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Update on oral appliance therapy

Oral appliances are increasingly recommended for selected patients with obstructive sleep apnoea (OSA) and those who do not tolerate nor prefer continuous positive airway pressure. The most commonly used oral appliance advances the lower jaw during sleep, the so-called mandibular advancement device...

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Detalles Bibliográficos
Autores principales: Marklund, Marie, Braem, Marc J.A., Verbraecken, Johan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: European Respiratory Society 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9488498/
https://www.ncbi.nlm.nih.gov/pubmed/31554705
http://dx.doi.org/10.1183/16000617.0083-2019
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author Marklund, Marie
Braem, Marc J.A.
Verbraecken, Johan
author_facet Marklund, Marie
Braem, Marc J.A.
Verbraecken, Johan
author_sort Marklund, Marie
collection PubMed
description Oral appliances are increasingly recommended for selected patients with obstructive sleep apnoea (OSA) and those who do not tolerate nor prefer continuous positive airway pressure. The most commonly used oral appliance advances the lower jaw during sleep, the so-called mandibular advancement device (MAD). Patients seek treatment because of disturbing snoring, daytime symptoms, apnoeas that disturb sleep and the longer term consequences with regard to cardiovascular risks. MADs reduce the apnoea–hypopnoea index, although to various degrees among patients. Effects on daytime sleepiness have been observed mainly among the more severe OSA patients. Blood pressure may be reduced in MAD-treated OSA patients. There is, however, uncertainty about which patients will respond to this therapy in terms of apnoea reductions, decreased sleepiness and other symptoms, and reduced risk for future impaired health. The occurrence of side-effects also remains difficult to predict at present. The majority of sleep apnoea patients suffer from various comorbidities in terms of cardiovascular diseases, type 2 diabetes and depression. The most recent findings indicate that phenotyping of patients, considering various aspects of this multifaceted disease, will shed more light on the indications for MADs in patients with nightly sleep breathing disturbances. This review summarises the most recent knowledge about MAD treatment.
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spelling pubmed-94884982022-11-14 Update on oral appliance therapy Marklund, Marie Braem, Marc J.A. Verbraecken, Johan Eur Respir Rev Sleep and Breathing Conference Review Oral appliances are increasingly recommended for selected patients with obstructive sleep apnoea (OSA) and those who do not tolerate nor prefer continuous positive airway pressure. The most commonly used oral appliance advances the lower jaw during sleep, the so-called mandibular advancement device (MAD). Patients seek treatment because of disturbing snoring, daytime symptoms, apnoeas that disturb sleep and the longer term consequences with regard to cardiovascular risks. MADs reduce the apnoea–hypopnoea index, although to various degrees among patients. Effects on daytime sleepiness have been observed mainly among the more severe OSA patients. Blood pressure may be reduced in MAD-treated OSA patients. There is, however, uncertainty about which patients will respond to this therapy in terms of apnoea reductions, decreased sleepiness and other symptoms, and reduced risk for future impaired health. The occurrence of side-effects also remains difficult to predict at present. The majority of sleep apnoea patients suffer from various comorbidities in terms of cardiovascular diseases, type 2 diabetes and depression. The most recent findings indicate that phenotyping of patients, considering various aspects of this multifaceted disease, will shed more light on the indications for MADs in patients with nightly sleep breathing disturbances. This review summarises the most recent knowledge about MAD treatment. European Respiratory Society 2019-09-25 /pmc/articles/PMC9488498/ /pubmed/31554705 http://dx.doi.org/10.1183/16000617.0083-2019 Text en Copyright ©ERS 2019. https://creativecommons.org/licenses/by-nc/4.0/This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.
spellingShingle Sleep and Breathing Conference Review
Marklund, Marie
Braem, Marc J.A.
Verbraecken, Johan
Update on oral appliance therapy
title Update on oral appliance therapy
title_full Update on oral appliance therapy
title_fullStr Update on oral appliance therapy
title_full_unstemmed Update on oral appliance therapy
title_short Update on oral appliance therapy
title_sort update on oral appliance therapy
topic Sleep and Breathing Conference Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9488498/
https://www.ncbi.nlm.nih.gov/pubmed/31554705
http://dx.doi.org/10.1183/16000617.0083-2019
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