Somnodent vs Herbst in Mild and Moderate OSA Patients
Somnodent vs Herbst in Mild and Moderate OSA Patients
Obstructive sleep apnea (OSA) is a common chronic sleep disorder that often requires lifelong
 care. The prevalence in the Netherlands is estimated around 300.000 patients. Due to longer
 life expectancy and increase in weight in the general population, its prevalence is expected
 to rise. Patients with mild and moderate OSA are treated primarily with an oral appliance at
 present time. Different oral appliances are available, but most used is the mandibular
 advancement device (MAD). This study focuses on two different types of MAD: the classic
 Herbst appliance, which is attached to the mandible and the maxilla and has an iron bar to
 regulate the open space; and the Somnodent, which consists of two separate splints, fixed on
 the mandible and the maxilla, but has no iron bar attached.
Inclusion Criteria:

 -  18 years and older

 -  Ability to speak, read, and write Dutch.

 -  Ability to follow-up.

 -  Ability to use a computer with internet connection for online questionnaires.

 -  Diagnosis with symptomatic mild or moderate OSA (5 < AHI < 30).

 -  Expected to maintain current lifestyle (sports, medicine, diet, etc.)

 Exclusion Criteria:

 -  Untreated periodontal problems, dental pain, and a lack of retention possibilities for
 an MAD.

 -  Medication used/related to sleeping disorders.

 -  Evidence of respiratory/sleep disorders other than OSA (eg. central sleep apnea
 syndrome).

 -  Systemic disorders (based on medical history and examination; e.g. rheumatoid
 arthritis)

 -  Temporomandibular disorders (based on the function examination of the masticatory
 system).

 -  Medical history of known causes of tiredness by day, or severe sleep disruption
 (insomnia, Periodic Limb Movement Disorder, Narcolepsy).

 -  Known medical history of mental retardation, memory disorders, or psychiatric
 disorders.

 -  Reversible morphological upper airway abnormalities (e.g. enlarged tonsils). -
 Inability to provide informed consent.

 -  simultaneous use of other modalities to treat OSA.

 -  Previous treatment with a MAD.