September 27, 2019
By Reuters Staff
NEW YORK (Reuters Health) - Mandibular-advancement devices (MAD) may be an effective alternative to continuous positive airway pressure (CPAP) for treating obstructive sleep apnea/hypopnea syndrome (OSAS) in patients with Parkinson's disease (PD), a new pilot study suggests.
OSAS occurs commonly in PD patients, Dr. Valerie Cochen De Cock of Beau Soleil Clinic in Montpellier, France, and colleagues note in Sleep Medicine, online August 30.
"OSAS may induce sleep fragmentation and hypoxia associated with increased cardiovascular risks, cognitive dysfunctions and sleepiness, and it is considered to be one of the most disabling non motor symptoms of PD," they add.
The authors enrolled 20 patients with PD and OSAS in the study. Ten received MAD treatment because they refused or could not tolerate CPAP, while a matched group of PD patients with OSAS received CPAP.
Patients in both groups reported similar improvement in sleep quality, although sleepiness improved significantly with CPAP but not with MAD.
MAD reduced the apnea/hypopnea index (AHI) from 50.8 to 9.4 (P<0.001), and oxygen desaturation index from 22.0 to 3.8 (P<0.05). Eight patients had a reduction in AHI of more than 50% with MAD.
Usability and co-sleeper satisfaction were higher for MAD than CPAP. Adherence averaged 7.5 hours per night with MAD and 4.7 hours with CPAP.
"MAD seems to be a convenient and efficacious treatment of OAS in PD," Dr. De Cock and her team write. "A large, randomized study is needed to confirm if MAD is as efficacious as CPAP . . . Meanwhile, in clinical practice, this solution should already be discussed especially when CPAP is not well tolerated or refused."
Dr. De Cock was not available for an interview by press time.
Sleep Med 2019.
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