Prediction of oral appliance treatment outcomes in obstructive sleep apnea: A systematic review

Okuno, Kentaro; Pliska, Benjamin T.; Hamoda, Mona M.; Lowe, Alan A.; Almeida, Fernanda R.

doi:10.1016/j.smrv.2015.11.007

Cited by 80 publications

(62 citation statements)

References 43 publications

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“…The trend was stronger towards treatment effect when patients with normal baseline ambulatory blood pressure were excluded. As per the systemic review by Okuno et al [173] although oral appliances have demonstrated good efficacy in patients with mild to severe levels of OSA, they are not completely effective in all patients. Studies vary in the degree of bias and the definitions applied for treatment success.…”

Section: Treatmentmentioning

confidence: 99%

Review of and Updates on Hypertension in Obstructive Sleep Apnea

Ahmad

Makati

Akbar

2017

International Journal of Hypertension

111

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Obstructive sleep apnea (OSA) is a prevalent sleep disorder as is hypertension (HTN) in the 21st century with the rising incidence of obesity. Numerous studies have shown a strong association of OSA with cardiovascular morbidity and mortality. There is overwhelming evidence supporting the relationship between OSA and hypertension (HTN). The pathophysiology of HTN in OSA is complex and dependent on various factors such as sympathetic tone, renin-angiotensin-aldosterone system, endothelial dysfunction, and altered baroreceptor reflexes. The treatment of OSA is multifactorial ranging from CPAP to oral appliances to lifestyle modifications to antihypertensive drugs. OSA and HTN both need prompt diagnosis and treatment to help address the growing cardiovascular morbidity and mortality due to these two entities.

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Section: Treatmentmentioning

confidence: 99%

Review of and Updates on Hypertension in Obstructive Sleep Apnea

Ahmad

Makati

Akbar

2017

International Journal of Hypertension

111

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“…65 Nonetheless, the accuracy of these tools to predict OSA response to MAS treatment varies greatly (see Fig. 2), 113 and most are inadequate to be considered for clinical practice due to high cost and/or complexity. Comprehensive phenotyping of OSA patients has the potential to identify characteristics that can predict-individually or in combination-OSA response to MAS treatment.…”

Section: Patient Selectionmentioning

confidence: 99%

Mandibular Advancement Splints

Bamagoos

Sutherland

Cistulli

2016

Sleep Medicine Clinics

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“…The use of a Mandibular Repositioning Appliance (MRA) is indicated in patients with a primary snore, mild OSAS or who are CPAP intolerant. 7 Despite the low MRA rate of success of 48%, 8 important health outcomes were similar after 1 month of optimal MRA and CPAP treatment in patients with moderate severe OSAS. The results may be explained by the greater efficacy of CPAP being offset by inferior compliance relative to MRA, resulting in similar effectiveness.…”

Section: Introductionmentioning

confidence: 98%

“…In spite of obtaining good results, studies that evaluate the remotely controlled mandibular positioner and drug-induced sleep endoscopy are very difficult to execute. 8 To predict the success of the MRA, it is fundamental that Polysomnography (PSG) be used with accurate criteria sucess. The predictor must be simple, not invasive and easily accessible.…”

Section: Introductionmentioning

confidence: 99%

Predictors of success for mandibular repositioning appliance in obstructive sleep apnea syndrome

et al. 2017

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The characteristics of non-obese patients with mild to moderate Obstructive Sleep Apnea Syndrome (OSAS) who will present with a good response to Mandibular Repositioning Appliance (MRA) treatment have not yet been well established in the literature. The aim of this study is to assess whether polysomnographic (PSG), demographic, anthropometric, cephalometric, and otorhinolaryngological parameters predict MRA success in the treatment of OSAS. Forty (40) males with mild and moderate OSAS were assessed pretreatment and 2-months post-treatment after wearing an MRA. Demographic, anthropometric, otorhinolaryngological (ENT), cephalometric, and polysomnographic parameters, including continuous positive airway pressure (CPAP) titrated pressure, dental models, Epworth Sleepiness Scale, quality of life (Short Form SF-36), and mood state (Profile of Mood States -POMS), were assessed. The responders exhibited fewer oropharyngeal alterations, increased upper pharyngeal space, reduced lower airway space, and increased mandibular intercanine width, and they had milder disease. Nevertheless, no predictive factors of MRA success could be found. MRA was more successful among men with a more pervious airway, a larger interdental width and milder OSAS. However, a combined [1] functional and structural assessment is needed to successfully predict the [2] effectiveness of MRA treatment of OSA.

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Prediction of oral appliance treatment outcomes in obstructive sleep apnea: A systematic review

Cited by 80 publications

References 43 publications

Review of and Updates on Hypertension in Obstructive Sleep Apnea

Review of and Updates on Hypertension in Obstructive Sleep Apnea

Mandibular Advancement Splints

Predictors of success for mandibular repositioning appliance in obstructive sleep apnea syndrome

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