Whilst there has been a consistent observation across studies that subjective daytime sleepiness improves with oral appliances, randomized controlled trials using inactive control devices suggest that at least part of this improvement could be a placebo effect (12,13), similar to that identified with sham CPAP and oral tablet placebo (24,25). With regards to objective sleepiness there are indications of a small improvement, although more work is required in this area. In one study, the mean sleep latency on the multiple sleep latency test after four weeks of MAS treatment was significantly improved compared with an inactive control oral device, but the mean increase was relatively small (1.2 minutes) (13). Two studies compared oral appliances to CPAP over 8 to 12 weeks, using the maintenance of wakefulness test, and found no significant difference (26,27).

Sleep Apnea

Sleep Apnea

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