Non-CPAP therapies in obstructive sleep apnea: mandibular advancement device therapy.

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Marklund M1, Verbraecken J, Randerath W.

Abstract: The aim of the European Respiratory Society Task Force was to review the evidence in favour of MAD therapy. Effects of tongue-retaining devices are not included in this report. Custom-made MADs reduce apnoea/hypopnoea index (AHI) and daytime sleepiness compared with placebo devices. Milder cases and patients with a proven increase in upper airway size as a result of mandibular advancement are most likely to experience treatment success with MADs. A custom-made device titrated from an initial 50% of maximum mandibular advancement has been recommended. The treatment must be followed up and the device adjusted or exchanged in relation to the outcome.