Background: The high efficacy of continuous positive airway pressure (CPAP) in treating obstructive sleep apnea (OSA) patients is sometimes limited because of intolerance. Mandibular advancement devices (MAD) are proven to be efficient in treating mild to moderate sleep apnea and snoring. We examined patients who had been treated in Community Dental Care with a titrable Herbst-type MAD. The aim of the study was to evaluate the quality of sleep based on self report. Methods: A questionnaire was mailed to patients (n = 184) who had received treatment for OSA or snoring between 2007 and2010 inthe Helsinki Health Centre Oral Care Unit. The patients were referred to the clinic for primary treatment, or because another treatment modality had failed. Results: Of the respondents (n = 142, 78.4%), OSA had been diagnosed in 74%, while the MAD was applied for snoring to the remaining. Among all respondents, 78.4% had worn the MAD at least three nights per week. With the MAD in situ, sleep was felt significantly less disrupted (p < 0.001) and more restorative (p < 0.001), and snoring was markedly reduced (p < 0.001). Daytime tiredness was also markedly less frequent (p < 0.001). Conclusions: Treatment with a MAD improved perceived sleep quality and awoke alertness in mild and moderate OSA patients and in snorers. This study supports such treatment to be initiated and monitored in community dental care.
 Young, T., Palta, M., Dempsey, J., Skatrud, J., Weber, S. and Badr. S. (1993) The occurrence of sleep-disordered breathing among middle-aged adults. The New England Journal of Medicine, 328, 230-235. doi:10.1056/NEJM199304293281704
 Pahkala, R., Puustinen, R., Tuomilehto, H., Ahlberg, J. and Seppa, J. (2011) Risk factors for sleep-disordered breathing: The role of craniofacial structure. Acta Odontologica Scandinavica, 69, 137-143. doi:10.3109/00016357.2010.545033
 Giles, T.L., Lasserson, T.J., Smith, B., White, J., Wright, J.J. and Cates C.J. (2006) Continuous positive airway pressure for obstructive sleep apnoea in adults. Cochrane Database of Systematic Reviews, CD001106.
 Aarab, G., Lobbezoo, F., Hamburger, H.L. and Naeije, M. (2011) Oral appliance therapy versus nasal continuous positive airway pressure in obstructive sleep apnea: A randomized, placebo-controlled trial. Respiration, 81, 411-419. doi:10.1159/000319595
 Aarab, G., Lobbezoo, F., Heymans, M.W., Hamburger, H.L. and Naeije, M. (2011) Long-term follow-up of a randomized controlled trial of oral appliance therapy in obstructive sleep apnea. Respiration, 82, 162-168. doi:10.1159/000324580
 Randerath, W.J., Heise, M., Hinz, R. and Ruehle, K.H. (2002) An individually adjustable oral appliance vs continuous positive air pressure in mild-to-moderate obstructive sleep apnea syndrome. Chest, 122, 569-575. doi:10.1378/chest.122.2.569
 Partinen, M. and Gislason, T. (1995) Basic nordic sleep questionnaire (BNSQ): A quantitated measure of subjective sleep complaints. Journal of Sleep Research, 4, 150-155. doi:10.1111/j.1365-2869.1995.tb00205.x
 Ohrbach, R., List, T., Goulet, J.P. and Svensson, P. (2010) Recommendations from the international consensus workshop: Convergence on an orofacial pain taxonomy. Journal of Oral Rehabilitation, 37, 807-812. doi:10.1111/j.1365-2842.2010.02088.x
 Epstein, L.J., Kristo, D., Strollo Jr., P.J., Friedman, N., Malhotra, A., Patil, S.P., et al. (2009) Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. Journal of Clinical Sleep Medicine, 5, 263-276.
 Gauthier, L., Laberge, L., Beaudry, M., Laforte, M., Rompré, P.H. and Lavigne, G.J. (2009) Efficacy of two mandibular advancement appliances in the management of snoring and mild-moderate sleep apnea: A cross-over randomized study. Sleep Medicine, 3, 329-336. doi:10.1016/j.sleep.2008.03.011
 Barnes, M., McEvoy, R.D., Banks, S., Tarquinio, N., Murray, C.G., Vowles, N., et al. (2004) Efficacy of positive airway pressure and oral appliance in mild to moderate obstructive sleep apnea. American Journal of Respiratory and Critical Care Medicine, 170, 656-664. doi:10.1164/rccm.200311-1571OC
 Gauthier, L., Laberge, L., Beaudry, M., Laforte, M., Rompré, P.H. and Lavigne, G.J. (2011) Mandibular advancement appliances remain effective in lowering respiratory disturbance index for 2.5 -4.5 years. Sleep Medicine, 12, 844-849. doi:10.1016/j.sleep.2011.05.004
 Tuomilehto, H., Gylling, H., Peltonen, M., Martikainen, T., Sahlman, J., Kokkarinen, J., et al. (Kuopio Sleep Apnea Group) (2010) Sustained improvement in mild obstructive sleep apnea after a dietand physical activitybased lifestyle intervention: Postinterventional follow-up. The American Journal of Clinical Nutrition, 92, 688-696. doi:10.3945/ajcn.2010.29485
 Tuomilehto, H., Peltonen, M., Partinen, M., Lavigne, G., Eriksson, J.G., Herder, C., et al. (Finnish Diabetes Prevention Study Group) (2009) Sleep duration, lifestyle intervention, and incidence of type 2 diabetes in impaired glucose tolerance: The finnish diabetes prevention study. Diabetes Care, 32, 1965-1971. doi:10.2337/dc08-1980