Mandibular advancement device for the treatment of snoring-induced noise exposure: an objective assessment of the therapeutic effect

Purpose The mandibular advancement device (MAD) is now an internationally recognized treatment option for snoring and obstructive sleep apnea. However, the extent to which this treatment method reduces snoring-induced noise exposure for bed partners has only been investigated subjectively to date. The purpose of this study is to carry out an objective assessment using acoustic methods. Methods 19 subjects (15 males aged 28–71, mean 52.9 years) participated in a non-randomized crossover on-off/off-on controlled observational study (with/without MAD) involving two full-night extended polygraphy sessions and acoustic measurements. Results A significant improvement in sleep apnea (Apnea-Hypopnea Index [AHI] from 24.1/h to 14.5/h, p < 0.001) was recorded in subjects using an MAD. A highly significant reduction was observed in all physical and acoustic measurements across all parameters assessed [mean sound pressure level (35db[A] to 32.3db[A], p < 0.001); mean sound energy LAeq (27.5db[A] to 25.6db[A], p < 0.001); Snoring Index (455 to 293, p < 0.001); percentage snoring time (12.6% to 8.1%, p < 0.001)]. Snoring-induced noise exposure, assessed as per the Psycho-acoustic Snore Score, also fell from 23.1 to 12.7 (p < 0.001). Conclusion This study is the first to show through objective (psycho-)acoustic measurements that, in addition to treating obstructive sleep apnea, an MAD has a significant positive effect on snoring and therefore on noise exposure for the bed partner.