Defining and Measuring Compliance With Oral Appliance Therapy

Innovations in mandibular advancement splint therapy for obstructive sleep apnoea

“…The collection of efficacy and adherence data is routine for CPAP therapy in clinical practice, and is now available for MAS therapy. The American Academy of Dental Sleep Medicine defines adequate compliance with oral appliance (OA) as a minimum of ≥80% of total sleep time per night, starting when the OA is placed in the mouth and ending when the OA is removed from the mouth, ≥5 nights per week (Radmand et al, 2021). A number of small studies have looked at objectively recorded MAS compliance over an initial 3 month period, and most have found average compliance rates to be in excess of 6 h per night (Sutherland et al, 2021b).…”

Dental Sleep Medicine Standards for Screening, Treatment, and Management of Sleep-Related Breathing Disorders in Adults Using Oral Appliance Therapy: An Update

“…[26][27][28] Finally, the patient should be educated about the importance of sleep hygiene and duration. 29 The patient should understand the effect of ambient room lighting, temperature, the use of electronics in bed, and the importance of regular sleep schedules. Although these considerations may not directly affect OA efficacy, they can collectively fragment sleep and exacerbate daytime sleepiness, thus reducing the patient's perception of OA benefit.…”

“…The AADSM defines compliance as "the appliance being worn for a minimum of ≥80% per night, starting when the OA is placed in the mouth and ending when the OA is removed from the mouth, ≥5 nights per week." 29 Compliance can be measured either subjectively (diaries and questionnaires) and/or objectively (use of compliance monitors). OA compliance should stress that the patient should sleep a minimum of 7 hours per night and wear their appliance for the duration of their sleep every night.…”

“…Additionally, as part of this discussion on compliance and duration of sleep, proper sleep hygiene should also be reinforced. 29 The patient may be categorized as fully compliant, improving over time, or noncompliant based on the collected compliance data. Because patients with untreated or subtherapeutic OSA can eventually experience long-term health risks, noncompliant patients should be referred to their medical provider to consider alternate therapies.…”

“…Because patients with untreated or subtherapeutic OSA can eventually experience long-term health risks, noncompliant patients should be referred to their medical provider to consider alternate therapies. 29 OAs should be evaluated by the QD on a yearly basis for signs of wear, fractures, and bacterial and/ or fungal growth and replaced according to the patient's needs. The medical provider should also be notified if the patient terminates OAT.…”