Stabilization Splints May Worsen Obstructive Sleep Apnea

This article deals with the question of whether the  stabilization splint, which is commonly used for treating TMJ and bruxism, may pose a risk of worsening obstructive sleep apnea in patients with that condition. While a few earlier studies have touched on this matter, this is the first study to use quantitative measures to answer the question. All subjects had 3 recordings done in a sleep laboratory while wearing a splint and 3 recordings without it. Also, it is the first one to use a randomized format in which each patient is his own control; half of the patients wore a splint first and then slept without it, while the other half followed the opposite protocol.

The result was that there was a change in just one of the two variables studied. The variable affected, called AHI, which stand for Apnea-Hypopnea Index is a measure of obstructed airflow during sleep. If the index is higher than 5 events per hour and is accompanied by excessive daytime sleepiness, that qualifies for a diagnosis of obstructive sleep apnea. The second measure is called the Epworth Sleepiness Scale, which is a more subjective assessment of sleep disturbance.

In this study, the Epworth Sleepiness Scale was not different between the two conditions of wearing or not wearing a stabilization splint, but there was some difference in the AHI scores. While this difference was relatively small, it was in the negative direction of worse scores while wearing a splint. The researchers comment that this may not be clinically significant in the short run, and there are no long-run data. However, they caution dentists who want to make a stabilization splint for their patients to at least inquire about whether obstructive sleep apnea is a condition they may have.