Objective: The aim of our study is to explore the efficacy, observance, and usability of Mandibular Advancement Device in patients with  Parkinson’s disease (PD) and Obstructive Sleep Apnea Syndrome (OSAS).

Background: OSAS is frequent and disturbing in patients with PD. Continuous Positive Airway Pressure (CPAP) is the gold standard treatment of OSAS and its efficacy has already been demonstrated in this peculiar population. However, this treatment is not always well tolerated in this population. Patients have severe maintenance sleep disorders reducing the acceptability of the device. Visuo-spatial disorders disturb their ability to wear their mask alone, increasing the need of help of the caregiver, sometimes repetitively during the night. Mandibular Advancement Device (MAD) is a validated alternative treatment to OSAS in the general population.

Method: Twenty patients with PD and moderate or severe OSAS were included in the study. Ten patients had refused or not tolerated CPAP so that they were treated with MAD. They were matched for sex, age and BMI to ten patients with PD treated with CPAP. We explored the efficacy of MAD on sleep disorders complaints (PDSS-2) and on sleep recordings in these patients. We compared adherence, tolerance and usability of CPAP and MAD in these two groups.

Results: MAD improved sleep disorders on PDSS-2, apnea hypopnea and oxygen desaturation indexes. Observance was much better with MAD than with CPAP. Side effects were similar, but usability and satisfaction of the care giver were much better with MAD than CPAP.

Conclusion: MAD is efficacious, characterized by a good adherence and simple to use in PD with OSAS

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MDS Abstracts - https://www.mdsabstracts.org/abstract/mandibular-advancement-device-in-parkinsons-disease-an-efficacious-and-usable-device-in-a-disabling-disease/