Mandibular exercises improve mandibular advancement device therapy for obstructive sleep apnea

• Published in: Sleep & breathing 2011-12, Vol.15 (4), p.717-727
• Main Authors: Cunali, Paulo Afonso, Almeida, Fernanda R., Santos, Camila D., Valdrichi, Natália Y., Nascimento, Liliane S., Dal-Fabbro, Cibele, Tufik, Sérgio, Bittencourt, Lia Rita A.
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Combined Modality Therapy; Dentistry; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes; Double-Blind Method; Exercise Therapy; Female; Fundamental and applied biological sciences. Psychology; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Humans; Internal Medicine; Male; Mandibular Advancement - instrumentation; Medical disorders; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Nervous system (semeiology, syndromes); Neurology; Original Article; Orthodontic Appliances; Otorhinolaryngology; Pediatrics; Pneumology/Respiratory System; Polysomnography; Portugal; Sleep apnea; Sleep Apnea, Obstructive - diagnosis; Sleep Apnea, Obstructive - rehabilitation; Sleep. Vigilance; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the upper aerodigestive tract; Surveys and Questionnaires; Therapy; Vertebrates: nervous system and sense organs
• ISSN: 1520-9512; 1522-1709
• DOI: 10.1007/s11325-010-0428-2

Rationale Temporomandibular disorder (TMD) has been the most common contraindication for mandibular advancement device (MAD) as a treatment for obstructive sleep apnea syndrome (OSAS). Exercising the mandible is a recommended form of therapy for TMD. Objectives To assess the efficacy of mandibular exercises in the control of pain, changes of quality of life and to assess the impact of MAD compliance in OSAS patients with previously diagnosed TMD. Methods A blind, randomized, and controlled trial was used to evaluate 29 OSAS patients with TMDs were divided in two groups: the exercise support therapy (ST) and placebo therapy (PT), who were evaluated prior to and 120 days after MAD treatment. Treatment outcomes were measured using the Fletcher and Luckett sleep questionnaire, Epworth sleepiness scale, SF-36 inventory of quality of life, polysomnography, diary of MAD usage, and the research diagnostic criteria for TMD. Measurements and main results ST group showed significant improvement in their sleep quality and life quality when compared to the PT group ( p