Drug induced sleep endoscopy and simultaneous polysomnography to predict the effectiveness of mandibular advancement device in obstructive sleep apnea treatment

Purposes To evaluate whether mandibular advancement device therapy is recommended in patients affected by obstructive sleep apnea. Methods In order to predict oral appliances therapy response, drug induced sleep endoscopy with cardio-respiratory polygraphy and mandibular advancement device simulator was carried out. Patients in which upper airway obstruction was resolved on all levels and AHI was normalized (< 5/h), were referred for oral appliance therapy. At 5 months follow up, a cardio-respiratory polygraphy with MAD was performed. Results 36 patients who have evidence of resolution of UA collapse and AHI below 5 events per hour, were referred for MAD therapy. At follow up, the mean AHI decreased from 29.1 +/- 13.1 to 3.3/h +/- 1.9 (p < 0.001). All the patients were responders. Conclusion Combining the evaluation of drug induced sleep endoscopy and cardio-respiratory polygraphy data simultaneously during mandibular protrusion, has the potential to be a useful tool for prediction of MAD therapy response.