When adherence to CPAP fails, how do we treat workers with obstructive sleep apnea?
Aims: A cross-sectional study was designed to evaluate the effectiveness of a mandibular advancement device (MAD) with respect to respiratory and sleep parameters among miners with obstructive sleep apnea syndrome (OSAS) and primary snore. Methods: The target sample was composed by 102 Braz...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Thieme Revinter Publicações Ltda.
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| Series: | Sleep Science |
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| Online Access: | https://cdn.publisher.gn1.link/sleepscience.org.br/pdf/v15nspea18.pdf |
| _version_ | 1797368535985422336 |
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| author | Maria de Lourdes Rabelo Guimarães Pedro Guimarães Azevedo Sérgio Barros-Vieira Maxime Elbaz Damien Leger Ana Paula Hermont |
| author_facet | Maria de Lourdes Rabelo Guimarães Pedro Guimarães Azevedo Sérgio Barros-Vieira Maxime Elbaz Damien Leger Ana Paula Hermont |
| author_sort | Maria de Lourdes Rabelo Guimarães |
| collection | DOAJ |
| description | Aims: A cross-sectional study was designed to evaluate the effectiveness of a mandibular advancement device (MAD) with respect to respiratory and sleep parameters among miners with obstructive sleep apnea syndrome (OSAS) and primary snore.
Methods: The target sample was composed by 102 Brazilian miners with a history of non-adherence to continuous positive airway pressure. All patients were treated with a MAD and underwent pre and post-treatment full-night polysomnography. Ethical approval and consents were obtained. Bivariate and logistic regression analyses were conducted. The level of statistical significance was set at 5%.
Results: After the treatment with MAD, 71.8% of patients presented a decrease ≥ 50% in the basal apnea-hypopnea index (AHI), 51.2% presented an AHI < 5 events/h and 83.3% reached an AHI<10/h, whereas 22.5% did not show any changes and 7.5% of the sample presented an increase in the AHI (p<0.05). There was an increase in the mean SpO2 nadir (p<0.001) and in the baseline duration of the REM sleep stage (p<0.05). The MAD significantly decreased snore events (p<0.05). Multivariate analysis did not identify predictive factors related to therapy success (decrease ≥ 50% of AHI). However, basal AHI was a significant predictor related to the secondary endpoint (AHI<10/h) (OR= 1.06, IC 95%1.00-1.13, p=0.007).
Conclusions: The MAD therapy showed significant improvements in AHI, minimum oxygen saturation, REM sleep and snoring. |
| first_indexed | 2024-03-08T17:33:52Z |
| format | Article |
| id | doaj.art-a0f7efab9bcc49f3af396bea8ec20416 |
| institution | Directory Open Access Journal |
| issn | 1984-0659 1984-0063 |
| language | English |
| last_indexed | 2024-03-08T17:33:52Z |
| publisher | Thieme Revinter Publicações Ltda. |
| record_format | Article |
| series | Sleep Science |
| spelling | doaj.art-a0f7efab9bcc49f3af396bea8ec204162024-01-02T13:33:19ZengThieme Revinter Publicações Ltda.Sleep Science1984-06591984-006315Special1135142001810.5935/1984-0063.20220012When adherence to CPAP fails, how do we treat workers with obstructive sleep apnea?Maria de Lourdes Rabelo Guimarães0Pedro Guimarães Azevedo1Sérgio Barros-Vieira2Maxime Elbaz3Damien Leger4Ana Paula Hermont5Universidade Federal de Minas Gerais, Faculty of Medicine, Belo Horizonte, Brazil, - Belo Horizonte - Minas Gerais - Brazil.Universidade Federal de Minas Gerais, Faculty of Medicine, Belo Horizonte, Brazil, - Belo Horizonte - Minas Gerais - Brazil.UNISONO- Centre de Diagnostique et Traitement des Troubles du Sommeil, - Vitória - Espírito Santo - Brazil.Université Paris Descartes, Sorbonne Paris Cité, EA, Vigilance Fatigue Sommeil et Santé Publique - Paris - Paris - France.Hôtel-Dieu, centre du Sommeil et de la Vigilance, Consultation de pathologie professionnelle Sommeil Vigilance et Travail, - Paris - Paris - France.Universidade Federal de Minas Gerais, Faculty of Dentistry, Belo Horizonte, Brazil, - Belo Horizonte - Minas Gerais - Brazil.Aims: A cross-sectional study was designed to evaluate the effectiveness of a mandibular advancement device (MAD) with respect to respiratory and sleep parameters among miners with obstructive sleep apnea syndrome (OSAS) and primary snore. Methods: The target sample was composed by 102 Brazilian miners with a history of non-adherence to continuous positive airway pressure. All patients were treated with a MAD and underwent pre and post-treatment full-night polysomnography. Ethical approval and consents were obtained. Bivariate and logistic regression analyses were conducted. The level of statistical significance was set at 5%. Results: After the treatment with MAD, 71.8% of patients presented a decrease ≥ 50% in the basal apnea-hypopnea index (AHI), 51.2% presented an AHI < 5 events/h and 83.3% reached an AHI<10/h, whereas 22.5% did not show any changes and 7.5% of the sample presented an increase in the AHI (p<0.05). There was an increase in the mean SpO2 nadir (p<0.001) and in the baseline duration of the REM sleep stage (p<0.05). The MAD significantly decreased snore events (p<0.05). Multivariate analysis did not identify predictive factors related to therapy success (decrease ≥ 50% of AHI). However, basal AHI was a significant predictor related to the secondary endpoint (AHI<10/h) (OR= 1.06, IC 95%1.00-1.13, p=0.007). Conclusions: The MAD therapy showed significant improvements in AHI, minimum oxygen saturation, REM sleep and snoring.https://cdn.publisher.gn1.link/sleepscience.org.br/pdf/v15nspea18.pdforal appliancesmandibular advancement deviceobstructive sleep apneaoccupational medicineprevention of accidents |
| spellingShingle | Maria de Lourdes Rabelo Guimarães Pedro Guimarães Azevedo Sérgio Barros-Vieira Maxime Elbaz Damien Leger Ana Paula Hermont When adherence to CPAP fails, how do we treat workers with obstructive sleep apnea? Sleep Science oral appliances mandibular advancement device obstructive sleep apnea occupational medicine prevention of accidents |
| title | When adherence to CPAP fails, how do we treat workers with obstructive sleep apnea? |
| title_full | When adherence to CPAP fails, how do we treat workers with obstructive sleep apnea? |
| title_fullStr | When adherence to CPAP fails, how do we treat workers with obstructive sleep apnea? |
| title_full_unstemmed | When adherence to CPAP fails, how do we treat workers with obstructive sleep apnea? |
| title_short | When adherence to CPAP fails, how do we treat workers with obstructive sleep apnea? |
| title_sort | when adherence to cpap fails how do we treat workers with obstructive sleep apnea |
| topic | oral appliances mandibular advancement device obstructive sleep apnea occupational medicine prevention of accidents |
| url | https://cdn.publisher.gn1.link/sleepscience.org.br/pdf/v15nspea18.pdf |
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