Official websites use. Share sensitive information only on official, secure websites. Mandibular repositioning devices MRDs are an effective treatment option for obstructive sleep apnea syndrome OSAS , particularly in patients who refuse or cannot tolerate continuous positive airway pressure CPAP. However, sex differences in the response to therapy and predictors of response are not clearly defined. MRD therapy was titrated over 3β6 months. In women vs. On multivariate analysis, significant predictors of MRD treatment success were overbite and baseline apnea index in men, and neck circumference and no previous CPAP therapy in women.
There were sex differences in the occurrence of side effects. Temporomandibular joint pain was the most common reason for stopping MRD therapy. Keywords: Obstructive sleep apnea, Mandibular repositioning device, Sex differences, Apnea-hypopnea index. Obstructive sleep apnea syndrome OSAS is characterized by repetitive complete or partial occlusions of the upper airway with persistent inspiratory efforts during sleep, followed by oxyhemoglobin desaturations and terminated by arousals.
OSAS is a public health burden because of its medical and socioeconomic consequences, including a higher likelihood of vehicle crashes and occupational accidents, increased risk of cardiovascular diseases, neurocognitive dysfunction, and impaired quality of life [ 1 ].
The gold standard treatment for OSAS is continuous positive airway pressure CPAP , which has been shown to reduce sleepiness [ 2 ] and road accidents [ 3 ], and might decrease cardiovascular risk and mortality [ 4 ].
However, compliance with CPAP is an issue in up to half of all users [ 5 ], potentially limiting its effectiveness [ 6 ]. Mandibular repositioning devices MRDs enlarge the upper airway during sleep by holding the mandible in a forward position and are an effective alternative to CPAP, particularly in mild-to-moderate OSA or in patients not adherent to or refusing CPAP [ 7 ].
