Sleep and Breathing

, Volume 20, Issue 4, pp 1363–1366 | Cite as

Can treatment with statins have a negative influence on the tolerance of mandibular advancement devices?

  • Mónica González
  • Emilio Macias-Escalada
  • Juan Cobo
  • Maria Pilar Fernández Mondragón
  • Gerardo Gómez-Moreno
  • Marian Martínez-Martínez
  • Felix de Carlos
Dentistry • Short Communication



Statins are considered the most effective drugs used in the treatment of dyslipidemias. Some of their adverse effects are related to muscle problems. Myalgias produced by statins appear more often during exercise. Mandibular advancement devices (MAD) force the propulsory and elevatory musculature of the mandible to exercise by making the jaw move forward. The aim of this study is to evaluate the incidence of muscular side effects (referred, spontaneous, or under palpation pain, myofascial pain, mandibular rigidity and fatigue, tension and sensitivity of the masticatory muscles) in a group of patients with a diagnosis of obstructive sleep apnea being treated with MAD.


This was a prospective study, involving consecutively 104 patients with a diagnosis of OSAS, and who had begun treatment with a custom made oral device. Muscular side effects were collected by anamnesis (verbal request and questionnaires), psychological status and clinical assessment (manual muscle palpation in the masticatory and cervical muscle groups), before and during MAD treatment.


Of the total sample, 22.1 % presented muscular side effects with the oral device. However, in patients taking statins, this percentage was 57.1 %, as opposed to 16.7 % of the non-statins patients (p < 0.001). The risk of suffering muscular alterations during oral device treatment is higher in statin patients (odds ratio 6.67, p = 0.002).


Treatment with statins can give rise to the appearance of undesirable side effects among patients being treated with oral devices.


Dyslipidemias Statins Myotoxicity Sleep apnea Mandibular advancement devices 



Our thanks to Pedro Muñoz, epidemiologist of the Cantabrian Health Service for his help with the statistical analysis.

Compliance with ethical standards


No funding was received for this reached

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria, educational grants; participation in speakers bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Mónica González
    • 1
  • Emilio Macias-Escalada
    • 2
  • Juan Cobo
    • 2
  • Maria Pilar Fernández Mondragón
    • 3
  • Gerardo Gómez-Moreno
    • 4
  • Marian Martínez-Martínez
    • 1
  • Felix de Carlos
    • 2
  1. 1.Sleep and Ventilation Unit, Respiratory DivisionMarqués de Valdecilla University HospitalSantanderSpain
  2. 2.Department of Surgery and Medical-Surgical Specialties, Area of OrthodonticsFaculty of Medicine, University of OviedoOviedoSpain
  3. 3.Department of Stomatology IFaculty Of Odontology, Basque CountryVizcayaSpain
  4. 4.Department of Special Care in Dentistry, Pharmacological Research in DentistryFaculty of Dentistry, University of GranadaGranadaSpain

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