Restoration of sleep using a novel biomimetic protocol for adult OSA: Clinical case report

Abstract

Background

A sleep study of a 56-year old male with excessive daytime sleepiness demonstrated an AHI of 16.4hr⁻¹ with 13% of total sleep time in REM sleep and a mean oxygen desaturation (SpO₂) of 86%.

Clinical presentation

On intra-oral examination, it was found that the patient had maxillary hypoplasia and bilateral torus mandibularis. A 3D cone-beam CT (CBCT) scan was taken, and 28 craniofacial parameters were measured. Surgical reduction of the mandibular tori followed by biomimetic oral appliance therapy (BOAT) was initiated. After 14 months, a post-treatment CBCT scan revealed that 70% of parameters measured had improved. Therefore, another sleep study was performed with no device in the mouth. This follow-up home sleep test demonstrated that the AHI fell to 5.3hr⁻¹hr; with 27% REM sleep, and a mean SpO₂ of 93% without any device in the mouth.

Conclusion

These findings suggest that BOAT might be able to restore sleep in certain adult cases.

Keywords:

• Oral appliance therapy
• palatal expansion
• obstructive sleep apnea

Acknowledgments

This work was accepted as a poster at the American Thoracic Society in May, 2017. We would like to thank Derek Preble for his contribution to this work.