Aggravation of Respiratory Disturbances by the Use of an Occlusal Splint in Apneic Patients: A Pilot Study

Purpose: This pilot study was designed to test the hypothesis that the use of a single oral splint may aggravate respiratory disturbance in sleep apneic patients. Materials and Methods: A group of 10 patients with a history of snoring and a recording night confirming a diagnosis of sleep apnea were included. Patients were then invited to spend 2 nights in the sleep laboratory: night 2 to establish baseline data (baseline night) and night 3, 1 week later, to assess the influence of an occlusal maxillary splint on sleep (splint night). The following variables were analyzed under blind conditions: total sleep time, sleep efficiency and number of awakenings, microarousals, apneahypopnea index per hour of sleep (AHI), respiratory disturbances index per hour of sleep (RDI), and percentage of sleeping time with snoring. Results: No statistically significant difference in AHI was noted between baseline and splint nights. However, four patients experienced an aggravation in apnea diagnosis category on the night they used the splint. The AHI was increased by more than 50% in 5 of the 10 patients. The RDI showed a 30% increase from baseline to splint nights. The percentage of sleeping time with snoring also increased by 40% with the splint. Conclusion: This open study suggested that the use of an occlusal splint is associated with a risk of aggravation of respiratory disturbances. It may therefore be relevant for clinicians to question patients about snoring and sleep apnea when recommending an occlusal splint.