{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T16:51:40Z","timestamp":1775148700222,"version":"3.50.1"},"reference-count":60,"publisher":"American Spinal Injury Association","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1]]},"abstract":"\n Objectives:<\/jats:title>\n To determine the effectiveness of a mandibular advancement device (MAD) in individuals with spinal cord injury (SCI) who suffer from obstructive sleep apnea (OSA) syndrome, and to identify potential predictive factors of response to MAD.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Forty individuals (34 men and 6 women) with an apnea-hypopnea index (AHI) of more than 15 were included in the MAD uncontrolled clinical trial. The outcomes were evaluated through polygraphic examination before therapy and after 1 and 6 months. Subjective daytime sleepiness (Epworth Sleepiness Scale [ESS]) and quality of life (WHOQOL-BREF) were assessed at baseline and after 6 months. Throughout the study, side effects were continuously monitored.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Thirty-five individuals completed the study. The mean AHI decreased from 35.7 \u00b1 15.6 to 18.5 \u00b1 10.6 at 6 months (\n P<\/jats:italic>\n < .0001). ESS improved from 9.3 \u00b1 5.2 to 6.8 \u00b1 3.5 (\n P<\/jats:italic>\n = .0001), while no significant change was observed in WHOQOL-BREF scores. Participants with severe (AHI >30) OSA had shorter time since injury and higher body mass index (BMI) than those with moderate OSA (AHI 15-30). According to the criterion for treatment success of at least 50% improvement in AHI, MADs were effective in 48.6% of participants. Younger age and lower WHOQOL-BREF scores were the only factors significantly associated with treatment success.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n MADs appear to be an effective treatment for both moderate and severe OSA in people with SCI. They may be a suitable alternative for individuals who decline or are unable to tolerate continuous positive airway pressure therapy.<\/jats:p>\n <\/jats:sec>","DOI":"10.46292\/sci24-00062","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T16:36:46Z","timestamp":1763483806000},"page":"147-159","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of Mandibular Advancement Device for Obstructive Sleep Apnea in Chronic Spinal Cord Injury"],"prefix":"10.46292","volume":"31","author":[{"given":"Lenka","family":"Honzatkova","sequence":"first","affiliation":[{"name":"2nd Faculty of Medicine, Charles University, Prague, Czech Republic"},{"name":"Paraple Centre, Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marnie","family":"Graco","sequence":"additional","affiliation":[{"name":"Institute for Breathing and Sleep, Austin Health, Melbourne, VIC, Australia"},{"name":"Department of Physiotherapy, University of Melbourne, Melbourne, VIC, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiri","family":"Kriz","sequence":"additional","affiliation":[{"name":"2nd Faculty of Medicine, Charles University, Prague, Czech Republic"},{"name":"Spinal Cord Unit, Department of Rehabilitation and Sports Medicine, University Hospital Motol, Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"25425","reference":[{"issue":"12","key":"b1","series-title":"J Am Acad Nurse Pract","first-page":"695","article-title":"Obstructive sleep apnea hypopnea syndrome and metabolic syndrome: A synergistic cardiovascular risk factor","volume":"24","author":"Goodson BL","year":"2012","unstructured":"Goodson BL, Wung SF, Archbold KH. Obstructive sleep apnea hypopnea syndrome and metabolic syndrome: A synergistic cardiovascular risk factor. J Am Acad Nurse Pract. 2012;24(12):695-703."},{"issue":"3 Pt 1","key":"b2","series-title":"Am J Respir Crit Care Med","first-page":"866","article-title":"Predictors of improvements in daytime function outcomes with CPAP therapy","volume":"161","author":"Kingshott RN","year":"2000","unstructured":"Kingshott RN, Vennelle M, Hoy CJ, Engleman HM, Deary IJ, Douglas NJ. Predictors of improvements in daytime function outcomes with CPAP therapy. Am J Respir Crit Care Med. 2000;161(3 Pt 1):866-871."},{"key":"b3","series-title":"Indian J Med Res","first-page":"245","article-title":"Adherence to continuous positive airway pressure treatment for obstructive sleep apnea: Implications for future interventions","volume":"131","author":"Weaver TE","year":"2010","unstructured":"Weaver TE, Sawyer AM. 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Positive airway pressure for sleep-disordered breathing in acute quadriplegia: A randomised controlled trial. Thorax. 2019;74(3):282-290."},{"issue":"5","key":"b10","series-title":"Sleep","first-page":"zsae068","article-title":"Not there yet; the challenge of treating sleep-disordered breathing in people living with spinal cord injury\/disease","volume":"47","author":"Berlowitz DJ","year":"2024","unstructured":"Berlowitz DJ, Graco M. Not there yet; the challenge of treating sleep-disordered breathing in people living with spinal cord injury\/disease. Sleep. 2024;47(5):zsae068."},{"issue":"5","key":"b11","series-title":"Sleep","first-page":"667","article-title":"Sleep-related breathing disorders in adults: Recommendations for syndrome definition and measurement techniques in clinical research","volume":"22","author":"American Academy of Sleep Medicine Task Force Report","year":"1999","unstructured":"American Academy of Sleep Medicine Task Force Report. 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