NEW YORK (Reuters Health) - A new device worn in the mouth during sleep can help prevent interrupted rest and snoring, researchers from Australia report.

The investigators, led by Dr. Peter Cistulli from University of New South Wales in Sydney, tested a device known as a mandibular advancement splint in 24 patients with obstructive sleep apnea, a condition of interrupted periods of breathing during sleep that is often associated with snoring.

``The splint undoubtedly works well in a substantial number of patients, even with more severe forms of obstructive sleep apnea,'' Cistulli told Reuters Health.

The splint consists of two hinged plates--something like dentures without the teeth--that are designed to keep the lower jaw from falling backwards when it relaxes during sleep, thereby keeping the tongue from blocking airflow.

According to the report in a recent issue of the American Journal of Respiratory and Critical Care Medicine, it took an average of about 20 weeks for patients to realize the full benefits of the splint (which requires adjustment to move the lower jaw forward in small increments).

On average, episodes of sleep apnea fell from 30 per hour without the splint to only 14 per hour with the splint, the authors report. Snoring decreased by 65%, and the snoring was somewhat less noisy.

Fifteen of the patients experienced partial or complete resolution of their sleep apnea, the report indicates, but nine patients got no measurable relief. Still, all but one patient indicated a desire to continue using the splint, because they felt it did improve their symptoms.

Side effects were common but not troublesome, including excessive salivation, gum irritation, mouth dryness, jaw discomfort and tooth grinding, the researchers note.

Based on these results, Cistulli and colleagues conclude that their splint is a reasonable alternative to continuous positive airway pressure (CPAP), the standard treatment for moderate to severe sleep apnea. CPAP consists of a facemask that introduces a gentle stream of air into the nose to keep the airway from collapsing. Although effective, CPAP can be cumbersome.

Cistulli cautioned that the positive results could not be generalized to all oral appliances, because of design differences.

SOURCE: American Journal of Respiratory and Critical Care Medicine

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