. Methods: This study was a randomized placebo-controlled clinical trial. Thirty UARS patients were randomized in two groups: placebo and mandibular advancement device (MAD) groups. UARS criteria were presence of sleepiness (Epworth Sleepiness Scale >= 10) and/or fatigue (Modified Fatigue Impact Scale >= 38) associated with an apnea/hypopnea index <= 5 and a respiratory disturbance index (RDI) > 5 events/hour of sleep, and/or flow limitation in more than 30% of total sleep time. All patients completed the Pittsburgh Sleep Quality Index (PSQI), the Functional Outcomes of Sleep Questionnaire, the Beck Anxiety and Depression Inventories, underwent full-night polysomnography, multiple sleep latency test, and Psychomotor Vigilance Test (PVT). Evaluations were performed before and after 1.5 years of treatment. Results: RDI, number of respiratory effort-related arousal, percentage of total sleep time with flow limitation, and arousal index significantly decreased after 1.5 years of MAD treatment. PSQI total score improved, severity of depression symptoms decreased, and mean reaction time in the PVT, based on the first measurement taken at 8: 00 am, significantly decreased (p=.03) at the end of the protocol. Conclusions: The MAD was effective in decreasing respiratory events in UARS patients. For UARS, 1.5 years of oral appliance therapy also improved sleep quality and sustained attention, and decreased the severity of depression symptoms.
Keywords Upper airway resistance syndrome
excessive daytime sleepiness
mandibular advancement device
sleep disordered breathing
oral appliance therapy
xmlui.dri2xhtml.METS-1.0.item-coverage Cary
Language English
Sponsor Associacao Fundo de Incentivo a Pesquisa (AFIP)
Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)
Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)
Date 2017
Published in Sleep. Cary, v. 40, n. 12, p. -, 2017.
ISSN 1550-9109 (Sherpa/Romeo, impact factor)
Publisher Oxford Univ Press Inc
Extent -
Origin http://dx.doi.org/10.1093/sleep/zsx175
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000419000600014
URI https://repositorio.unifesp.br/handle/11600/58068

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