Effectiveness of Narval CC™ device in the treatment of obstructive sleep apnea.

Mandibular advancement devices (MAD) are used in sleep apnea with varying results. We aimed to examine whether or not a MAD should be an integral treatment modality in the care of our patients with obstructive sleep apnea. We designed a feasibility study and included 32 patients after meeting inclusion criteria. Only 3 patients did not finish the second sleep study exam. The intervention was an individually designed MAD and a sleep study exam was performed prior and post treatment. The outcome objective was an apnea-hypopnea index of under 10 and with a 50% reduction. Patient population had a baseline AHI of 19.0 and mean reduction of AHI with MAD treatment to 13.3 yielding a MAD efficacy rate of 31% when outcome objectives were applied. The average reduction in AHI was 24.8% with 9 of the 29 patients actually experiencing an increase in AHI with MAD treatment. When there was a reduction in AHI using the MAD device the AHI reduction rate was 49.1% and there was a tendency for better treatment outcome when apnea-hypopnea was predominantly supine. A mandibular advancement device serves as an important treatment modality in the care of patients with obstructive sleep apnea due to patient satisfaction and compliance. The broad range of treatment response to our MAD device highlights the importance of performing a sleep study exam after initiation of treatment with a MAD but also illustrates the complexity and need for individually tailored treatment for patients with obstructive sleep apnea.