Clinical co-morbidities in obstructive sleep apnea syndrome treated with mandibular repositioning appliance

Clinical co-morbidities in obstructive sleep apnea syndrome treated with mandibular repositioning appliance

Author Machado, Marco Antonio Cardoso Autor UNIFESP Google Scholar
Carvalho, Luciane Bizari Coin de Autor UNIFESP Google Scholar
Juliano, Maria Ligia Autor UNIFESP Google Scholar
Taga, Marcel Frederico de Lima Autor UNIFESP Google Scholar
Prado, Lucila Bizari Fernandes do Autor UNIFESP Google Scholar
Prado, Gilmar Fernandes do Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Introduction: Intraoral mandibular repositioner appliances (IOMRAs) are designed to enlarge pharyngeal airway space advancing the mandible and increasing genioglossus tone during sleep. Obstructive sleep apnea syndrome (OSAS) treatment with IOMRAs is beneficial, but there is a lack of studies in the literature defining the target population more inclined to respond to this treatment.Methods: We contacted by telephone 188 previously treated patients with IOMRA, detecting 20 not improved patients (Study Group). Twenty improved patients of the remaining 168 were randomly paired according to gender, age, apnea, and hypopnea index as Control Group. Both groups answered questionnaires for diagnosis of sleep disorders, depression, anxiety, and the Epworth sleepiness scale. We did a descriptive and inferential statistical analysis. the inferential analysis was divided into two steps: univariate analysis using Fischer exact test and a multiple inferential analysis using a stepwise regression model.Results: Although the final model included only insomnia, we concluded that the presence of gastric, neurological and rheumatic diseases also tended to be associated with the self-perception of non-improvement. the association between the accumulation of gastric, neurological, and rheumatic diseases and insomnia and improvement demonstrated that an increase in one of these diseases correspond to a two-fold increase in the chance of non-improvement.Conclusions: Insomnia was the most important factor compromising the, success of OSAS treatment with IOMRAs, and the isolated presence of gastric, neurological and rheumatic diseases, but especially their combination, reduces the perception rate of welt-succeeded treatment with IOMRAs. (c) 2005 Elsevier B.V. All rights reserved.
Keywords insomnia
sleep apnea
intraoral appliances
adult
Language English
Date 2006-06-01
Published in Respiratory Medicine. London: W B Saunders Co Ltd, v. 100, n. 6, p. 988-995, 2006.
ISSN 0954-6111 (Sherpa/Romeo, impact factor)
Publisher W B Saunders Co Ltd
Extent 988-995
Origin http://dx.doi.org/10.1016/j.rmed.2005.10.002
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000238016500005
URI http://repositorio.unifesp.br/handle/11600/28915

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