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Oral device reduces snoring, sleep apnea

A custom-made oral device used while sleeping reduces snoring and obstructive sleep apnea, however it does not significantly alter daytime sleepiness or quality of life, according to study results.

Marie Marklund, DDS, PhD, senior lecturer in the department of odontology at Umeå University in Sweden, and colleagues conducted a randomized, placebo-controlled, parallel trial on 91 participants with daytime sleepiness to test whether an adjustable, oral device improved daytime sleepiness and quality of life in individuals with daytime sleepiness and snoring or mild to moderate obstructive sleep apnea.

The device intended to advance the mandible by at least 6 mm to 7 mm in participants using it.

Forty-five participants received the oral device; 76% of the participants used them the whole night for every night during the 4-month trial period. Eighty-nine percent of the participants in the control group (n = 46) who used an upper-jaw device, maintained use of the device every night during the trial.

The researchers noted snoring in participants who used the oral device decreased from four times a week to once a week (P < .001). Forty-nine percent of participants recorded apnea-hypopnea index score lower than 5 compared with 11% of participants using the placebo device (OR = 7.8; 95% CI, 2.6-23.5).

However, participants using the oral device did not see much difference in mental health from the Short-Form 36-Item Health Survey compared with the placebo group (OR = –0.9; 95% CI –5.6 to 3.8).

The researchers also identified a minimal difference between the two groups from baseline to follow-up in median Karolinska Sleepiness Scale (KSS). The median KSS score of 7 or higher measured four times daily for 1 week was 10 times at baseline and seven at follow-up in the oral device group. In comparison, the median KSS scored 7 or higher 12 times at baseline and eight times at follow-up for the participants using the placebo.

The researchers wrote some suggestions as to who should use the oral device as well as who should likely use another therapy in treating symptoms.    

“We suggest an oral appliance when treating patients with mild to moderate sleep apnea without daytime sleepiness,” the researchers wrote. “However, for sleep apnea patients with daytime sleepiness, positive airway pressure therapy should be recommended as the first treatment of choice.”

Disclosure: The researchers report no relevant financial disclosures.