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Clinical Evidence

Clinical evidence supporting the use of mandibular advancement devices to prevent snoring is collected here on an on-going basis. Hundreds of studies showing the immediate benefits have been conducted and new evidence surfaces almost monthly. As the proven principle of mandibular advancement, or sometimes called mandibular repositioning, is largely the same across all makes and models, these papers are not limited to the Somnofit MAD alone. It is the unique materials, clear instructions and straps which set Somnofit apart from other MADs. A Somnofit-specific study can be found towards the bottom of this page.


MAS: Mandibular Advancement Splint

MAD: Mandibular Advancement Device

MRS: Mandibular Repositioning Splint

MRA: Mandibular Respositioning Appliance

MAP: Mandibular Advancement Prosthesis

The above five abbreviations refer to the same type of solution.

AHI: Apnoea/Hypopnoea Index

Clinical Evidence - MADs Reduce Snoring

  • O'Sullivan, Hillman et al. concluded: "Snores per sleep minute, corrected for time in apnea, and sound intensity of snores (% snores > or = 50 dB) decreased with the MAS from 11.0 +/- 5.8 and 42.0 +/- 25.0% to 9.0 +/- 6.0 (p < 0.01) and 26.2 +/- 25.2% (p < 0.01), respectively. " In this study, the number of snores reduced significantly and the sound was far less audible.

  • Pancer, Al-Faifi et al. found: Before treatment with MAD, "96% of patients were judged to snore loudly "often" or "always" by their bedpartners, whereas only 2% were judged so while using dental appliance". in terms of long-term use they concluded: "Follow-up clinical assessment in 121 patients conducted on the average 350 days after the insertion of the appliance revealed that 86% of patients continued to use the appliance nightly; 60% were very satisfied with the appliance, 27% were moderately satisfied, 11% were moderately dissatisfied, and 2% were very dissatisfied."

  • Marklund, Stenlund and Franklin state: "The mandibular advancement device is recommended for women with sleep apnea, for men with supine-dependent sleep apneas defined by a lateral apnea-hypopnea index of < 10, and for snorers without sleep apnea."

  • Regarding safety of using such dental splints as a snoring remedy, Bondemark and Lindman commented: "It was concluded that 2 years' treatment with a mandibular advancement splint had no adverse effects on the craniomandibular status and function, but the observed occlusal changes requires further evaluation."

  • Petitjean, Chammas et al. reported: "The different available studies report an improvement either on nocturnal respiratory events or on the quality of sleep. The decrease in the intensity of snoring is confirmed by the patient's partner and by objective studies. [...] A polysomnographically proved cure has been reported with AHI < 10/h. Sleep architecture is also improved with wearing MAD demonstrating a decrease in the time passed in stage 1 sleep and an increase in slow wave sleep and rapid eye movement sleep (REM)."

  • Robertson, Murray et al. concluded: "The mean Snoring Outcomes Survey change was significantly greater for those who preferred MRS to CPAP (mean score difference, 27.15) [...] CONCLUSION: The majority of disruptive snorers can be managed effectively with conservative treatments and therefore avoid surgery."

  • After a ten year follow-up study, Jauhar, Lyons et al. commented: "The mandibular advancement device appears to be an effective long-term solution for a significant number of patients with problem snoring and also those with mild to moderate obstructive sleep apnea."

  • Saletu, Anderer, Parapatics et al. found that "Apart from its good therapeutic effects on snoring and respiratory variables (snoring showed complete or partial response in 68%, the apnea-hypopnea index in 67% of the apnea patients), the MRA also improved psychopathology, objective and subjective sleep and awakening quality."

  • Smith and Battagel found: "The questionnaires and sleep recordings suggested that the MAS significantly reduced snoring incidence (p<0.05) and improved sleep quality. Daytime tiredness, as assessed by the Epworth Sleepiness Scale, was significantly reduced (p<0.001). Initial side effects of muscular and TMJ discomforts were mostly resolved after 1 month of appliance wear. Conclusions: Use of a MAS improves snoring incidence and sleep quality in most patients with non-apneic snoring."

  • Regarding safety of mandibular advancement splints as a solution for snoring, Hammond, Gotsopoulos et al. commented: "Side effects of MAS use over long periods are common but mild and well tolerated by most patients, and dentofacial changes are negligible."

  • In a UK-specific study, Minha, Dutt et al. found that "Despite being useful in alleviating snoring, the prosthesis was poorly tolerated. Side-effects include increased salivation, temporomandibular joint pain, intra-oral and myofacial discomfort. Patients who persevered with the prosthesis found the early side-effects resolved after a few weeks and snoring reduced. MAP can be used in the initial management of snorers but patients need to be educated and encouraged, especially in the first few weeks." For these reasons, Somnofit is specifically designed for optimum patient-comfort.

  • Cooke and Battagel reported after their research: "the advanced MAD reduced the snores per hour from a median of 398 to 17 (P = 0.002). Sleeping partners reported a marked improvement in their own daytime tiredness (P = 0.002) and sleep disturbance (P = 0.001) when the subject wore the active appliance."

Clinical Evidence - Somnofit MAD Reduces Snoring

  • In 2007, Dr P.-J. Monteyrol of the Tondu sleep clinic in Bordeaux, France studied seven snorers who also suffered from mild sleep apnoea. They were called in for a full check-up via Polysomnography before, and a few months later, whilst using the Somnofit MAD. The Apnoea/Hypopnoea Index (number of times shallow breathing or full breathing lapses occured) dropped 36% on average. The total percentage of time snoring during the night fell by 63%. Micro-arousals (bodily reactions to sleep anomalies) fell by 52%, making bedtime much more restful. These results meant vast improvements in sleep quality for many of the subjects.
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