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Gurgel M, Kurita L, Fonteles C, Ribeiro T, Costa F, Freitas B, Bruin V, Cevidanes L, Chaves-Junior C. Condylar Position in the Treatment of Obstructive Sleep Apnea with a Mandibular Advancement Device: A Pilot Study. Sleep Sci 2023; 16:e381-e388. [PMID: 38197027 PMCID: PMC10773499 DOI: 10.1055/s-0043-1776870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 01/23/2023] [Indexed: 01/11/2024] Open
Abstract
Objective To evaluate, through a tomographic analysis, the positional changes of the condyle when using a mandibular advancement device (MAD) for the treatment of obstructive sleep apnea (OSA), and to assess if the condylar positions influence OSA polysomnographic patterns. Materials and Methods Ten OSA patients underwent treatment with an MAD, and polysomnographic and tomographic examinations were performed before therapy (T0) and after MAD placement (T1). Results By comparing the T0 and T1 measurements, we observed advancement and extrusion of the condyles in all patients ( p < 0.001), as well as a decrease in the apnea-hypopnea index (AHI) ( p < 0.001), increases in the mean ( p = 0.001) and minimum ( p < 0.001) oxyhemoglobin saturation, and a significant correlation between the anterior displacement of the right ( p = 0.003) and left ( p = 0.015) condyles. Discussion Condylar advancement was directly correlated with OSA improvement: the greater the advancement, the better the AHI.
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Affiliation(s)
- Marcela Gurgel
- Department of Clinical Dentistry, School of Pharmacy, Dentistry and Nursing, Universidade Federal do Ceará, Fortaleza, CE, Brazil
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, United States
| | - Lucio Kurita
- Department of Clinical Dentistry, School of Pharmacy, Dentistry and Nursing, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | - Cristiane Fonteles
- Department of Clinical Dentistry, School of Pharmacy, Dentistry and Nursing, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | - Thyciana Ribeiro
- Department of Clinical Dentistry, School of Pharmacy, Dentistry and Nursing, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | - Fabio Costa
- Department of Clinical Dentistry, School of Pharmacy, Dentistry and Nursing, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | - Benedito Freitas
- Department of Clinical Dentistry, School of Dentistry, Universidade Federal do Maranhão, São Luis, MA, Brazil
| | - Veralice Bruin
- Department of Clinical Medicine, School of Medicine, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | - Lucia Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, United States
| | - Cauby Chaves-Junior
- Department of Clinical Dentistry, School of Pharmacy, Dentistry and Nursing, Universidade Federal do Ceará, Fortaleza, CE, Brazil
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Medeiros C, Bruin V, Férrer D, Paiva T, Montenegro Júnior R, Forti A, Bruin P. Excessive daytime sleepiness in type 2 diabetes. ACTA ACUST UNITED AC 2014; 57:425-30. [PMID: 24030181 DOI: 10.1590/s0004-27302013000600003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 05/29/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To examine excessive daytime sleepiness (EDS) in type 2 diabetes. SUBJECTS AND METHODS Patients (N = 110) were evaluated regarding Epworth Sleepiness Scale (EDS), sleep quality (Pittsburgh Sleep Quality Index), depressive symptoms (Beck Depression Inventory), Restless Legs Syndrome (RLS), risk of obstructive sleep apnea (OSA) (Berlin questionnaire), and comorbidity severity (Charlson Comorbidity Index). Patients were compared with individuals with arterial hypertension and without diabetes. RESULTS Diabetic patients had more EDS, depressive symptoms, and higher comorbidity severity than hypertensive patients (p < 0.005). In diabetic patients, poor quality sleep (53.3%), and high risk of OSA (40.9%) and RLS (14.5%) were found; EDS (55.5%) was associated with depressive symptoms present in 44.5% individuals (OR = 1.08; 95% CI: 1.01-1.15), and remained so after data were controlled for age, gender, body mass index, and glycated hemoglobin (OR = 2.27; 95% CI 1.03-5.03). CONCLUSIONS Sleep abnormalities are frequent. EDS affects most of the patients and is independently associated with depressive symptoms. Adequate antidepressant therapy should be tested for the effects on EDS.
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