Mandibular advancement device in the treatment of the apnea hypopnea syndrome

Sleep apnea hypopnea syndrome (SAHS) constitutes a major health problem. Continuous positive airway pressure (CPAP) is so far the treatment of choice . However, in patients with CPAP intolerance, the mandibular advancement device (MAD) is positioned as a therapeutic alternative. A descriptive study on 37 patients diagnosed with SAHS who used MAD between 2016-2018 was performed. The characteristics of the patients were evaluated, as well as the modification of the Epworth test and the polygraphic respiratory parameters with the use of MAD. A total of 37 patients were studied. The mean age was 55 years (SD 10), 28 (73.7%) males and 10 (26.3%) females. The mean body mass index (BMI) of the patients at the beginning of the study was 27.5 (SD 3.5) and the BMI at the time of the polygraph control with the MAD was 27.2 (SD 3.4), with no evidence of statistically significant differences. Regarding the Epworth test, the respiratory events and the oximeter profile, a significant improvement was observed with the use of MAD in all the evaluated parameters, except in the mean saturation (Image 1). The profile of the patients with respect to SAHS severity and its correction with the use of MAD is reflected in Image 2. Prior to the use of MAD, 27 patients presented an AHI≥15/hour and with the use of MAD, only 4 patients persisted with an AHI≥15. None of them maintained the severe degree. The change was statistically significant (p MAD is a beneficial alternative treatment in patients who reject the use of CPAP, presenting a high control of the disease.