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Ulysses Magalang, MD

Award Name CCTS Dentistry Pilot
Award Date 04/14/2009

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Effects of Mandibular Devices on Insulin Sensitivity

The Ohio State University College of Dentistry, in collaboration with the Center for Clinical and Translational Science (CCTS), has awarded Ulysses Magalang, MD, with funding for his proposal to determine the effects of mandibular advancement devices (MAD) on health outcomes in Obstructive Sleep Apnea (OSA) patients.

Magalang, an Associate Professor in the Divison of Pulmonary, Allergy, Critical Care, and Sleep Medicine, along with his research team will examine the effects of MAD treatment on insulin sensitivity, blood pressure, psychologic well-being, and quality of life in patients with OSA who are unable to tolerate Continuous Positive Airway Pressure (CPAP) therapy.

Sleep apnea affects more than 20 million Americans and occurs when the area behind the tongue and soft palate becomes obstructed repeatedly, causing a person to stop breathing numerous times during sleep. It can range from mild to severe and the condition has been associated with an increased risk for stroke, hypertension, heart disease, depression, and diabetes.

The most common treatment for OSA patients is CPAP, delivered by a machine through a specially designed mask that prevents the throat from collapsing during sleep. While CPAP is a highly effective treatment for sleep apnea, it is estimated that at best, only 50% of patients tolerate and continue to use the machine long term.

Magalang and his team have proposed a study to better understand the effects of MAD for the treatment of sleep apnea. MAD is a dental device that is worn by the patient only during sleep and protrudes the lower jaw forward, preventing the airway from collapsing.

“There is a need for alternative therapy for sleep apnea,” says Magalang. “MAD has been used in the past to treat OSA, but the health outcomes as a result of this treatment have not really been evaluated. Some patients just cannot tolerate CPAP and we need to know the health outcomes of these alternative therapies.”

Magalang hopes that by providing evidence for the effects of MAD therapy on selected health outcomes, practitioners will consider this form of treatment when the patient is unable to tolerate CPAP.

“There is good evidence that the hypoxic stress, caused by the repetitive dipping of the oxygen levels in sleep apnea, is associated with insulin resistance, a marker for the development of diabetes and also an important risk factor for heart disease,” he said. “We need to know whether MAD treatment improves insulin resistance.”

Over the course of 3 months, the study will examine 40 randomized subjects who have reported that they cannot tolerate CPAP. The research team also includes: Allen Firestone, DDS, Department of Orthodontics; Dara Schuster, MD, Divison of Endocrinology; and Sharla Wells-DiGregorio, PhD, Department of Psychiatry.

By Caitlin O'Brien, Tuesday, June 23, 2009.

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