Compliance and Efficacy of Titratable Thermoplastic versus Custom Mandibular Advancement Devices

Friedman, Michael; Hamilton, Craig S.; Samuelson, Christian G.; Kelley, Kanwar; Pearson-Chauhan, Kristine; Taylor, David; Taylor, Renwick; Maley, Alexander; Hirsch, Martin A.

doi:10.1177/0194599812439683

Cited by 40 publications

(57 citation statements)

References 16 publications

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“…Furthermore, previous studies for both treatment modalities used similar criteria of success. 10,18,23,26,27 However, further studies in a larger number of patients are needed to identify the optimum criterion of success that is specific to a treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Studies for CPAP therapy were excluded. Treatment success was defined by the following 6 criteria used in the literature: (1) posttreatment AHI < 10/h 11,14,17 ; (2) posttreatment AHI < 20/h 15,20 ; (3) reduction in the AHI > 50% and posttreatment AHI < 10/h 27 ; (4) reduction in the AHI > 50% and posttreatment AHI < 15/h 12,28 ; (5) reduction in the AHI > 50% and posttreatment AHI < 20/h 10,13,18,21,23,25,26 ; and (6) a reduction in the AHI > 50%. 24,29 …”

Section: Criteria Of Treatment Successmentioning

confidence: 99%

“…Most criteria were based on the AHI value ( Table 1). [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] However, sleep clinicians encounter patients who state that their quality of sleep improved with non-CPAP treatment, even though their AHI had not improved. Therefore, we analyzed each criterion, based on sleep quality, as assessed by the cardiopulmonary coupling (CPC) technique.…”

Section: Introductionmentioning

confidence: 99%

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A Comparison of Different Success Definitions in Non-Continuous Positive Airway Pressure Treatment for Obstructive Sleep Apnea Using Cardiopulmonary Coupling

Lee

Hong

Kim

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives: The definition and the criteria for the successful treatment of obstructive sleep apnea vary, depending on the study. This study aimed to compare different success criteria of non-continuous positive airway pressure (non-CPAP) treatment for obstructive sleep apnea in terms of sleep quality by using cardiopulmonary coupling. Methods: We included 98 patients who had been treated with sleep surgery or with a mandibular advancement device at our sleep clinic from January 2011 to March 2013. The success and failure groups were divided by 6 criteria that have been used in the literature. The validity of each of the 6 criteria was evaluated by cardiopulmonary coupling-based sleep quality. Results: The parameters of cardiopulmonary coupling indicated that sleep quality improved with non-CPAP treatment: low-frequency coupling decreased from 57.4% ± 17.7% to 46.9% ± 16.5%, whereas high-frequency coupling increased from 30.2% ± 17.1% to 37.4% ± 16.7%. In multiple regression analysis, only the criterion of a reduction in the apnea-hypopnea index greater than 50% was significantly associated with sleep quality improvement (p = 0.016; 95% confidence interval, 1.008-1.076 in the high-frequency coupling increment; p = 0.001; 95% confidence interval, 1.025-1.099 in the low-frequency coupling decrement). Conclusions: Cardiopulmonary coupling analysis showed that a reduction in the apnea-hypopnea index of more than 50% might be the optimal criterion to determine the success or failure of non-CPAP treatment in terms of sleep quality. Keywords: cardiopulmonary coupling, non-continuous positive airway pressure, obstructive sleep apnea, sleep quality, success criteria Citation: Lee WH, Hong SN, Kim HJ, Rhee CS, Lee CH, Yoon IY, Kim JW. A comparison of different success definitions in non-continuous positive airway pressure treatment for obstructive sleep apnea using cardiopulmonary coupling.

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Section: Discussionmentioning

confidence: 99%

Section: Criteria Of Treatment Successmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Comparison of Different Success Definitions in Non-Continuous Positive Airway Pressure Treatment for Obstructive Sleep Apnea Using Cardiopulmonary Coupling

Lee

Hong

Kim

et al. 2016

Journal of Clinical Sleep Medicine

View full text Add to dashboard Cite

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“…2 These devices protrude the mandible anteriorly, which then has the effect of increasing the size of the upper airway. The tongue is anchored to the mandible, and this protrusion moves the tongue base away from the back wall of the oropharynx (which is a common site of collapse in those with OSA).…”

Section: Mandibular Advancement Devicesmentioning

confidence: 99%

“…Depending on third-party reimbursement, cost to the patient can be up to $3,000, but is typically much less ($0-600). 2 The AASM has recommended that follow-up be conducted every 6 months for the first year of use with a MAD, then annually after that; the devices tend to deteriorate or become maladjusted, and regular follow-up can help address this.…”

Section: Mandibular Advancement Devicesmentioning

confidence: 99%