Abstract
In this case, we assessed the feasibility of managing obstructive sleep apnea (OSA) with an oral appliance (OA) for an edentulous patient. Given that promoting patient compliance with continuous positive airway pressure (CPAP) is challenging, OA therapy could improve patient adherence and quality of life. A 56-year-old male with a medical history of moderate OSA and insomnia was referred to our center by a sleep physician for OA therapy. He reported intolerance to CPAP with different types of masks and nasal pads. Upon clinical examination, the patient had a fully edentulous maxilla and three healthy abutment teeth in the mandible. He wore a complete upper denture and a lower partial denture both day and night. We used a custom-made adjustable OA (semiedentulous design) for both dentures. During the last follow-up visit, a significant improvement in OSA indexes was observed. The patient's apnea[FIGURE DASH]hypopnea index (AHI) decreased from 11.8/h to 6.8/h, whereas his nadir oxygen saturation increased from 83% to 92%. The rapid eye movement (REM) stage of sleep drastically improved from 15.7% to 26.6%, and the respiratory disturbance index decreased from 40/h to 15.8/h at the REM stage. OA was an effective alternative to a tongue retainer device for a completely and partially edentulous patient refusing to comply with CPAP and unable to tolerate the tongue retainer device. Further studies with larger sample sizes using different OAs are recommended.