03 Oct MATRx and Mandibular Advancement Splints; changes to sleep studies coming?
Mandibular Advancement Splints are a common treatment for Obstructive Sleep Apnoea (OSA). These look much like the mouthguards that your favourite football stars wear on the weekend. These work by having two plates, these plates (or mouth guards) sit over your teeth (top and bottom) and connect help keep your lower jaw forward. It is thought that by stabilising and/or protruding the lower jaw forward, the MAS devices prevent the soft tissue of the upper airway from collapsing and thus treating OSA.
MAS – the pro’s:
- Patient compliance is generally pretty good. The devices are easy to wear and can be a comfortable sleep therapy
MAS – the con’s:
- These don’t always work for every patient, i.e. the efficacy of therapy is lower than other OSA treatment
- Can have side effects on the jaw, bite and dentition
MAS – the summary:
- What these devices may lose in efficacy they may gain in compliance
- Its hard to know if the MAS will work prior to having the device made, can be a $2000 treatment that may or may not treat OSA
- A fully fitted MAS device can cost a similar amount to CPAP (CPAP = gold standard treatment for OSA)
Recently Sutherland et al tested a device called MATRx at the Royal North Shore Hospital in Sydney. What this device does, is it allows a MAS to be adjusted remotely, i.e. by a sleep technician while a patient is asleep in the sleep unit. They found that by adjusting the device overnight during a sleep study, they could actually give a good indication of whether or not the MAS would be suitable or not.
Why is this important? Well, if a disposable MAS could be made cheaply and used during a sleep study, we could potentially identify those patients who may be suitable for a MAS device. More importantly, we could identify those who are NOT suitable candidates for MAS. These patients otherwise need to pay for the device up front, then have a sleep study to see if it works. Hopefully, in time, patients may be able to have a trial device made, and have the sleep study to assess its effectiveness before having to spend the money to have the device made.
Go here for the original article: http://www.aasmnet.org/JCSM/ViewAbstract.aspx?pid=30965