Improving Nocturnal Sleep and Excessive Daytime Somnolence in Moderate to Severe Obstructive Sleep Apnea-Hypopnea Syndrome by using Oral Appliances (P7.316)

Objectives: Introduce Oral Appliances (OA) in Cuba for the treatment of moderate to severe OSAHS and study its efficacy by mean of polisomnographic studies (PSG) and Epworth Sleepiness Scale (ESS). Background: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is characterized by snoring, periodic events of apneas and hypopneas disrupting sleep with sleep fragmentation, frequent oxygen desaturation and multiple arousals provoking excessive daytime sleepiness (EDS) with deterioration of cognitive functions (attention-concentration, memory, dexterity, creativity) also increasing traffic accidents, the risk of cadio-encephalic vascular diseases and affecting quality of life. Oral appliances has proved their usefulness in mild to moderate but little studies have been conducted in moderate and severe OSAHS. Methods: 7 of 11 patients with clinical and PSG diagnosis of moderate and severe OSAHS were selected for OA treatment (SAS Zúrich), 4 were excluded because not enough tooth in each hemi-arches required for OA treatment. Epworth scale was applied pre-treatment for EDS assessment. PSG and ESS were performed at 3 month post-treatment for assessment OA efficacy. OA adherence was also explored at 3 and 6 months post-treatment. Results: i) significant decrease of apnea index, apnea-hipopnea index, arousal index and blood oxygen desaturation during sleep in all patients (100[percnt]), ii) significant decrease of daytime somnolence severity assessed by the Epworth scale (100[percnt] patients), iii) good adherence: 71.4[percnt] (5 patients using OA more than 20 nights/month) at 3 and 6 months. Conclusions: Oral appliances seem to be a feasible and effective alternative in our country and in those where Continuous Positive Airway Pressure (CPAP) treatment is not easily available for the treatment of moderate to severe OSAHS and its harmful effects.