Weight gain may affect mandibular advancement device therapy in patients with obstructive sleep apnea: a retrospective study

• Published in: Sleep & breathing Vol. 23; no. 2; pp. 531 - 534
• Main Authors: Vuorjoki-Ranta, Tiina-Riitta, Aarab, Ghizlane, Lobbezoo, Frank, Tuomilehto, Henri, Ahlberg, Jari
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-06-2019; Springer Nature B.V
• Subjects: Adult; Aged; Apnea; Dentistry; Female; Follow-Up Studies; Humans; Internal Medicine; Male; Mandible; Medicine; Medicine & Public Health; Middle Aged; Neurology; Occlusal Splints; Otorhinolaryngology; Oxygen; Oxygen - blood; Patients; Pediatrics; Pneumology/Respiratory System; Primary Health Care; Retrospective Studies; Risk Factors; Sleep; Sleep apnea; Sleep Apnea, Obstructive - physiopathology; Sleep Apnea, Obstructive - therapy; Sleep Breathing Physiology and Disorders • Original Article; Sleep disorders; Treatment Failure; Weight Gain - physiology; Mandibular advancement device; Primary health care; Obstructive sleep apnea; Overweight
• ISSN: 1520-9512; 1522-1709
• DOI: 10.1007/s11325-018-1728-1

Purpose
The aim was to analyze whether or not weight gain influences the treatment outcome of patients with obstructive sleep apnea (OSA) treated with mandibular advancement devices (MAD).
Methods
As a part of a follow-up study among OSA patients treated with MAD in primary oral health care, a group of 28 patients reporting worsening of daytime or nighttime symptoms of OSA was given closer examination. Altogether, 21 subjects had a complete set of recordings and were enrolled into the study.
Results
Only three subjects had lost weight during the study period. The mean weight gain of 3.6 kg ± 7.1 kg was significant (
p
 = 0.035). According to linear regression, weight gain was independently significantly associated with lower mean peripheral oxygen saturation 92.4 (SD 1.8 (% per hour) (
p
 = 0.019)) and lowest oxygen saturation 80.1 (SD 7.2 (%) (
p
 = 0.024)) scores.
Conclusions
Weight gain is detrimentally associated with MAD treatment in patients with OSA. These findings suggest that regular follow-up by an experienced dentist is advisable to assess for possible worsening of OSA. Patient support to encourage weight control may be an important adjunct to MAD treatment for OSA.