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Non-apneic snoring and the orthodontist: the effectiveness of mandibular advancement splints

Derbyshire Royal Infirmary, Derby, UK

J. M. Battagel

Dental Institute, Royal London Hospital, London, UK

Address for correspondence: Mrs A.M. Smith, Orthodontic Department, Derbyshire Royal Infirmary, London Road, Derby, DE1 2QY, UK. Email: Anne-Marie.Smith{at}sdah-tr.trent.nhs.uk

Objective: Non-apneic snoring is a very common problem, which impacts on all family members. Oral appliances have been used in the management of snoring. These posture the mandible forward during sleep, opening the airway and so reducing the potential for noise generation. This articles aims to objectively evaluate the effectiveness of mandibular advancement splints (MAS) in non-apneic snorers.

Design: Prospective clinical trial.

Setting: University Dental Hospital and School.

Subjects and methods: 35 consecutively referred adults with proven non-apneic snoring.

Interventions: Subjects were fitted with a removable, adjustable Herbst MAS.

Main outcome measures: Questionnaires determined changes in snoring incidence, daytime tiredness, any side effects and their duration. Eleven subjects completed overnight domiciliary sleep recordings of oxygen saturations, pulse rates and sound profile, before and 1 month after fitting the MAS.

Results: The questionnaires and sleep recordings suggested that the MAS significantly reduced snoring incidence (p<0.05) and improved sleep quality. Daytime tiredness, as assessed by the Epworth Sleepiness Scale, was significantly reduced (p<0.001). Initial side effects of muscular and TMJ discomforts were mostly resolved after 1 month of appliance wear.

Conclusions: Use of a MAS improves snoring incidence and sleep quality in most patients with non-apneic snoring.

Key words: Dental devices, mandibular advancement splints, sleep disordered breathing, non-apneic snoring