Efficacy and compliance in treatment of sleep apnea with Herbst mandibular advancement splints (OHA Version)

Amoric, M

doi:10.1016/j.ortho.2013.02.008

Cited by 3 publications

(8 citation statements)

References 32 publications

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“…The factors listed above associated with MAD adherence in the treatment of OSA indicate that there are both similarities and differences in physical and psychological status of patients, type of device, and professional guidance during treatment between MAD and CPAP. Both treatments cause different side effects, but for each device, a high frequency or severity of side effects negatively affects adherence [18,60]. Unlike CPAP, in the case of MAD treatment, TMD is also a reason for poor adherence [55], although a case report has described TMD-related side effects in association with CPAP as well [90].…”

Section: Discussionmentioning

confidence: 99%

“…Research has shown that type D patients reported a significantly lower adherence to MAD treatment and exhibit a higher discontinuation rate when compared to patients without a type D personality [47,59]. Also, a poor psychological disposition (i.e., perception of their state of health, and their mental state measured by a depression test) had an association with poor MAD adherence [60].…”

Section: Physical and Psychological Status Of Patientsmentioning

confidence: 99%

“…Regular follow-up of patients by a sleep physician and a dental practitioner is required to monitor the treatment response, side effects, and adherence. In order to increase adherence, communication skills of the practitioner and early recognition and attention to symptoms of side effects are important [60,69,70,82]. Attali et al suggested that, as with other chronic diseases, early follow-up of OSA patients (e.g., repeating PSG) is very important because short-term efficacy is strongly predictive for continuation of MAD therapy [61].…”

Section: Professional Guidance During Mad Treatmentmentioning

confidence: 99%

“…Sometimes, patients with OSA start with another treatment modality before being referred for MAD therapy. When patients are previously treated with another treatment modality, they come from a situation of treatment failure, so Amoric et al stated that there is a likelihood this category of patients will be more inclined to abandon this new treatment as well, because of their poor psychological acceptance ability [60]. Friedman et al found that adherence to a custom (50.9%) or a self-molded (32.5%) MAD was poor after 6 months, but explained that this adherence rate was acceptable because all patients in this study had previously failed OSA therapy (e.g., CPAP and/ or upper airway surgery) [74].…”

Section: Previous Treatments Of Osamentioning

confidence: 99%

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Factors associated with treatment adherence to mandibular advancement devices: a scoping review

van der Hoek,

Rosenmöller,

van de Rijt

et al. 2023

Sleep Breath

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Purpose Obstructive sleep apnea (OSA) is frequently treated with continuous positive airway pressure (CPAP) or mandibular advancement devices (MADs). For various reasons, both treatment options are often affected by low adherence. While factors associated with low CPAP adherence are described in the literature extensively, less is known about adherence to MAD therapy. This scoping review aimed to synthesize the body of literature on the factors associated with adherence to MAD treatment. Methods A systematic literature search was conducted using bibliographic databases PubMed, Embase.com, Web of Science, and the Cochrane Library (Wiley) to identify relevant studies that described factors associated with adherence to MAD in the treatment of OSA or snoring combined with OSA in adults. Results The literature search yielded a total of 694 references. Forty studies were found eligible for inclusion. The literature showed that factors with a possible negative influence on the adherence to MAD treatment are personality aspects; failing effectiveness of MAD; side effects during MAD therapy; using a thermoplastic MAD; dental treatments during MAD therapy; and a poor first experience with the MAD with inadequate guidance by professionals. Factors that may have a positive effect on MAD adherence include effectiveness of therapy, custom-made MAD, good communication skills of the practitioner, early recognition of side effects, stepwise titration of the MAD, and positive first experience with MAD. Conclusions The knowledge of factors associated with MAD adherence can be used to provide further insight into individual adherence to OSA treatments.

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