Journal
JOURNAL OF CLINICAL SLEEP MEDICINE
Volume 10, Issue 3, Pages 255-262Publisher
AMER ACAD SLEEP MEDICINE
DOI: 10.5664/jcsm.3522
Keywords
Obstructive sleep apnea; sleep apnea; oral appliance; mandibular advancement splint; snoring; inflammatory markers; homeostatic markers; TAFIa; fibrinolysis; interleukin-10
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Funding
- Polish Ministry of Science [N402 179834]
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Study Objective: Obstructive sleep apnea (OSA) is associated with systemic inflammation and a hypercoagulable state. The current study aim was to investigate whether mandibular advancement splint (MAS) therapy affects inflammatory and hemostatic parameters in patients with mild-to-moderate OSA. Methods: Twenty-two patients with mild-to-moderate OSA and 16 control subjects were studied. OSA subjects were treated with a titratable MAS for 6 months. Baseline plasma C-reactive protein, interleukin-1 beta, interleukin-10, interleukin-6, P-selectin, fibrinogen, D-dimer, plasminogen activator inhibitor-1 (PAI-1), thrombin-antithrombin complex, activated thrombin-activatable fibrinolysis inhibitor (TAFIa), 6-keto-PGF1 alpha, glucose, and fibrin clot lysis time (CLT) were measured in all subjects. After 3 months of MAS therapy, measurements were repeated for the 22 patients, and after 6 months all measurements were repeated for all study subjects. Results: MAS treatment reduced significantly AHI at 3 months (24 vs 13.1/h) and further improved it at 6 months (13.1 vs 7.05/h). Compared with controls, OSA subjects had a significant higher baseline mean levels of fibrinogen, TAFIa, 6-keto-PGF1a, and glucose. MAS treatment significantly improved levels of IL-1 beta, D-dimer, TAFIa, and CLT. Despite residual apneas, MAS treatment group presented similar measured homeostatic and inflammatory levels to controls except for glucose. Conclusion: Treatment with MAS in mild-to-moderate OSA subjects improves the inflammatory profile and homeostatic markers.
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