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CC BY-NC-ND 4.0 · Sleep Sci 2022; 15(S 01): 135-142
DOI: 10.5935/1984-0063.20220012
ORIGINAL ARTICLES

When adherence to CPAP fails, how do we treat workers with obstructive sleep apnea?

Authors

  • Maria de Lourdes Rabelo Guimarães

    1   Universidade Federal de Minas Gerais, Faculty of Medicine, Belo Horizonte, Brazil, - Belo Horizonte - Minas Gerais - Brazil.

  • Pedro Guimarães Azevedo

    1   Universidade Federal de Minas Gerais, Faculty of Medicine, Belo Horizonte, Brazil, - Belo Horizonte - Minas Gerais - Brazil.

  • Sérgio Barros-Vieira

    2   UNISONO- Centre de Diagnostique et Traitement des Troubles du Sommeil, - Vitória - Espírito Santo - Brazil.

  • Maxime Elbaz

    3   Université Paris Descartes, Sorbonne Paris Cité, EA, Vigilance Fatigue Sommeil et Santé Publique - Paris - Paris - France.

  • Damien Leger

    4   Hôtel-Dieu, centre du Sommeil et de la Vigilance, Consultation de pathologie professionnelle Sommeil Vigilance et Travail, - Paris - Paris - France.

  • Ana Paula Hermont

    5   Universidade Federal de Minas Gerais, Faculty of Dentistry, Belo Horizonte, Brazil, - Belo Horizonte - Minas Gerais - Brazil.
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Aims A cross-sectional study was designed to evaluate the effectiveness of a mandibular advancement device (MAD) with respect to respiratory and sleep parameters among miners with obstructive sleep apnea syndrome (OSAS) and primary snore.

Methods The target sample was composed by 102 Brazilian miners with a history of non-adherence to continuous positive airway pressure. All patients were treated with a MAD and underwent pre and post-treatment full-night polysomnography. Ethical approval and consents were obtained. Bivariate and logistic regression analyses were conducted. The level of statistical significance was set at 5%.

Results After the treatment with MAD, 71.8% of patients presented a decrease ≥ 50% in the basal apnea-hypopnea index (AHI), 51.2% presented an AHI < 5 events/h and 83.3% reached an AHI<10/h, whereas 22.5% did not show any changes and 7.5% of the sample presented an increase in the AHI (p<0.05). There was an increase in the mean SpO2 nadir (p<0.001) and in the baseline duration of the REM sleep stage (p<0.05). The MAD significantly decreased snore events (p<0.05). Multivariate analysis did not identify predictive factors related to therapy success (decrease ≥ 50% of AHI). However, basal AHI was a significant predictor related to the secondary endpoint (AHI<10/h) (OR= 1.06, IC 95%1.00-1.13, p=0.007).

Conclusions The MAD therapy showed significant improvements in AHI, minimum oxygen saturation, REM sleep and snoring.

Oral Appliances - Mandibular Advancement Device - Obstructive Sleep Apnea - Occupational Medicine - Prevention Of Accidents

FUNDING STATEMENT

This work was supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001


ETHICAL APPROVAL

Informed consent was obtained from all individual participants included in the study. The study was conducted accordingly to the principles of the Helsinki Declaration and received the approval of the Ethical Committee of Hospital Felício Rocho BHMG (CAAE – 0002.0.240.000-11). The results of the study will be disseminated by print media and through lectures and booklet distribution at mining occupational environments.




Publication History

Received: 13 May 2021

Accepted: 17 August 2021

Article published online:
01 December 2023

© 2023. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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