Abstract：
INTRODUCTION:Mandibular advancement (MA) has emerged over the last decade as an alternative solution to nasal continuous airway pressure (nCPAP) for the treatment of obstructive sleep apnea syndrome (OSAS). OBSERVATION:We report the case of a patient with history of chronic atrial fibrillation and moderate supine-dependent OSAS in whom central sleep apneas developed during treatment by a bi-bloc MA device. Central apneas increased with the level of MA and preferentially occurred in the supine position. We hypothesized that mouth opening under excessive mandibular advancement in supine position may have led to pharyngeal narrowing at the base of the tongue and potentially unstable ventilation. Sleep fragmentation that enhanced during progressive MA may also have compromised ventilatory control stability in our patient. Finally, chronic atrial fibrillation may have predisposed to central sleep apneas. CONCLUSION:Our case report highlights the importance of follow-up nocturnal recordings during progressive MA.
journal_name
Rev Mal Respirjournal_title
Revue des maladies respiratoiresauthors
Gindre L,Gagnadoux F,Meslier N,Fleury B,Gustin JM,Racineux JLdoi
10.1016/s0761-8425(06)71821-6subject
Has Abstractpub_date
2006-11-01 00:00:00pages
477-80issue
5 Pt 1eissn
0761-8425issn
1776-2588pii
MDOI-RMR-11-2006-23-5-0761-8425-101019-20064167journal_volume
23pub_type
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journal_title：Revue des maladies respiratoires
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journal_title：Revue des maladies respiratoires
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journal_title：Revue des maladies respiratoires
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