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EFFECTS OF THE MANDIBULAR ADVANCEMENT DEVICE ON DAILY SLEEPENESS AND POLYSOMNOGRAPHICAL PROFILE IN INTERCITY BUS DRIVERS WITH OBSTRUCTIVE SLEEP APNEA SYNDROME: A PILOT STUDY
Mandibular advancement devices (MAD) are indicated for the treatment of Obstructive Sleep Apnea Syndrome (OSAS), since they reduce the collapse of the upper airways and keep the jaw and tongue in a protruded position.
To evaluate the effects of MAD on the polysomnographic profile and daytime sleepiness of intercity bus drivers with OSAS.
This is a quasi-experimental pilot study that evaluated male intercity bus drivers from a municipality in the interior of Rio Grande do Sul-RS. The sample was accessed non-probabilistically and for convenience. After selection, anthropometric and labor data were collected, and the Epworth Sleepiness Scale was applied and the diagnosis of OSAS was made by type III polysomnography (ApneaLinkAir®, RESMED, Sidney, Australia). The Epworth Sleepiness Scale was evaluated before and after treatment with MAD, where it consists of 8 questions that demonstrate the presence of sleepiness (0 - 3 points). The score ranges from 0 to 24 points and when a score ≥ 10 indicates an increased daytime sleepiness. Type III polysomnography was performed before and after treatment, which was applyed during his sleep night at the individual's home. The severity of OSAS was defined by the Apnea-Hypopnea Index (AHI), where 5 - 15 classifies it as mild, 15 - 29, moderate and ≥ 30, severe. The treatment was performed through the prefabricated MAD (BluePro®, BLUESOM, Orvault, França), which allows the individualization of the device for each individual. Each patient used the MAD, after the presence of OSAS was conformed by polysomnographic examination, and than personalized by a dentist with extensive clinical experience. After adaptation to the device, they remained for a period of 8 to 12 weeks.
Male sample (n = 5) with an average age of 46.20 ± 11.32 years old and body mass index of 32.41 ± 2.42 Kg/m2. There was a significant reduction in sleepiness (Pre: 10.80 ± 6.30 Post: 7.60 ± 4.77) (p = 0.030), as well as the AHI (Pre: 36.88 ev/h ± 15.62 ev/h Post: 12, 26 ev/h ± 9.12 ev/h) (p = 0.006).
In the evaluated sample, it was observed that drivers of intercity bus drivers with obstructive sleep apnea syndrome who used the mandibular advancement device obtained a reduction in daytime sleepiness and an improvement in polysomnographic profile.
Obstructive sleep apnea syndrome, sleep, sleepiness, polysomnography.
Antônio Rocha, Litiele Evelin Wagner, Lilian Abentroth, Jorge Machado Caram, Marilene Trindade, Dulciane Nunes Paiva