Mandibular advancement device as treatment trial for catathrenia (nocturnal groaning).

Abstract

STUDY OBJECTIVES\nCatathrenia is a rare disease, classified as isolated symptoms and normal variants under sleep-related breathing disorders in the International Classification of Sleep Disorders, third edition. Because of its rarity, the research on its pathogenesis and treatment is insufficient. This study aimed to evaluate whether the mandibular advancement device (MAD) could be considered an alternative treatment trial and if so, to explore factors predicting its effectiveness.\n\n\nMETHODS\nThirty patients (12 males and 18 females, aged 16 to 67 years) with catathrenia participated in the study. They underwent standard clinical evaluation, questionnaires, physical examinations, craniofacial evaluations, video-polysomnography, and imaging of the upper airway before and after the insertion of the MAD. Groaning index (GI, groaning episodes per hour of sleep) and apnea-hypopnea index (AHI) were evaluated and anatomic factors predicting effectiveness were explored.\n\n\nRESULTS\nThe sleep efficiency of most patients was higher than 80% and groaning was present throughout all stages of sleep. With the insertion of MAD, GI decreased significantly from 5.8 (2.7, 14.3) to 2.8 (1.3, 12.2) events/h (P = 0.014). Age had a negative effect on efficacy. Mandibular repositioning of MAD, especially the amount of vertical opening and changes of cross-sectional area of hypopharynx, was positively related with efficacy.\n\n\nCONCLUSIONS\nThe MAD could be considered a possible treatment trial for those seeking treatment for groaning.\n\n\nCLINICAL TRIAL REGISTRATION\nRegistry: Chinese Clinical Trial Registry; Identifier: ChiCTR-COC-17013239; URL: http://www.chictr.org.cn/showproj.aspx?proj=22286.