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The tongue-retaining device: efficacy and side effects in obstructive sleep apnea syndrome.

Abstract : STUDY OBJECTIVES: The tongue-retaining device is a customized monobloc oral appliance used in the treatment of obstructive sleep apnea syndrome (OSAS). This study evaluated tongue-retaining device efficacy and its tolerance by patients with OSAS. METHODS: The charts of 84 apneic patients were retrospectively analyzed, and patients were contacted by telephone to answer an oral questionnaire. The median follow-up time was 5 years. RESULTS: Based on the apnea-hypopnea index, a complete or partial response was obtained in 71% of the cases. The mean apnea-hypopnea index decreased significantly from 38 to 14 (p < 0.001) with the tongue-retaining device. The subjective intensity of snoring decreased by 68% (p < 0.0001) and the Epworth Sleepiness Scale score decreased from 9 to 6 (p < 0.05). An age of more than 60 years associated with a mandibular protrusion distance inferior or equal to 7 mm was predictive of a nonresponse (odds ratio [OR]: 7.25; 95% confidence interval [CI]: 1.43-36.7; p < 0.02). The compliance rate, as determined by answers to the questionnaire, was 52% after 5 years of follow-up. Nasal obstruction was a negative predictor of good compliance (OR: 6.94; 95% CI: 0.28-0.79; p < 0.005), whereas patients with Class I occlusion were more compliant than patients with Class II or III occlusions (OR: 3.83; 95% CI: 1.00-2.81; p < 0.05). CONCLUSIONS: Tongue-retaining device performance tended to be similar to that of the mandibular advancement device. Thus, teams trained in tongue-retaining device fabrication and fitting may propose it as an alternative to continuous positive airway pressure, taking nasal obstruction into consideration as a contraindication.
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https://www.hal.inserm.fr/inserm-00452395
Contributor : Pierre Chauvin <>
Submitted on : Tuesday, February 2, 2010 - 11:44:41 AM
Last modification on : Wednesday, August 19, 2020 - 11:16:51 AM

Identifiers

  • HAL Id : inserm-00452395, version 1
  • PUBMED : 19961027

Citation

Diane Lazard, Marc Blumen, Pierre Lévy, Pierre Chauvin, Dorothée Fragny, et al.. The tongue-retaining device: efficacy and side effects in obstructive sleep apnea syndrome.. J Clin Sleep Med, 2009, 5 (5), pp.431-8. ⟨inserm-00452395⟩

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