Stabilization Splints May Worsen Obstructive Sleep Apnea

The TMJ Association thanks Charles S. Greene, D.D.S., Clinical Professor, Department of Orthodontics, UIC College of Dentistry, Chicago, IL for this research summary.

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.


Effects of Occlusal Stabilization Splints on Obstructive Sleep Apnea: A Randomized Controlled Trial Authors: Maria Nikolopoulou, DDS, MSc/Jari Ahlberg, DDS, PhD/Corine M. Visscher, PT, PhD/Hans L. Hamburger, MD, PhD/Machiel Naeije, PhD/Frank Lobbezoo, DDS, PhD Journal of Orofacial Pain 2013; 27: (3) 199-205

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