Assessment of the impact of vertical dimension alterations on the quality of sleep in elderly patients wearing upper and lower full dentures

Objectives: The loss of vertical dimension of occlusion (VDO) is a problem that affects stomatognathic system performance, mainly in edentulous patients. Thus, diseases related to musculature failure such as obstructive sleep apnea syndrome (OSAS) are common in these patients. Consequently, efficient and low-cost therapeutic strategies such as intraoral devices (IOD) used to expand the upper airway (UA) are needed to improve the quality of sleep in these patients. The aim of this study was to assess both the subjective and objective effect of VDO increase on the quality of sleep in 19 elderly patients using bimaxillary total prostheses (TPs) before and after placement of new TPs and therapy with intraoral devices (IOD) especially designed to increase VDO without causing mandibular advancement. Methods: For this purpose, questionnaires surveying quality of sleep (Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index and sleep anamnestic questionnaire) and polysomnography tests (PSG) were performed at three different phases: baseline without TPs, with TPs and with IODs. Conclusions: It was concluded that the tested IODs may contribute to improvements in the quality of sleep for patients and their sleeping partners because they led to significant decreases in snoring. Most patients also expressed a preference for IOD use while sleeping. However, the use of IOD did not significantly improve polysomnography parameters compared to the baseline and thus cannot be indicated for the treatment of OSAS.