Predicting compliance for mandible advancement splint therapy in 96 obstructive sleep apnea patients

Abstract

The treatment of choice in obstructive sleep apnea (OSA) is continuous positive airway pressure (CPAP). Mandible advancement splint (MAS) offers an option for patients with mild or moderate OSA, who refuse or are unable to tolerate CPAP. The aim of the study was to find predictive factors in OSA for MAS therapy. The study group comprised 96 consecutive OSA patients who were sent for MAS therapy during 2008. Data were collected on the patients' general and dental condition, diagnosis, and treatment for OSA. Panoramic and cephalometric radiographs were analysed. The treatment compliance rate and problems with the use of the MAS were recorded. This rate was 57% and the significant affecting factors were protrusion of the mandible with MAS during the adaptation to the appliance as well as shorter maxillary and mandible lengths. The compliance of the MAS therapy was best in patients with short maxilla and mandible, which should be taken into consideration when planning MAS therapy for OSA patients. Finally, a sleep study should be part of the follow-up in this patient population.

Assessment of interfering factors in non‐adherence to oral appliance therapy in severe sleep apnea

“…Our present study demonstrates an OA adherence rate of 57.6% in patients with severe sleep apnea syndrome with a marked difference between groups. These findings are congruent with the 50–65% adherence rates found in studies that examined mild to moderate OSA (Clark et al , ; McGown et al , ; Doff et al , ; Ingman et al , ). This rate is also in keeping with the overall global adherence rate that estimates that only 50% of patients with chronic diseases in developed countries follow treatment recommendations (WHO, ).…”

Efficacy of Oral Appliance Therapy as a First-Line Treatment for Moderate or Severe Obstructive Sleep Apnea: A Korean Prospective Multicenter Observational Study

“…9,10,16,17 The objectively measured percentage of days with good adherence (i.e., the percentage of days on which the OA was worn for >4 h) was 63.4±28.4%, and the duration of OA use was 6.3±1.2 h/day, which is similar to the results of previous studies. 9,20,21 The present patients with severe OSA benefited from the OA treatment. Half of the patients had an AHI of <10/h, and 20% had a normal AHI after the treatment.…”

Oral appliance in sleep apnea treatment: respiratory and clinical effects and long-term adherence

“…In a randomized placebo-controlled study, Marklund et al showed that a custom-made oral appliance reduces snoring, obstructive sleep apnea, and restless legs without effects on daytime sleepiness and quality of life when compared with a control group [11]. Similar to CPAP therapy, the adherence to OA therapy is also poor [12,13]. Patients with short maxilla and mandible have been reported to have better adherence to OA [13].…”