The tongue-retaining device: efficacy and side effects in obstructive sleep apnea syndrome.
| Autor: | Lazard DS; Assistance Publique-Hôpitaux de Paris, Hôpital Beaujon, Service d'ORL et de Chirurgie Cervico-Faciale, Clichy, France. diane.lazard@bjn.aphp.fr, Blumen M, Lévy P, Chauvin P, Fragny D, Buchet I, Chabolle F |
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| Jazyk: | angličtina |
| Zdroj: | Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine [J Clin Sleep Med] 2009 Oct 15; Vol. 5 (5), pp. 431-8. |
| Abstrakt: | Study Objectives: The tongue-retaining device is a customized monobloc oral appliance used in the treatment of obstructive sleep apnea syndrome (OSAS). This study evaluated tongue-retaining device efficacy and its tolerance by patients with OSAS. Methods: The charts of 84 apneic patients were retrospectively analyzed, and patients were contacted by telephone to answer an oral questionnaire. The median follow-up time was 5 years. Results: Based on the apnea-hypopnea index, a complete or partial response was obtained in 71% of the cases. The mean apnea-hypopnea index decreased significantly from 38 to 14 (p < 0.001) with the tongue-retaining device. The subjective intensity of snoring decreased by 68% (p < 0.0001) and the Epworth Sleepiness Scale score decreased from 9 to 6 (p < 0.05). An age of more than 60 years associated with a mandibular protrusion distance inferior or equal to 7 mm was predictive of a nonresponse (odds ratio [OR]: 7.25; 95% confidence interval [CI]: 1.43-36.7; p < 0.02). The compliance rate, as determined by answers to the questionnaire, was 52% after 5 years of follow-up. Nasal obstruction was a negative predictor of good compliance (OR: 6.94; 95% CI: 0.28-0.79; p < 0.005), whereas patients with Class I occlusion were more compliant than patients with Class II or III occlusions (OR: 3.83; 95% CI: 1.00-2.81; p < 0.05). Conclusions: Tongue-retaining device performance tended to be similar to that of the mandibular advancement device. Thus, teams trained in tongue-retaining device fabrication and fitting may propose it as an alternative to continuous positive airway pressure, taking nasal obstruction into consideration as a contraindication. |
| Databáze: | MEDLINE |
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