Evaluation of Variable Mandibular Advancement Appliance for Treatment of Snoring and Sleep Apnea*

Objective: To evaluate an adjustable mandibular positioning appliance for treatment of snoring and sleep apnea. Methods: One hundred thirty-four patients with baseline apnea/hypopnea index (AHI) of 37 6 28 events/h (mean 6 SD) received the appliance. The efficacy of the appliance was assessed by the following investigations, performed at baseline and with the appliance: polysomnography, Epworth sleepiness scale, bedpartners ’ assessment of snoring severity, patients ’ assessment of side effects, and overall satisfaction. Results: Thirteen patients were lost to follow-up. An additional 46 patients had no follow-up polysomnography, but answered the questionnaires. A total of 75 patients had polysomnography at baseline and with the appliance. We found a significant reduction in AHI from 44 6 28 events/h to 12 6 15 events/h (p < 0.0005) and a reduction in the arousal index from 37 6 27 events/h to 16 6 13 events/h (p < 0.05). Epworth scores fell from 11 6 5 to 7 6 3 (p < 0.0005). Bedpartners’ assessment revealed marked improvement in snoring. For example, at baseline 96 % of patients were judged to snore loudly “often ” or “always ” by their bedpartners, whereas only 2 % were judged so while using dental appliance. The most frequent side effect was teeth discomfort