The role of oral appliance therapy in obstructive sleep apnoea

Johal, Ama; Hamoda, Mona M.; Almeida, Fernanda R.; Marklund, Marie; Tallamraju, Harishri

doi:10.1183/16000617.0257-2022

Cited by 12 publications

(8 citation statements)

References 141 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The MJM analysis replicated the same AHI distribution as determined by PG and captured the global trend of AHI changes with a high level of agreement. In addition to providing accurate data on the change in AHI between two time points (as obtained using PSG and PG), at-home MJM monitoring provides the opportunity for continuous monitoring of a progressive AHI response, allowing real-time adjustment of mandibular protrusion, ensuring that the MAD is optimized for each individual ( 9 , 27 ).…”

Section: Discussionmentioning

confidence: 99%

“…Although CPAP is more effective than MADs for reducing the apnea–hypopnea index (AHI) and oxygen desaturation index (ODI), MADs have shown comparable effects to CPAP on sleep structure and health outcomes ( 7 , 8 ). Additionally, patient preference and adherence favor oral appliance therapy, thereby balancing the slightly lower efficacy ( 9 ). Nevertheless, practical limitations to the implementation and titration of MADs continue to limit the large-scale adoption of such therapy in clinical practice.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Mandibular Jaw Movement Automated Analysis for Oral Appliance Monitoring in Obstructive Sleep Apnea: A Prospective Cohort Study

Pépin,

Cistulli,

Crespeigne

et al. 2024

Annals ATS

View full text Add to dashboard Cite

Rationale Oral appliances are second-line treatments after continuous positive airway pressure for obstructive sleep apnea (OSA) management. However, the need for oral appliance titration limits their use as a result of monitoring challenges to assess the treatment effect on OSA. Objectives To assess the validity of mandibular jaw movement (MJM) automated analysis compared with polysomnography (PSG) and polygraphy (PG) in evaluating the effect of oral appliance treatment and the effectiveness of MJM monitoring for oral appliance titration at home in patients with OSA. Methods This observational, prospective study included 135 patients with OSA eligible for oral appliance therapy. The primary outcome was the apnea–hypopnea index (AHI), measured through in-laboratory PSG/PG and MJM-based technology. Additionally, MJM monitoring at home was conducted at regular intervals during the titration process. The agreement between PSG/PG and MJM automated analysis was revaluated using Bland-Altman analysis. Changes in AHI during the home-based oral appliance titration process were evaluated using a generalized linear mixed model and a generalized estimating equation model. Results The automated MJM analysis demonstrated strong agreement with PG in assessing AHI at the end of titration, with a median bias of 0.24/h (limits of agreement, −11.2 to 12.8/h). The improvement of AHI from baseline in response to oral appliance treatment was consistent across three evaluation conditions: in-laboratory PG (−59.6%; 95% confidence interval, −59.8% to −59.5%), in-laboratory automated MJM analysis (−59.2%; −65.2% to −52.2%), and at-home automated MJM analysis (−59.7%; −67.4% to −50.2%). Conclusions Incorporating MJM automated analysis into the oral appliance titration process has the potential to optimize oral appliance therapy outcomes for OSA.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Mandibular Jaw Movement Automated Analysis for Oral Appliance Monitoring in Obstructive Sleep Apnea: A Prospective Cohort Study

Pépin,

Cistulli,

Crespeigne

et al. 2024

Annals ATS

View full text Add to dashboard Cite

show abstract

“…When a patient presents with a particular dental or palatal configuration, orthodontists and dentists should be aware of the possibility of OSA and should consider referring the patient to a sleep expert when necessary. Furthermore, it is important to properly plan oral appliance therapy-which is frequently used to treat OSA-to minimize negative dental alterations and maximize airway patency [87]. In some circumstances, orthodontic procedures may help address the anatomical abnormalities that underlie OSA [88].…”

Section: Palatal and Dental Changesmentioning

confidence: 99%

“…For individuals with OSA, the use of oral appliance therapy-such as mandibular advancement devices, or MADs-is a typical course of treatment [87]. By pushing the jaw forward, these devices increase the patency of the upper airway, which can help lessen OSA symptoms.…”

Section: Oral Appliance Therapy and Dental Considerations And Collabo...mentioning

confidence: 99%

Oral Health Implications of Obstructive Sleep Apnea: A Literature Review

Maniaci,

Lavalle,

Anzalone

et al. 2024

Biomedicines

View full text Add to dashboard Cite

Background: Obstructive sleep apnea (OSA) is a prevalent sleep disorder characterized by repeated episodes of partial or complete obstruction of the upper airway during sleep. While the systemic implications of OSA are well documented, the dental consequences are less frequently discussed yet equally significant. This review aims to elucidate the oral health impacts of OSA, emphasizing the importance of interdisciplinary care. Methods: A comprehensive literature search was conducted across several databases to identify studies examining the relationship between OSA and various oral health parameters. The review included observational studies, clinical trials, and systematic reviews published in English up to January 2024. Results: OSA was significantly associated with heightened risks of bruxism, dry mouth, periodontal disease, temporomandibular joint disorders, palatal and dental changes, and alterations in taste sensation. Mouth breathing associated with OSA was a critical factor in exacerbating xerostomia and dental caries. Furthermore, the systemic inflammation induced by OSA appeared to correlate with the severity of periodontal disease. Patients using oral appliance therapy for OSA also showed notable changes in dental occlusion and required ongoing dental monitoring. Conclusions: The findings underscore the bidirectional relationship between OSA and oral health, highlighting the need for dental professionals to be integral participants in the management of OSA. Early dental evaluation and intervention can contribute to the overall health and quality of life of individuals with OSA. The review advocates for the development of clinical guidelines to facilitate the early identification and management of OSA-related oral health issues within dental practice and encourages a collaborative approach to patient care.

show abstract

“…It is common practice to discuss non-surgical treatments with snoring and OSA patients. These treatments include weight loss, sleep hygiene, the use of oral appliances, and undergoing myofunctional therapy [14][15][16][17][18]. Positive airway pressure therapy (PAP) represents the first-line treatment option for moderate to severe OSA under indications and is followed by PAP titration [19].…”

Section: Introductionmentioning

confidence: 99%

Consensus Statements among European Sleep Surgery Experts on Snoring and Obstructive Sleep Apnea: Part 2 Decision-Making in Surgical Management and Peri-Operative Considerations

Olszewska,

De Vito,

O’Connor-Reina

et al. 2024

JCM

View full text Add to dashboard Cite

Background: Reaching consensus on decision-making in surgical management and peri-operative considerations regarding snoring and obstructive sleep apnea (OSA) among sleep surgeons is critical in the management of patients with such conditions, where there is a large degree of variability. Methods: A set of statements was developed based on the literature and circulated among eight panel members of European experts, utilizing the Delphi method. Responses were provided as agree and disagree on each statement, and the comments were used to assess the level of consensus and develop a revised version. The new version, with the level of consensus and anonymized comments, was sent to each panel member as the second round. This was repeated for a total of five rounds. Results: The final set included a total of 71 statements: 29 stand-alone and 11 with 42 sub-statements. On the 33 statements regarding decision-making in surgical management, there was 60.6%, 27.3%, and 6.1% consensus among all eight, seven, and six panelists, respectively. On the 38 statements regarding the peri-operative considerations, there was 55.3%, 18.4%, and 15.8% consensus among all eight, seven, and six panelists, respectively. Conclusions: These results indicate the need for an expanded review of the literature and discussion to enhance consensus among the sleep surgeons that consider surgical management in patients with snoring and OSA.

show abstract

The role of oral appliance therapy in obstructive sleep apnoea

Cited by 12 publications

References 141 publications

Mandibular Jaw Movement Automated Analysis for Oral Appliance Monitoring in Obstructive Sleep Apnea: A Prospective Cohort Study

Mandibular Jaw Movement Automated Analysis for Oral Appliance Monitoring in Obstructive Sleep Apnea: A Prospective Cohort Study

Oral Health Implications of Obstructive Sleep Apnea: A Literature Review

Consensus Statements among European Sleep Surgery Experts on Snoring and Obstructive Sleep Apnea: Part 2 Decision-Making in Surgical Management and Peri-Operative Considerations

Contact Info

Product

Resources

About