engleski

An adjustable mandibular advancement device for the treatment of obstructive sleep apnea syndrome and its implications on glucose metabolism: a prospective 1-year follow-up study

OBJECTIVES: Obstructive sleep apnea syndrome (OSAS) is recognized as an independent risk factor for insulin resistance, glucose intolerance and type 2 diabetes. The aim of this study was to determine the efficacy of the custom-made adjustable mandibular advancement device (MAD) after 1 year of treatment and its implications on the glucose metabolism. METHODS: A total of 15 patients with mild to moderate OSAS were treated with custom-made adjustable MAD and they were followed-up after 1 year of treatment. Sleep studies in the sleep clinic were performed with and without the MAD and fasting blood samples were obtained at baseline and at the time of follow-up. RESULTS: The mean apnea-hypopnea index (AHI) decreased significantly from 22.9±5.9 at baseline to 9.75±4.63 after 1 year of treatment (P<0.001), measured with the same polysomnography device. Fasting plasma glucose values (5.26±0.52 to 4.89±0.51 mmol/L, P<0.001) and fasting plasma insulin values (65.17±58.38 to 98.12±62.97 µU/ml, P=0.022) decreased significantly after 1 year of MAD treatment. There were no significant changes in the plasma glucose and insulin values after 120 minutes of oral glucose tolerance test (P>0.05). CONCLUSIONS: Our results indicate that the tested MAD was effective in reducing symptoms in mild to moderate OSAS patients by decreasing AHI and significantly decreasing fasting plasma glucose and insulin values.

Obstructive sleep apnea syndrome (OSAS) ; mandibular advancement device (MAD) ; apnea-hypopnea index (AHI)

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