Obstructive sleep apnea (OSA) is a condition characterized by repetitive complete or partial obstruction of the upper airway during sleep. There is evidence that links OSA to long-term cardiovascular morbidity, including hypertension, myocardial infarction and stroke, and to an increased risk of motor vehicle accidents. These cardiovascular co-morbidities and motor vehicle accidents result in an increased risk of mortality in OSA patients. Hence, untreated OSA is associated with serious medical consequences, which underlines the importance of timely recognition, accurate diagnosis, and effective treatment of this disorder.
Continuous positive airway pressure (CPAP) is generally considered the “gold standard” treatment for OSA. Although CPAP is a highly efficacious treatment, there is a need for other treatment options, because the effectiveness of CPAP is often limited by poor patient acceptance and tolerance, as well as by a suboptimal compliance. Nowadays, mandibular advancement devices (MADs) are widely prescribed for the treatment of mild-to-moderate OSA. These oral appliances are often considered by patients to be a more acceptable treatment modality compared to CPAP.
During this lecture recent evidence on the effects and side-effects of MADs will be presented. Further, the prediction of MAD treatment outcome will be discussed.