Treatment of Obstructive Sleep Apnea With Mandibular Advancement Device (MAD) in a 58-year-old Female Patient With Psychiatric Comorbidity: Case Report With 6-Month Follow-up.

BACKGROUND

Obstructive sleep apnea (OSA) and major depressive disorder frequently coexist, creating a complex bidirectional relationship that influences diagnosis and treatment adherence. Continuous positive airway pressure (CPAP) remains the gold standard for OSA treatment; however, poor tolerance or refusal is common, particularly among patients with psychiatric comorbidities.

CASE REPORT: A case of a 58-year-old female patient with moderate OSA and major depressive disorder who declined CPAP therapy due to psychological discomfort is presented. Following multidisciplinary evaluation, a mandibular advancement device (MAD) was implemented as an alternative treatment. Over a 6-month follow-up, significant improvements were observed in OSA severity and depressive symptoms, including increased oxygen saturation, reduced apneic events, and enhanced mood, despite stable pharmacological treatment.

CONCLUSIONS

This case demonstrates the clinical effectiveness of MADs in managing OSA in patients intolerant to CPAP, especially those with psychiatric comorbidities. The importance of interdisciplinary collaboration in the management of complex cases is also emphasized.