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Tracking Pulse Oximeter Findings Before, During and After Titration of Mandibular Advancement Devices for Patients with Mild and Moderate Obstructive Sleep Apnea

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Technical Report

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Uniformed Services University of the Health Sciences Bethesda United States

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Introduction Sleep disorders, to include obstructive sleep apnea OSA, are prevalent in military personnel and can be risk factors for many medical and pain conditions as well as impact quality of life and operational readiness. Military veterans are four times more likely to have an OSA diagnosis compared to the general population. The management of OSA includes devices that provide positive airway pressure PAP to displace oral tissues to affect upper airway patency during sleep. PAP devices have multiple issues regarding their adherence. Another option for OSA management is oral appliance therapy that advances the mandible forward increasing upper airway opening. Patients diagnosed with moderate or severe OSA by providers from the Walter Reed National Military Medical Center WRNMMC Sleep Disorders Center will be invited to participate in this study until 20 patients meet study criteria and consent for participation they will have had their initial sleep study performed by this service. Methods The recruited subjects will be evaluated by Navy Medicine Professional Development Center NMPDC Orofacial Pain Center providers for utilization of an oral appliance to help manage OSA symptoms. A mandibular advancement device MAD, an oral appliance used for the management of OSA, will be fabricated by the NMPDC Maxillofacial Prosthodontic Department and delivered by NMPDC Orofacial Pain Center providers to study participants for use while sleeping at home. Subjective measures will be used to assess daily jaw comfort, stress, oral appliance adherence levels and sleep quality during the six to eight week MAD titration period. MAD titration involves a standardized incremental mandibular advancement each night to facilitate upper airway opening while sleeping. The VirtuOx portable pulse oximeter will obtain continuous, nightly oxygenation levels during home MAD titration.

Subject Categories:

  • Medicine and Medical Research
  • Anatomy and Physiology

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